本校學位論文庫
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程晚晴
張東航
大健康學院
社會工作學碩士學位課程(中文學制)
碩士
2022
光照治療對失智症者激越行為的介入研究
An Intervention Study of the Effects of Bright Light Therapy on Agitation in Adults With Dementia
光照治療 ; 失智症 ; 激越行為
light therapy ; dementia ; agitation
背景：失智症者的激越行為是十分普遍的，光照治療是一種用於緩解失智症症狀的非藥物治療方法。在中國，有關光照治療對老年失智症影響的研究數量有限。
方法：於2023年1月下旬至2023年3月上旬在澳門一間安老院舍進行了一項單盲隨機對照試驗，干預期為4周。最終31例受試者納入分析，其中10例被隨機分配到室外光照組，11例被分配到室內光照組，10例被分配到對照組。實驗組中的受試者保證在早上暴露在2500勒克斯的環境光照下。
結果：本研究發現干預後實驗組和對照組之間的CMAI存在顯著差異，但MMSE無統計學差異。與對照組相比，室內或室外實驗光照條件下的受試者在為期 4 週的治療期間表現出顯著變化。然而，室內和室外光照組之間的CMAI沒有統計學差異。
結論：本研究解釋了光照治療的成效，支持使用光照治療來減緩激越行為。該研究對社會工作者和照護者在為安老院舍中患有失智症的長者設計光照治療方案提供了證據支持。這也意味著家庭照護者可採用光照治療來減少家中失智症者的激越行為。
方法：於2023年1月下旬至2023年3月上旬在澳門一間安老院舍進行了一項單盲隨機對照試驗，干預期為4周。最終31例受試者納入分析，其中10例被隨機分配到室外光照組，11例被分配到室內光照組，10例被分配到對照組。實驗組中的受試者保證在早上暴露在2500勒克斯的環境光照下。
結果：本研究發現干預後實驗組和對照組之間的CMAI存在顯著差異，但MMSE無統計學差異。與對照組相比，室內或室外實驗光照條件下的受試者在為期 4 週的治療期間表現出顯著變化。然而，室內和室外光照組之間的CMAI沒有統計學差異。
結論：本研究解釋了光照治療的成效，支持使用光照治療來減緩激越行為。該研究對社會工作者和照護者在為安老院舍中患有失智症的長者設計光照治療方案提供了證據支持。這也意味著家庭照護者可採用光照治療來減少家中失智症者的激越行為。
Backgrounds: Agitation in people with dementia are prevalent. Bright light therapy is a non-pharmacological treatment used to alleviate dementia symptoms. There is a limited number of studies examining the effects of light treatment for the elderly with dementia in China.
Methods: A single-blind, randomized controlled trial was performed in an elderly nursing home in Macao from Late January to Early March 2023. This intervention period lasted four weeks. A total of 31 participants were included in this study: 10 participants were randomly assigned to the outdoor sunshine treatment group, 11 participants were randomly assigned to the indoor light-box treatment group, and 10 were randomly assigned to the treat-as-usual control group. Those in the two experimental groups were guaranteed exposure to ambient light at 2,500 lux in the morning.
Results: This study found significant differences in CMAI between experimental and control groups after intervention but no statistical difference in cognitive states. Participants in either outdoor or indoor experimental light conditions evidenced a significant change over the 4-week treatment period, as compared to the control group. However, there was no statistical difference in CMAI between outdoor and indoor experimental groups.
Conclusions: Bright light therapy reveals the essential effects and supports the use of ambient light exposure to mitigate dementia progression and reduce agitation. This study produces significant implications for informing social workers and nursing practitioners to design light treatment programs for the elderly with dementia in institutionalized nursing homes. This study also provides evidence to support caregivers adopting the ambient light treatment to decrease the elderly’s agitation at home.
Methods: A single-blind, randomized controlled trial was performed in an elderly nursing home in Macao from Late January to Early March 2023. This intervention period lasted four weeks. A total of 31 participants were included in this study: 10 participants were randomly assigned to the outdoor sunshine treatment group, 11 participants were randomly assigned to the indoor light-box treatment group, and 10 were randomly assigned to the treat-as-usual control group. Those in the two experimental groups were guaranteed exposure to ambient light at 2,500 lux in the morning.
Results: This study found significant differences in CMAI between experimental and control groups after intervention but no statistical difference in cognitive states. Participants in either outdoor or indoor experimental light conditions evidenced a significant change over the 4-week treatment period, as compared to the control group. However, there was no statistical difference in CMAI between outdoor and indoor experimental groups.
Conclusions: Bright light therapy reveals the essential effects and supports the use of ambient light exposure to mitigate dementia progression and reduce agitation. This study produces significant implications for informing social workers and nursing practitioners to design light treatment programs for the elderly with dementia in institutionalized nursing homes. This study also provides evidence to support caregivers adopting the ambient light treatment to decrease the elderly’s agitation at home.
2023
中文
77
致謝 I
摘要 III
Abstract IV
目錄 VI
圖目錄 X
表目錄 XI
第一章 緒論 1
1.1研究背景 1
1.2問題陳述 2
1.3研究間隙 6
1.4研究目的 8
1.5研究意義 8
1.5.1理論意義 8
1.5.2實踐意義 9
1.6名詞解釋 10
1.6.1失智症 10
1.6.2光照治療 11
1.6.3激越行為 11
第二章 文獻綜述 13
2.1失智症的發生機制 13
2.2激越行為的影響因素 15
2.3光照治療的作用機制 17
2.4國外光照治療的研究現狀 18
2.5國內光照治療的研究現狀 22
第三章 研究設計 25
3.1研究問題及假設 25
3.2研究方法 25
3.3研究對象 26
3.3.1研究對象的來源 26
3.3.2納入標準 27
3.3.3排除標準 27
3.3.4研究對象的退出 27
3.4研究工具 28
3.5研究方案 29
3.5.1準備階段 29
3.5.2實施階段 30
3.5.1結束階段 31
3.6倫理考量 31
3.6.1質量保證措施 31
3.6.2安全性 32
3.6.3保密性 32
3.7數據處理 32
第四章 研究結果與分析 33
4.1實驗組、對照組前測結果 33
4.1.1一般人口學資料分析 33
4.1.2干預前評分分析 34
4.2幹預效果 35
4.2.1干預後評分分析 35
4.2.2組內前後比較 40
4.2.3兩因素重複測量方差分析 43
第五章 討論 46
5.1現狀分析 46
5.1.1一般人口學資料特徵 46
5.1.2MMSE和CMAI前測評分分析 46
5.2幹預效果分析 47
5.2.1光照治療對激越行為的影響 47
5.2.2 室外與室內光照對激越行為的影響 48
5.2.3光照治療對認知功能的影響 49
5.3實踐意涵 50
第六章 總結與展望 52
6.1研究優勢與不足 52
6.2研究建議 52
6.3主要結論 54
參考文獻 55
作者簡歷 72
附錄 測量工具 73
摘要 III
Abstract IV
目錄 VI
圖目錄 X
表目錄 XI
第一章 緒論 1
1.1研究背景 1
1.2問題陳述 2
1.3研究間隙 6
1.4研究目的 8
1.5研究意義 8
1.5.1理論意義 8
1.5.2實踐意義 9
1.6名詞解釋 10
1.6.1失智症 10
1.6.2光照治療 11
1.6.3激越行為 11
第二章 文獻綜述 13
2.1失智症的發生機制 13
2.2激越行為的影響因素 15
2.3光照治療的作用機制 17
2.4國外光照治療的研究現狀 18
2.5國內光照治療的研究現狀 22
第三章 研究設計 25
3.1研究問題及假設 25
3.2研究方法 25
3.3研究對象 26
3.3.1研究對象的來源 26
3.3.2納入標準 27
3.3.3排除標準 27
3.3.4研究對象的退出 27
3.4研究工具 28
3.5研究方案 29
3.5.1準備階段 29
3.5.2實施階段 30
3.5.1結束階段 31
3.6倫理考量 31
3.6.1質量保證措施 31
3.6.2安全性 32
3.6.3保密性 32
3.7數據處理 32
第四章 研究結果與分析 33
4.1實驗組、對照組前測結果 33
4.1.1一般人口學資料分析 33
4.1.2干預前評分分析 34
4.2幹預效果 35
4.2.1干預後評分分析 35
4.2.2組內前後比較 40
4.2.3兩因素重複測量方差分析 43
第五章 討論 46
5.1現狀分析 46
5.1.1一般人口學資料特徵 46
5.1.2MMSE和CMAI前測評分分析 46
5.2幹預效果分析 47
5.2.1光照治療對激越行為的影響 47
5.2.2 室外與室內光照對激越行為的影響 48
5.2.3光照治療對認知功能的影響 49
5.3實踐意涵 50
第六章 總結與展望 52
6.1研究優勢與不足 52
6.2研究建議 52
6.3主要結論 54
參考文獻 55
作者簡歷 72
附錄 測量工具 73
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