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研究生:林柔廷
研究生(外文):Rou-Ting Lin
論文名稱:探討音樂治療對於青少年憂鬱症狀及自殺行為之改善成效
論文名稱(外文):The Effectiveness of Music Therapy on Depressive Symptoms and Suicidal Behaviors in Adolescents
指導教授:張秀如張秀如引用關係
指導教授(外文):Hsiu-Ju Chang
學位類別:碩士
校院名稱:臺北醫學大學
系所名稱:護理學研究所
學門:醫藥衛生學門
學類:護理學類
論文種類:學術論文
論文出版年:2010
畢業學年度:98
語文別:中文
論文頁數:112
中文關鍵詞:音樂治療青少年憂鬱症狀自殺行為
外文關鍵詞:Music TherapyAdolescentsDepressive symptomsSuicidal Behaviors
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研究目的︰本研究為探討團體音樂治療對改善青少年憂鬱症狀、自殺行為、認知三元素及焦慮症狀的成效,另外探討團體音樂治療結合漸進式肌肉放鬆法對改善青少年心率變異指標的成效。
研究方法︰本研究採實驗法研究設計,以台北市某公立高中學生為研究對象,先以問卷篩選,將符合自殺或憂鬱症狀的高危險群學生隨機分派為實驗組及控制組,實驗組给與音樂團體治療介入,控制組則僅維持一般學校常規處理。音樂治療方案結束後,再施於後測,比較實驗組於音樂治療後的成效,並與控制組作症狀改善程度上差異的比較。
結果︰本研究對象共38名,實驗組14名,控制組24名。實驗組於介入音樂團體治療後,生命態度量表(LAS-C)及其次量表、兒童憂鬱量表(CDI)及貝克焦慮量表(BAI)分數皆有顯著的下降,兒童認知三元素量表則有顯著的上升(CTI-C);實驗組在各量表得分亦較控制組改善,兩組間有顯著差異(p<0.05)。音樂治療結合漸進式肌肉放鬆療法在心率變異LF指標及LF/HF比例有顯著下降(p<0.05),在HF指標則有顯著上升(p<0.05)。
結論︰音樂團體治療有助於改善青少年的憂鬱症狀、自殺行為、認知三元素及焦慮;選擇和緩的音樂結合治療師口頭指導的漸進式肌肉放鬆法能有效幫助生理上達到放鬆的效果。建議學校可設計音樂團體於具有憂鬱傾向及自殺傾向之青少年,不僅僅可有效改善青少年的情緒、降低青少年自殺風險,更能協助青少年於日常生活中降低壓力的感受。




Purpose: This study was aimed to explore how music therapy would benefit the depressive symptoms, suicide bahavior, the cognitive triad of depression and anxiety symptoms in adolescents. Moreover, this study also explores how group music therapy featuring progressive muscle relaxation method would help adolescents improve HRV index (heart rate variability).
Method: A experimental research design was used in this study. Students subjects were recruited from a Taipei-city public high school. After questionnaire screening was conducted, the students meeting the definition of high risk group of suicide or depression were randomly assigned to the experiment and control groups. Music group therapeutic intervention was conducted in the experimental group. Students in the control group only received regular school routines. After music therapy project ended, post-tests were conducted to compare how experimental group would benefit from music group therapeutic intervention and also to compare symptom improvement differences between experimental and control groups.
Results: This study included 38 subjectss in total with 14 students in the experimental group and 24 one in the control. After music group therapy intervention had been applied on the experimental group, the scores of the Life Attitude Scale (LAS), and its subscales, Children’s Depression Inventory (CDI), and Beck Anxiety Inventory (BAI) dropped significantly and the scores of the cognitive triad for Children (CTI-C) increased significantly. The scores of each scale of the experimental group are all better than those in the control group (p<0.05). Music therapy featuring progressive muscle relaxation method has surly contributed to significant reductions in heart rate variability(HRV), LF indicator, and ratio between LF/HF (p<0.05) and significant increase in HF indicator (p<0.05).
Conclusions: Music group therapy can benefit depressive symptoms, suicide behavior, cognitive triad and anxiety symptoms in adolescents with depression and suicide risk. Physiological relaxation can really be achieved by selection of soft music featuring progressive muscle relaxation method instructed orally by therapist. It is hereby suggested that music group therapy shall be offered for adolescents suffering the tendency of depression and suicide in school so as to not only help adolescents improve emotional problems, reduce suicide risk but also assist adolescents in reducing perceived stress confronted during daily life.

第一章 緒論
第一節 研究背景及重要性 ………………………………… 1
第二節 研究目的 …………………………………………… 3
第三節 名詞定義 …………………………………………… 4
第二章 文獻查證
第一節 青少年憂鬱 ………………………………………… 6
第二節 音樂治療 …………………………………………… 16
第三節 心率變異 …………………………………………… 21
第三章 研究方法
第一節 研究設計 …………………………………………… 26
第二節 研究對象 …………………………………………… 28
第三節 研究工具 …………………………………………… 29
第四節 資料收集過程 ……………………………………… 36
第五節 音樂治療流程 ……………………………………… 38
第六節 倫理考量 …………………………………………… 41
第七節 資料分析 …………………………………………… 42
第四章 分析與結果
第一節 研究對象 …………………………………………… 44
第二節 各量表間相關性 …………………………………… 50
第三節 前測量表 …………………………………………… 55
第四節 實驗組與控制組在量表前後測得分差異比較 …… 57
第五節 實驗組於音樂放鬆之心率變異度前後測比較 …… 71
第五章 討論
第一節 音樂團體方案探討 ………………………………… 73
第二節 研究對象之基本人口學探討 ……………………… 74
第三節 音樂治療對於憂鬱症狀及自殺傾向的成效 ……… 76
第四節 音樂放鬆治療對心率變異的影響 ………………… 84
第六章 結論與建議
第一節 結論 ………………………………………………… 85
第二節 研究限制 …………………………………………… 86
第三節 建議 ………………………………………………… 87
第七章 護理上之應用
第一節 護理實務方面 ……………………………………… 88
第二節 研究應用方面 ……………………………………… 89
第三節 教育方面 …………………………………………… 90
參考資料
中文部分 …………………………………………………… 91
英文部分 …………………………………………………… 92
圖表目次
圖一 研究步驟 ……………………………………………… 27
圖二 資料收集過程 ………………………………………… 37
圖三 研究對象篩選過程 …………………………………… 45
圖四 生命態度量表兩組前後測得分比較 ………………… 64
圖五 兒童憂鬱量表兩組前後測得分比較 ………………… 65
圖六 兒童認知三元素量表兩組前後測得分比較 ………… 66
圖七 貝克焦慮量表兩組前後測得分比較 ………………… 67
圖八 實驗組及控制組的憂鬱程度前後測比較 …………… 69
圖九 實驗組及控制組的焦慮程度前後測比較 …………… 70
表一 研究設計 ……………………………………………… 6
表二 團體活動時間表 ……………………………………… 47
表三 實驗組及控制組基本人口學變項分佈及檢定……… 49
表四 各量表前測分數間相關性 …………………………… 52
表五 各量表後測分數間相關性 …………………………… 53
表六 實驗組及控制組間各量表分數檢定 ………………… 56
表七 實驗組各量表前後測得分差異比較 ………………… 60
表八 實驗組與控制組在各量表前後測得分差異比較 …… 62
表九 憂鬱程度及焦慮程度之前測及後測卡方檢定 ……… 68
表十 音樂放鬆療法之心率變異度前後測比較 …………… 71






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