音樂體適能導入慢性身心科病房活動之成效探討

Discussion on the effectiveness of introducing music fitness into activitiesin chronic psychosomatic wards

隨著年齡增長身體將會逐漸退化，包括身體功能、生活質量，近年來因應精神醫療技術進步，身心科患者亦面臨老化長期照顧課題。本研究旨在探討音樂體適能活動對慢性身心科病患的影響。採用回溯性研究設計，以2023年12月02日至2024年02月24日中部某身心科醫院慢性病房32位男性病患為研究對象。研究對象主要特徵為年齡集中在50-69歲(65.7%)，教育程度以高中/高職為主(50%)，除身心科疾病外，主要共病為高血壓(46.87%)和糖尿病(34.37%)。研究導入方案為期12週，每週進行2次、每次60分鐘的音樂體適能活動。使用長者功能性評估量表(ICOPE)及簡易智能狀態測驗(MMSE)進行評估。結果顯示參與者在多個面向均有顯著進步：身體功能方面，簡易身體功能評估(SPPB)量表中直線站立進步率達60.0%(p<.00**)，半並排站立進步率達21.0%(p<.02*)；認知功能方面，MMSE總分從0.88提升至0.94，進步率達6.8%(p<.00**)；情緒狀態方面，憂鬱指數降低77%(p<.00**)，課程滿意度從2.84分提升至4.30分(p<.00**)。相關分析顯示SPPB與MMSE呈顯著正相關(r=.70-.71,p<.01*)。研究結果證實音樂體適能活動能有效改善慢性身心科病患的身體功能、認知能力及情緒狀態。然而，本研究存在性別單一化、年齡分布集中及缺乏對照組等限制。建議未來研究應：(1)納入女性患者進行性別差異比較；(2)設計不同年齡層的差異化活動方案；(3)進行前瞻性隨機對照試驗；(4)探討不同類型和強度的音樂體適能活動對不同診斷類型病患的影響及其長期效果。

With aging, the body gradually deteriorates, including physical functions and quality of life. In recent years, with the advancement of psychiatric medical technology, psychiatric patients also face aging and long-term care issues. This study aims to investigate the effects of music fitness activities on chronic psychiatric patients. A retrospective research design was adopted, studying 32 male patients from the chronic ward of a psychiatric hospital in central Taiwan from December 2, 2023, to February 24, 2024. The study subjects were predominantly aged 50-69 years (65.7%), with high school/vocational education being the main educational background (50%). Besides psychiatric conditions, the main comorbidities were hypertension (46.87%) and diabetes (34.37%).
The intervention program consisted of 12 weeks of music fitness activities, conducted twice weekly for 60 minutes each session. Assessment was performed using the Integrated Care for Older People (ICOPE) and Mini-Mental State Examination (MMSE). Results showed significant improvements across multiple dimensions: in physical function, the Short Physical Performance Battery (SPPB) showed improvements in straight standing by 60.0% (p<.00**) and semi-tandem standing by 21.0% (p<.02*); in cognitive function, MMSE total scores increased from 0.88 to 0.94, showing a 6.8% improvement (p<.00**); in emotional state, depression index decreased by 77% (p<.00**), and program satisfaction increased from 2.84 to 4.30 (p<.00**). Correlation analysis showed a significant positive correlation between SPPB and MMSE (r=.70-.71, p<.01*).
The research confirms that music fitness activities effectively improve physical function, cognitive ability, and emotional state in chronic psychiatric patients. However, this study has limitations including gender homogeneity, concentrated age distribution, and lack of a control group. Future research recommendations include: (1) including female patients for gender comparison studies; (2) designing differentiated activity programs for various age groups; (3) conducting prospective randomized controlled trials; and (4) investigating the effects and long-term outcomes of different types