探討社區失智長者懷舊團體介入之社會參與的主體經驗

An Exploration of the Subjective Experiences of Older Adults with Dementia During Participation in Community-based Reminiscence Groups

研究目的：本研究旨在探討輕度至中度的社區失智長者參加懷舊團體的介入活動之社會參與的主體經驗。過往研究已證實懷舊療法在改善憂鬱情緒、增進認知功能具有成效，但對其如何具體促進社會參與及參與者的主觀體驗仍缺乏實證基礎，故深入探討之。研究方法：共有39位來自台灣北部的參與者，透過半結構指引深度訪談，進行逐字稿後，再將內容萃取相關主題並將資料進行類目分析與歸納。研究結果：歸納出五大主題（一）重新整合人生及自我價值；（二）緩解負向的心情；（三）提高社區活動參與性；（四）肯定自我的獨特性；（五）體現生命意義價值感。由結果得知懷舊活動不僅喚起長者的過往記憶，還增進了他們的社會參與感和心理健康。參與者普遍反映透過這些活動重新審視自我價值，減輕負向情緒，並建立良好的社交互動。研究結論：本研究結果支持懷舊團體的有效性，克服了社區居住老人認知功能下降時護理人員所面的挑戰。透過懷舊團體可改善其社會參與能力，並增加參與者與人群互動的機會。我們建議照顧過程中，宜多關注失智長者內心深處的需求，促進溝通和促進社會參與，並藉此做為失智長者照護方案的參考。未來也需要進行更多研究，來探索失智症患者在其他社會背景下的主觀體驗。

Purpose: Previous research demonstrated that reminiscence programs are effective in improving the depression and cognitive function of elderly adults with mild to moderate dementia. We explored the subjective experiences of community-dwelling elderly individuals in Taiwan with mild to moderate dementia as they participated in an intervention in the form of a reminiscence group in order to identify their perceptions of this intervention. Methods: We applied a qualitative approach with purposive sampling to conduct semi-structured in-depth interviews, resulting in a total of 39 participants from northern Taiwan. After transcribing the interviews verbatim, we extracted the content into relevant themes. Results: The analysis revealed 5 major themes: (1) reintegration of life and self-worth, (2) reduction of negative emotions, (3) enhancement of community activity participation, (4) affirmation of individual uniqueness, and (5) expression of the meaning and value of life. The intervention not only evoked memories for the participants, but also enhanced their mental health by allowing the opportunity for them to reintegrate meaning and self-worth in their lives and affirm their individuality, which enabled them to express their personal meaning and value of life and reduce negative emotions. Participants generally reported that these activities helped them to establish good social connections. Conclusions: These findings address the challenges faced by caregivers for community-dwelling elderly individuals experiencing cognitive decline by demonstrating the effectiveness of reminiscence groups. Group participation increased the opportunity for social interaction and strengthened social participation, both of which support better coping. We recommend addressing the inner needs of individuals with dementia during the caregiving process, facilitating communication, and promoting social participation. This study may serve as a reference for dementia care programs. Additional research is needed to explore the subjective experiences of individuals with dementia in other social contexts.