臺灣博碩士論文加值系統

焦慮是病患於接受呼吸器治療中常見的反應，但焦慮對病患的疾病復原，具相當負向的影響。音樂為非侵入性的措施，極易被病患所接受，國外已廣泛運用音樂治療於住院病患的焦慮緩解，效果頗受肯定。本研究之目的是探討聆聽音樂對於使用呼吸器病患焦慮緩解成效，研究中以實驗性研究設計，針對南部某醫學中心進行收案。實驗組病患每天接受一次，每次30分鐘的音樂治療，而控制組則予30分鐘休息，共進行為期兩天之研究。研究工具包括簡式焦慮量表及視覺焦慮量表，並以非侵入性的生理儀器監測血壓、心跳、呼吸、血氧濃度及指溫。本研究結果顯示，於第一天聆聽音樂過程後，能顯著的改善病患的焦慮主觀感受及舒張壓、平均動脈壓、呼吸；第二天聆聽音樂後，顯著的改善病患焦慮主觀感受、心跳、呼吸(p＜.05)。於比較兩組改變量之結果，接受第一天的聆聽音樂處置後，呼吸及主觀焦慮程度能顯著下降，且於第二天重複給予後，除呼吸及主觀焦慮程度顯著下降外，血氧濃度亦會顯著上升。實驗組病患在經重複聆聽音樂後，血氧濃度會上升0.77％，達統計上的顯著差異。本研究結果，可提供臨床護理人員之參考，期望運用聆聽音樂的方式，達到人性化護理之目標。

Anxiety is a common reaction happened in patients who receive ventilation therapy, and it often leads to negative impacts on patients’ recovery from diseases. Music therapy is considered as a non-invasion intervention and is easy for patients to accept. In some countries, music therapy has been used to relieve anxiety from patients with some encouraging results. The purpose of this study was to investigate the effectiveness of music listening on reduction of anxiety for patients who were on mechanical ventilators. Under the experimental design, all cases were collected from a medical center in southern Taiwan. While the experimental group patients were taking music therapy for 30 minutes daily, resting were assigned for the control group patients. Both facility anxiety and anxiety visual scales were utilized as the research tools for this two-day study. In addition, other non-invasive medical instruments for measuring heart and breathing rates, blood pressure, blood oxygen saturation and finger temperature of the experimental and control group patients were also employed. When compared with the controls, the experimental group patients showed significant improvements in sense of anxiety, diastolic pressure, mean arterial pressure and breathing rate after the first day’s therapy. Moreover, the result also showed significant improvements in sense of anxiety, heart and breathing rates of the experimental group patients after the second day’s therapy (p<0.05). To analyze the two groups’ data, we found that the breathing rate and sense of anxiety of experimental group patients were significant decreased after listening to music in the first day. We also found that not only the breath rate and sense of anxiety were significantly decreased in experimental group patients, but their blood oxygen concentrations were also increased after listening to music in the second day. This mean that the experimental group patients had their average blood oxygen concentration raised to 0.77% after listening to muscle, and that reached the statistical significant. The outcome of this study might serve as an important reference for clinical nursing staff. Finally, the use of music listening method was hoped to achieve the goal of humanized nursing.

第一章 緒論
第一節 研究背景及重要性 1
第二節 研究目的 2
第三節 研究問題 2
第二章 文獻查證
第一節 焦慮概念 3
第二節 焦慮與使用呼吸器病患間之關係 9
第三節 音樂治療與相關研究 13
第四節 音樂治療於重症病患之照顧 21
第五節 呼吸器病患音樂治療之依據 30
第六節 聆聽音樂對使用呼吸器病患生心理焦慮影響之概念圖 33
第三章 研究架構
第一節 名詞定義 34
第二節 研究假設及架構 36
第四章 研究方法
第一節 研究設計 37
第二節 研究對象 38
第三節 研究工具 39
第四節 資料收集過程 43
第五節 研究對象的權益及倫理考量 47
第六節 前趨研究及正式研究 48
第七節 資料分析與處理 51
第五章 研究結果
第一節 研究對象基本屬性及疾病狀況 53
第二節 研究對象於使用呼吸器之焦慮生理指標及焦慮程度 62
第三節 音樂喜好之評估及選擇類型 69
第四節 聆聽音樂對使用呼吸器病患焦慮改善之成效 71
第五節 病患焦慮程度與生理反應改變量之相關性分析 88
第六節 病患人口學屬性及疾病相關資料於主觀焦慮程度之關係 90
第七節 聆聽音樂滿意度評估及心理感受調查 94
第六章 討論
第一節 使用呼吸器病患之焦慮情形 97
第二節 聆聽音樂對使用呼吸器病患焦慮改善之成效 100
第三節 重複聆聽音樂對改善使用呼吸器病患焦慮程度之成效 104
第四節 探討聆聽音樂對緩解使用呼吸器病患焦慮之效益 105
第五節 聆聽音樂後病患的滿意度及心理感受評估 106
第七章 結論及建議
第一節 結論 108
第二節 護理上的應用 109
第三節 研究限制及建議 111

參考資料 114
附錄
附錄一 焦慮量表專家效度名單 123
附錄二 音樂曲目專家效度名單 124
附錄三 音樂治療專家效度鑑定函 125
附錄四 量表專家效度鑑定函 126
附錄五 專家內容效度修正前後對照表 127
附錄六 參與研究同意書(實驗組) 129
附錄七 參與研究同意書(控制組) 130
附錄八 音樂喜好評估問卷 131
附錄九 個案基本資料表 132
附錄十 簡式焦慮量表 134
附錄十一 視覺焦慮量表 135
附錄十二 聆聽音樂滿意度評估表 136
附錄十三 聆聽音樂心理感受問卷 137
附錄十四 國語老歌演奏曲目 138
附錄十五 國語流行音樂演奏曲目 139
附錄十六 台語老歌演奏曲目 140
附錄十七 台語流行音樂演奏曲目 141
附錄十八 英文抒情音樂演奏曲目 142
附錄十九 新世紀音樂曲目 143
附錄二十 大自然情境音樂曲目 144
附錄二十一 佛教音樂演奏曲目 145
附錄二十二 聖歌演奏曲目 146
附錄二十三 古典音樂演奏曲目 147

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