| 摘要: | 背景及目的：護理之家住民大部分為多重疾病、護理需求高之中重度以上依賴的個案，他們可能在機構中因生活模式改變、缺乏活動及親情支持，而造成負面情緒與身心、社交、認知功能逐漸衰退。園藝治療應用在護理之家住民，有許多正面成效的文獻。而文獻中大多針對園藝治療所帶來的立即效益做討論，但較少探討園藝治療介入時序長短帶來的效益結果是否不同，以及介入結束後是否仍有持續效益。本研究目的以探討園藝治療對護理之家住民的憂鬱狀況、正向情緒及福祉效益與介入的時序長短其相對關係及介入結束後效益持續性。 材料及方法：本研究為單組類實驗研究設計，採立意取樣，收案對象為台南某私立護理之家內的住民。園藝治療每週執行一次，每次活動時間為1.5小時，共計十週。活動介入前進行前測，於活動第五週、第十週分別進行後測，而活動結束後第四週與第八週進行追蹤測量。活動課程主題設計為二個循環課程，前五週進行第一個循環課程，後五週再進行二個循環課程，而兩個循環課程其活動特性與主題相同，僅對活動物件做變化。研究測量工具包括基本屬性資料表、簡式老人憂鬱量表、園藝治療福祉效益前後測問卷表、正向與負向情感量表進行評估。數據資料以SPSS18.0軟體為分析工具，統計方法包括基本資料屬性次數分配表、描述性統計、成對樣本t檢定。 結果：研究結果發現園藝治療介入週期長短與成效有相對關係，對於改善住民憂鬱、提升正向情緒及福祉效益，介入第十週的成效是優於介入第五週，最為顯著是「園藝知識」、「成就感」。而在活動結束後對於住民情緒改善效益則無持續性，但在福祉效益部分，由於兩個同性質的循環課程加深了住民對園藝技能的熟練度及參與度，因此在「邏輯認知」與「園藝知識」兩個項目上有增強持續效益作用。
Background and purpose: The majority of residents of nursing homes suffer from multiple illnesses or suffer from moderate to serious illnesses that require high nursing care needs. Lifestyle changes in nursing homes, the lack of activities, and the lack of family support for residents of nursing homes can lead to the onset of negative emotions and a gradual decline of their mind, body, social, and cognitive functions. In literature, there are numerous studies that have reported on the positive impact of horticultural therapy on nursing home residents. However, most of these studies focused on its immediate effect, whereas few studies have investigated whether different durations of horticultural therapy intervention lead to different outcomes. Furthermore, few research have studied the continued effects of horticultural therapy after the interventions have ended. The aim of this study was to investigate the effects of horticultural therapy on the state of depression, positive emotion and well-being of nursing home residents. In addition, the duration of the intervention and its impact on the continued benefits after the intervention ended was studied. Materials and Methods: The studied used a single-group, purposive sampling experimental design. Participants of this study were recruited from residents of a nursing home in Tainan City. Horticultural therapy activities were carried out once a week for ten weeks, with each session lasting 1.5 hours. A pre-test was carried out before the horticultural therapy session. A post-test was carried out at the end of week 5 and week 10. In addition, follow-up data were collected 4 weeks and 8 weeks after the end of the intervention. The horticultural therapy activities were designed to comprise two cycles: the first 5 weeks formed the first cycle, and the second 5 weeks made up the second cycle. The features and themes of these two cycles were similar with only the materials used being different. The following questionnaires were used in this study: the Basic Sociodemographic Information Questionnaire, the Geriatric Depression Scale – short form (GDS-15), the Efficacy of Horticultural Therapy Evaluation Form, and the Positive and Negative Affect Schedule (PANAS). Descriptive statistics and paired sample t-test analyses were carried out. All data were analyzed using SPSS 18.0 software. Results: Findings from this study showed a relationship between the duration of the horticultural therapy intervention and its effect on the participants. In terms of improving the state of depression, positive emotions, as well as the well-being of the participants, the post-test results showed significant improvements at week 10 compared to week 5. In particular, the ‘Horticultural knowledge’ and ‘Sense of accomplishment’ categories were found to have a significant impact. However, in terms of emotional effects, no lasting improvements were observed in the follow-up assessments of the nursing home residents. Nevertheless, with regard to the effect on their well-being, dividing the activities into two cycles helped the participants become more familiarized and involved with the activities. As a result, the ‘Logical understanding’ and ‘Horticultural knowledge’ categories showed continued benefits eight weeks after the intervention had ended. |
