臺灣博碩士論文加值系統

慢性精神分裂症病人因受精神症狀干擾造成焦慮、憂鬱、退縮而減少接受外界刺激。眾多復健活動中，多感官刺激療法在失智症族群之情緒反應、認知功能及問題行為改善成果卓效，但僅有少數研究探討多感官刺激療法運用於慢性精神分裂症患者，且多感官刺激療法之介入頻次與效果的關聯性亦尚未釐清，故本研究擬建構以多感官刺激為基礎的實證療程模式，並探討其對慢性精神分裂症病人情緒反應、精神症狀、生理及心理安適之成效。
本研究為交叉試驗，使用G-Power3.1.3，訂立中度Effect size ( f )= 0.30、alpha= 0.05、Power= 0.80、實驗過程為重複測量，另加以考量可能流失率10%，估算樣本數為60人。並在台灣南部某精神專科療養院進行，以抽籤方式隨機分派為實驗組或控制組進行第一階段評量，經過2週沖淡期，實驗組個案再進入第二階段的控制組，第一階段控制組則接受第二階段實驗組測試，每組30位，實驗組提供感官刺激室環境，病人依個人喜好自行選擇不同感官之刺激源，由研究人員協助使用30分鐘，共計6次；控制組則以臨床常規提供精神病人照護模式。
評量以問卷、行為觀察、生理回饋儀收集精神症狀、情緒反應、生理、行為表現及自覺安適程度等指標，並使用概似化估計方程式檢視介入方案對慢性精神分裂症病人之成效。
研究結果顯示，多感官刺激療法能改善病人之情緒反應，其中尤以對焦慮降低作用較為顯著，並能使呼吸率及心跳速率降低。且隨著介入次數越多在負面情緒的緩解及呼吸速率下降之效益越好。故本研究結果能建立具實證參照價值之多感官刺激療法方案於臨床慢性精神分裂症病患之照護中。

Increasing literatures on multisensory therapy are reported to promote positive mood and to reduce maladaptive behavior in dementia population. In chronic schizophrenia patients, sensory deprivation occurs because of a lack of stimuli from the residential environment and the disturbance of psychotic symptoms. There is dearth study in exploring the dose-response relationship of multisensory intervention in psychiatric patients. The study aims are to establish the evidence based multisensory intervention on chronic schizophrenia, to validate its dose-response relationship, clinical effects and efficacy in psychotic symptoms, mood status, biological responses and subjective wellbeing.
Based on the software G-Power 3.1.3，and the medium Effect size ( f ) is 0.30, alpha=0.05, and power=0.80, total 60 participants were recruited with the 10% attrition rate. Participants were randomly assigned to the experimental and control groups. Cross-over design with two-period, 2-phase was performed. The experimental group is provided a 6-session multisensory therapy program for 2 weeks. Each session lasted for 30 minutes. The control group received the routine care. The outcome measurement was assessed by questionnaires, behavior observation and biological recording. Generalized equation estimation was used to examine effects changed over time.
The study results confirmed that multisensory intervention can effectively decrease the negative emotional response, respiration rate and heart rate, especially significantly reducing in the anxiety. The positive dose-response relationship was found in emotional response and respiration rate. The evidence based sensory stimulation intervention protocol was established and the clinical effectiveness was also validated through the current study. To extend the contribution in science and knowledge development from this empirical research to chronic psychiatric rehabilitation care was recommended.

中文摘要 I
英文摘要 III
致謝 V
第壹章、緒論 1
第一節、研究動機及重要性 1
第二節、研究目的 4
第貳章、文獻探討 5
第一節、慢性精神分裂症 5
第二節、多感官刺激療法之概念 7
第三節、多感官刺激療法之應用 9
第参章、研究方法 13
第一節、研究架構 13
第二節、研究假設 14
第三節、研究設計與資料收集 15
第四節、研究場所及對象 16
第五節、倫理考量 18
第六節、 介入措施方案及流程 19
第七節、研究工具 21
第八節、資料處理與統計分析 24
第肆章、研究結果 27
第一節、研究對象之人口學基本屬性 27
第二節、順序及時間之影響 29
第三節、多感官刺激療法介入成效 33
第伍章、討論 40
第一節、研究設計、介入方案與樣本特性之討論 40
第二節、介入成效之討論 44
第陸章、結論與建議 47
第一節、結論 47
第二節、研究結果應用與建議 48
第三節、研究限制 50
參考文獻 51
附錄 60

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