精油穴位指壓對長照機構失智老人的憂鬱及社交參與成效

The Effectiveness of Aroma-acupressure on the Depression and Social Engagement in Elderly Dementia of Long-term Care Facilities

背景：機構老人隨著身體功能退化、居住環境改變或社交參與低等原因，出現情緒低落及適應不良情形，使得憂鬱成為機構老人的常見問題，除了藥物治療外，各種替代療法也在近年來逐漸被關注，精油穴位指壓則是其中一項有效的替代療法。目的：驗證精油穴位指壓對長照機構失智老人在憂鬱與社交參與情形的改善效果。方法：本研究為實驗性研究，採兩組前後重複測量，共收案62位65歲以上住在長照機構的失智住民，以隨機分配方式分為實驗組和對照組，實驗組以檸檬精油搭配穴位指壓，施予合谷、三陰交、神門和太奚穴等穴位；對照組則使用基底油進行四肢按摩，一周五天，共進行四週。結果指標包括憂鬱情緒、社交參與、認知功能，在前測（pre-test）、介入後二週（middle-test）、後測（post-test）及結束後兩週（post two-week test）進行評估及資料收集。結果：實驗組在憂鬱情緒明顯比對照組改善，且有維持保留效果至結束後兩週；在社交參與部份，兩組在後測和結束後兩週出現顯著增加；認知功能方面，實驗組個案在介入後二週和後測有顯著改善，並沒有維持到結束後兩週。結論：本研究認為精油穴位指壓能有效改善失智老人的憂鬱情形和認知功能，且兩組介入方式對改善社交參與情形有時間累積效果。關鍵字:精油穴位指壓、憂鬱、社交參與、失智。

Background: Deterioration of physical functions, changes in living environment, and low social engagement are the reasons why the elderly in institutions tend to experience depression and maladaptation of the environment, making depression a common problem. Besides medical therapy, alternative therapies have been mentioned recently. In addition to aroma-acupressure is one of the effective alternative therapies to deal with depression. Purpose: Evaluating the effectiveness of aroma-acupressure on depression and social engagement in elderly individuals with dementia in long-term care institutions. Methods: This study is an experimental research Our subjects include sixty-two≥65years old elderly in the long term care facility. All participants were randomly distributed in experimental group and control group. Lemon essential oil on four acupoints Hegu（LI 4）, Shenmen（HT 7）, Sanyinjiao（SP 6）, and Taixi（KI 3）was used in the experimental group, while base oil with limb massage was adopted for the control group, and administered for 4 weeks. Outcome indicators included depressed mood, social engagement, and cognitive function. The repeated assessments were carried out in week 0（pretest）, week 2（midtest）, week 4（posttest）, and week 6（two-week posttest）. Results: Depression was better improved in the experimental group than the control group, and the effect was maintained through two-week post treatment. Regarding social engagement, there were significant increases in the posttest and two-week posttest scores in both groups. In terms of cognitive function, the participants in the experimental group had significantly improved in the midtest and posttest assessments. However, this improvement was not maintained through the two-week posttest. Conclusions: This study suggests that aroma-acupressure can effectively improve depression and cognitive function in dementia, and two groups both had a cumulative effect on improving social engagement.