討音樂律動結合本土化認知刺激訓練於日間照顧中心長者之成效──前驅式研究

Testing Effectiveness of Localized Cognitive Stimulation Training With Musical Rhythm Courses Among Older People in Day Care Centers: A Pilot Study

背景日間照顧中心工作人員提供長者許多活動，但缺乏一個能符合台灣民情文化且有系統的課程，來提升長者認知功能及自我照顧能力，並改善憂鬱心情。
目的發展一系列音樂律動結合本土化認知刺激訓練課程，並檢測其對於日間照顧中心長者的認知功能及自我照顧能力的提升，以及改善憂鬱情緒之成效。
方法本研究採群體隨機對照實驗研究設計，用隨機方式將5家日間照顧中心分為實驗組、對照組和控制組。實驗組的長者接受由中心的直接照顧者提供音樂律動及結合腦力活化的本土化結構性認知刺激訓練。之後檢測不同組別參與者的認知功能、自我照顧能力，以及憂鬱情緒狀態。
結果研究結果發現實驗組研究參與者在注意力、進食、及憂鬱情緒出現顯著性改變外；在控制活動參與次數及參與度後，對照組的長者在第三次認知功能得分較第二次認知功能得分呈現顯著性的降低。
結論／實務應用研究證實該介入措施可運用於日間照顧中心長者預防自我照顧能力的衰退，同時也可預防長者認知功能衰退或憂鬱的情緒發生；未來需擴大收案樣本，以提高介入措施的成效之驗證。

Background: Staff caregivers of day care centers provide many activities for older people. However, there is a lack of a systematic curriculum based on Taiwanese culture to improve cognitive function, self-care ability, and depressive mood status in these individuals. Purpose: This study was designed to test the effectiveness of a series of localized cognitive stimulation training courses implemented by direct caregivers and aimed at improving cognitive function, self-care ability, and depressive mood in older people at day care centers. Methods: This cluster-randomized controlled trial research was conducted over a four-month period. The participants were randomly assigned to the experimental, comparison, or control groups based on their day care center affiliation. The experimental group received a series of localized cognitive stimulation training sessions with musical rhythm courses from day care center direct caregivers. The cognitive function, self-care ability, and depression mood state of the three groups were then tested. Results: The experimental group reported statistically significant changes in average scores for attention, feeding, and depressive mood. After controlling for time and degree of participation in activities, the comparison group reported a lower average score for cognitive function at timepoint 3. Conclusions/Implications for Practice: The results of this study support caregivers at day care centers implementing a series of localized cognitive stimulation training course interventions to prevent declines in activities of daily living and cognitive function and ameliorate depressive mood in older adults. In the future, a larger sample size should be used to improve the effectiveness of the intervention.