回憶治療改善機構老人憂鬱狀態之成效探討

The Effects of Reminiscence Therapy on Depressed Institutionalized Elderly

本研究目的在運用回憶治療改善機構老人憂鬱 o 以老人憂鬱量表（ GDS）評估，總分達11分以上者，為研究樣本，比較回憶治療介入措施前後憂鬱改善情形。共進行二個月前後八次回憶治療活動，計九位老人仝程參與，過 程包括評估3月、介紹期、活動期、評價期。結采顯示憂鬱住氏平均74.56歲，男性、已婚及無宗教信仰居多，多為外省籍、教育程度以高中職為主，平均 住機構時間為10.8個月﹔費用支付以退休金及子女共同分擔為主，子女及朋友最常來探望，平均每月探訪2.2次 ，進住機構原因以不想麻煩家人 為多。疾病診斷以高血壓及心臟病且同 時罹忠二種疾病居多。以魏氏符號等級排序檢定（ Wilcoxon Signed Ranked Test ）比較回憶活動介入措施後，憂鬱程度改變情形，結采憂鬱總分由21.67分降為14.44分，憂鬱強度由中重度減為輕度，平均得分由0.64分降為0.47分， 共減少。17分， 達統計顯著意義（ Z = 2.670 , p < .01 ）。 研究結采可知，透過回憶療法，可增加個案自我控制惑、自我肯定 、社會化、成就感改善憂鬱程度。建議 長期照護機構，可善用對老人具有意義的物品或事件作啟發回憶的工具，並利用非語言溝通如觸摸、按摩、肢體關節活動表達對老人關懷，且以同感心、尊重、關懷與體諒等態度和老人 建立治療性人際關係，以減少其憂鬱，促進老人健康。

The purpose of this intervening evaluation study was to investigate how reminiscence therapy may lessen the depression level of elderly people in long-term care institutions. Elders who were subjects of this study suffered minor depression with GDS scored 11 and above. Reminiscence therapy was implemented as the tool to ameliorate residents' depression level activities. The depression levels of the elders prior to and after the intervening activities were recorded, monitored and compared. A total of nine elderly residents participated in all of eight intervening activities over a twomonth period. The therapy comprised four stages: assessment, introduction, activity, and evaluation. According to results of this study, the average age of subjects was 74.56 years. Most of the subjects were males who were born in Mainland China and had graduated from high or vocational school. Many of them were married, and without any religious beliefs. The average length of their stay in the institution was 10.8 months. The expenses for the institution were covered by the elder's retirement pay or paid by their children. Children and friends visited the subjects in this study most frequently. On average, each was visited 2.2 times per month. The most common reason why they chose to stay in the institution was to avoid bothering their family. High blood pressure and cardiovascular disease were the two most common medical diagnoses for subjects, and many of them suffered both. Based on the Wilcoxon Signed Ranked Test, the depression level of our subjects of study had decreased from a score of 21.67 prior to the intervening therapy to a score of 14.44 after the intervening therapy. The average score for depression had also decreased from 0.64 to 0.47. A total decrement of 0.17 points was observed and the result was statistically significant (Z = - 2.670, p ＜ .01). According