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研究生:陳欣敏
研究生(外文):Hsin-Min Chen
論文名稱:探討八段錦運動於思覺失調症病患睡眠品質及健康體適能之成效
論文名稱(外文):The Effect of Baduanjin Exercise on Sleep Quality and Physical Fitness in Patients with Schizophrenia
指導教授:楊秋月楊秋月引用關係
指導教授(外文):Chiu-Yueh Yang
學位類別:碩士
校院名稱:國立陽明大學
系所名稱:護理學系
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:2017
畢業學年度:105
語文別:中文
論文頁數:64
中文關鍵詞:思覺失調症八段錦方案睡眠品質健康體適能
外文關鍵詞:Baduanjin programphysical fitnessschizophreniasleep quality
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  • 被引用被引用:3
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  • 下載下載:54
  • 收藏至我的研究室書目清單書目收藏:2
背景:思覺失調症常見症狀除幻聽、妄想外,睡眠障礙及活動量少亦常見於思覺失調症患者中,過去研究顯示八段錦方案之於老人或健康族群的睡眠品質、體適能可有改善,較少探討八段錦方案對於思覺失調症患者睡眠品質及體適能之成效。
目的:本研究旨在探討八段錦方案於思覺失調症病患於睡眠品質及健康體適能之成效。
方法:本研究以北部及東部某精神醫療機構共三個復健病房之思覺失調症共304名患者為研究對象,共徵得92位研究參與者同意,以區塊隨機抽樣隨機分派於實驗組47名及控制組45名研究參與者,共進行12週,以播放影帶、訓練的研究人員帶領實驗組每週進行3次八段錦方案,每次60分,控制組參與病房常規體能活動。研究工具包括:個案基本資料表、中文版雅典失眠自評量表(The Chinese version of the Athens Insomnia Scale, CAIS)、體適能評估與測驗(一分鐘仰臥起坐、坐姿體前彎及15公尺漸進式有氧心肺耐力跑),評估時間為八段錦方案介入前及介入結束後進行睡眠品質評估及體適能測量。本研究使用SPSS 23.0統計套裝軟體進行資料處理與分析,以平均值、標準差、中位數、百分比描述變項的基本特性;推論性統計以t-test 與χ2 test檢定實驗組與控制組於介入前基本屬性與成果指標之差異;在處置成效方面,以廣義估計方程式檢定處置前,後之成果指標之差異比較,顯著水準為.05。
結果:控制個案基本屬性後,廣義估計方程式模型顯示:(一)實驗組接受八段錦方案後對於睡眠品質之改善情形未達顯著效果;(二)實驗組接受八段錦方案後對於坐姿體前彎之改善顯著優於控制組(B = 4.01, p = .005);(三)實驗組接受八段錦方案後對於仰臥起坐之改善顯著優於控制組(B =3.95, p = .002);(四)實驗組接受八段錦方案後對於15公尺漸進式有氧心肺耐力跑之改善未顯著優於控制組(p = .701)。
結論:本研究結果顯示八段錦方案於12週介入後未能顯著提升睡眠品質與心肺耐力,但對於健康體適能之柔軟度及肌肉耐力可達顯著效果,未來可做為臨床照護病患之參考。
Background: Sleeping disturbance and exercise intolerance are the most common symptoms in schizophrenic patients, secondary to hallucination and delusion. Several studies have proved the effects of Baduanjin program on sleeping quality, physical fitness in old or healthy groups. However, seldom evidence was focused on the benefits of Baduanjin program on sleeping quality and physical fitness in patients with schizophrenia.
Purpose: To explore the effects of Baduanjin program on sleeping quality and physical fitness in patients with schizophrenia.
Method: Subjects were recruited from three psychiatric rehabilitation institutions locating in Northern and Eastern Taiwan. 92 patients with schizophrenia out of 304 completed the informed consent and were block randomized to experimental group or control group, with 47 and 45 subjects each. During the 12 weeks of intervention period, experimental group had to practice the Baduanjin program under the guidance of video and trained investigators. While the experimental group practiced Baduanjin program for 60 minutes at a time, thrice a week, the control group practiced only usual exercise at the same time. Except for demographic data, the Chinese version of the Athens Insomnia Scale, (CAIS) and physical fitness were collected before and after the Baduanjin program intervention. Physical fitness included 1-minute sit-up test, sit-and-reach test, and 15-meter Progressive Aerobic Cardiovascular Endurance Run, (15m PACER) test. IBM Predictive Analytics Suite Workstation statistic 23.0 were used for data analysis. Characteristics of variables were described with means (M), standard deviations (SD), mediums, and percentage. Inferential statistics, t-test and χ2 test, were applied to compare the group difference before intervention.. While the covariates were controlled using generalized estimating equations (GEE) with an exchangeable correlation structure, the effects of group, time, and the group by time interaction were tested. P value was set at .05 to detect significance.
Result: With controlling characteristics of variables, The GEE showed: (1) The distinction between the average pre-test and post-test score of CAIS for experimental group was nonsignificant; (2) Experimental group showed better improved in sit-and-reach test (B = 4.01, p = .005) than control group; (3) Experimental group showed better performance in 1-minute sit-up test (B =3.95, p = .002) than control group; (4) There were not group difference between pre-test and post-test in 15-meter progressive aerobic cardiovascular endurance run test (p = .701) .
Conclusion:According to our findings, 12-week of Baduanjin program may not be able to improve sleep quality and cardiorespiratory endurance; there were positive effects on muscle fitness and flexibility of physical fitness in schizophrenia. With physical benefits, Baduanjin program is conclusively recommended in psychiatric care.
誌謝i
摘要iii
Abstract iv
目錄vi
圖表目錄viii
第一章 緒論1
第一節 研究背景與動機1
第二節 研究目的與問題4
第二章 文獻查證5
第一節 思覺失調症5
第二節 八段錦方案7
第三節 睡眠品質9
第四節 健康體適能11
第五節 相關研究14
第三章 研究方法 15
第一節 研究設計15
第二節 研究架構17
第三節 名詞界定18
第四節 研究假設 19
第五節 研究對象20
第六節 研究工具21
第七節 資料收集過程23
第八節 統計資料與分析24
第九節 研究倫理考量25
第四章 研究結果 26
第一節 研究對象之基本屬性分布現況26
第二節 思覺失調症患者接受八段錦方案後對於健康體適能之成效30
第三節 思覺失調症患者接受八段錦方案後對於健康體適能之成效32
第五章 討論38
第一節 研究對象之基本屬性分布現況之討論38
第二節 思覺失調症患者接受八段錦方案後於睡眠品質之成效討論40
第三節 思覺失調症患者接受八段錦方案後於健康體適能成效討論41
第六章 結論與建議42
第一節 結論42
第二節 限制與建議43
第三節 護理應用44
參考文獻 45
附錄一 問卷52
附錄二 授權同意書58
附錄三 八段錦方案口訣及圖解動作介紹59
附錄四 人體試驗及倫理委員會審核同意書63

圖表目錄
表2-1相關研究表14
圖3-1收案流程圖16
圖3-2研究架構圖17
表4-1-1原始樣本研究對象基本屬性之比較27
表4-1-2完成研究之研究對象基本屬性之比較29
表4-2-1思覺失調症患者接受八段錦方案於睡眠品質(Chinese Version of the Athens Insomnia Scale)之成效31
圖4-2-1兩組在八段錦介入前後之睡眠品質分數變化31
表4-3-1思覺失調症患者接受八段錦方案於坐姿體前彎之成效33
圖4-3-1兩組在八段錦介入前後之坐姿體前彎分數之變化33
表4-3-2思覺失調症患者接受八段錦方案於仰臥起坐之成效35
圖4-3-2兩組在八段錦介入前後之仰臥起坐分數之變化35
表4-3-3思覺失調症患者接受八段錦方案於15公尺折返跑之成效37
圖4-3-3兩組在八段錦介入前後之15公尺折返跑分數之變化37
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