結構式團體懷舊療法於養護機構老人生活滿意度之改善成效

The Effect of Structured Group Reminiscence Therapy on the Life Satisfaction of Institutionalized Elderly

背景：長期照顧機構已成為生活無法自理長輩的居處選項，但老人於機構的生活滿意度卻未受到足夠重視。研究發現，團體懷舊療法可改善老人的生活滿意度，然而介入措施的實施與評量尚無共識。目的：探討於機構介入結構式團體懷舊療法，對老人生活滿意度之成效。方法：採類實驗研究設計，方便選取南部兩所養護機構共48位住民，實驗組（n = 23）接受每週一次，每次40分鐘，為期8週的團體懷舊介入活動；對照組（n = 25）接受機構常規照顧，兩組老人於介入前、介入後及4週後，分別接受「生活滿意度量表」測量。結果：實驗組與對照組之生活滿意度得分，除前測外均呈顯著差異，分別為前測：24.22、23.36（p =.063）；後測一：27.22、23.32（p ＜ .001）；後測二：26.43、23.00（p ＜ .001）。實驗組之後測均較前測有顯著提升（p ＜ .001），廣義估計方程式（generalized estimating equation）檢定顯示，實驗組較對照組之整體生活滿意度增加0.85，達顯著差異（p = .042）。結論：本研究證實8週的結構式團體懷舊方案，能有效提升老人之生活滿意度，可提供養護機構護理人員繼續教育之參考，並以組織、促進及評量團體懷舊措施之成效。

Background: Long-term care institutions have become an option for older people who are dependent in daily living. However, insufficient attention has been focused on assessing the life satisfaction of those currently residing in these institutions in Taiwan. Previous research indicates that group reminiscence may improve the life satisfaction of older adults. However, there is currently no consensus regarding the implementation and evaluation of reminiscence interventions. Purpose: To examine the effect of a structured group reminiscence protocol on the life satisfaction of institutionalized older adults. Methods: The study used a quasi-experimental design. A total of 48 older adults were conveniently recruited from two long-term care institutions in southern Taiwan. The experimental group (n = 23) received 8 weeks of structured- group reminiscence for 40 minutes weekly, while the control group (n = 25) received routine care from the institution. Both groups were evaluated using a life-satisfaction questionnaire before and after the intervention and again four weeks later. Results: Life satisfaction scores were statistically similar on the pre-test and significantly different on both post-test questionnaires for the two groups. The scores for the experimental and control groups were pre-test: 24.22 vs 23.36 (p = .063); post-test I: 27.22 vs 23.32 (p ＜ .001); and post-test II: 26.43 vs 23.00 (p ＜ .001). The mean post-test scores for the experimental group were significantly higher than the pre-test score (p ＜ .001). The generalized estimating equation test showed that the overall score of life satisfaction for the experimental group increased by 0.85-points (p = .042) more than the control group, which is a significant difference. Conclusions / Implications for Practice: The results support that the 8-week structured group reminiscence protocol effectively enhances life satisfaction in older adults. The results of this study may be referenced in the continuing education of nurses working in long-term care institutions in the context of helping nurses organize, facilitate, and evaluate this protocol.