正念減壓於機構糖尿病老人遷移焦慮及調適之成效

The Effectiveness of a Mindfulness-Based Intervention in Reducing Relocation Anxiety and Promoting Adaptation in Older People With Diabetes

背景：遷移到長照機構居住對糖尿病老人的身心健康是一大挑戰。有效的介入方案是機構醫療人員須面對之相當重要的課題。目的：本研究旨在探討正念對糖尿病老人遷移焦慮及因應調適改善之成效。方法：以高雄市四間長照機構為收案場所，採簡單隨機取樣，實驗組（n＝34）接受九週正念減壓課程介入；對照組（n＝32）則維持一般機構護理常規。研究工具包括個人基本資料表、遷移焦慮及調適問題量表作為評估指標。結果：共有實驗組30人，對照組30人，完成本研究。經由九週正念減壓課程介入後，實驗組在遷移焦慮（t＝5.15, p＜.01）及調適（t＝-5.57, p＜.01）前後測達顯著差異。正念減壓介入對機構糖尿病老人的遷移焦慮前測值＞30.13，即對本研究83.3％的機構糖尿病老人，有顯著的遷移焦慮下降成效（p＜.05）。正念減壓介入後機構糖尿病老人的調適前測值＜45.62，正念減壓介入後71.7％的機構糖尿病老人，有顯著的提升調適的成效（p＜.05）。結論／實務應用：本研究發現九週正念減壓課程介入有助於多數（七成以上）長照機構糖尿病老人改善遷移焦慮及調適程度，未來可做為長照機構推展改善糖尿病住民健康之參考。

Background: Relocating from home to a long-term facility is frequently a stressful event for older persons with diabetes. Therefore, it is important that nurses have available an intervention program that effectively reduces relocation anxiety and promotes adaptation in this population. Purpose: To evaluate the effectiveness of a mindfulness-based intervention in reducing relocation anxiety and promoting adaptation in older persons with diabetes. Methods: Four long-term care facilities in Kaohsiung City were selected as the study sites. Residents of these facilities who had diabetes and who had moved in within the previous year were recruited as participants using a simple random-sampling method. The experimental group (n = 34) received a 9-week mindfulness-based intervention and the control group (n = 32) received routine diabetes care and maintained their normal daily routine. Outcome measurements included a demographic datasheet, the Taiwanese version of the State Anxiety Inventory, and the individual mental factors subscale of the elderly adaptation problem scale. These measures were administered at baseline and upon completion of the intervention. Results: Thirty participants in each group completed the study. The mean differences between the baseline and posttest scores in the experimental group for relocation anxiety (t = 5.15, p < .01) and adaptation (t = -5.57, p < .01) were both significant. Among the participants who tested positive for relocation anxiety at pretest (a mean score > 30.13; 83.3% of the participants), those in the experimental group reported a more significant decrease (p < .05) in relocation anxiety at posttest than their control group peers. Among the participants who tested as having poor adaptation pretest (a mean scores < 45.62; 71.7% of the participants), those in the experimental group reported a more significant improvement (p < .05) in adaptation at posttest than their control group peers. Conclusions/Implications for Practice: The results indicate that the 9-week intervention has the potential to help older people with diabetes improve their relocation anxiety and adaptation. This study may be used as a reference to improve emotional distress among residents of long-term care facilities.