臺灣博碩士論文加值系統

研究背景：機構老人隨著身體功能退化、居住環境改變或社交參與低等原因，出現情緒低落及適應不良情形，使得憂鬱成為機構老人的常見問題，除了藥物治療外，各種替代療法也在近幾年逐漸提出探討，精油穴位指壓則是一項有效的替代療法。
研究方法：本研究為實驗性研究，採兩組前後重複測量，共收案62位65歲以上住在長照機構的長者，以隨機分配方式分為實驗組和對照組，實驗組以檸檬精油施予合谷、三陰交、神門和太奚穴之穴位指壓，對照組則使用肢體的一般按摩，研究共進行四週，並於介入結束後兩週進行追蹤。測量工具包括短式老人憂鬱評估量表（Geriatric Depression Scale Short Form, GDS-S）、簡易心智狀態問卷（SPMSQ）、社交參與量表（Index of Social Engagement, ISE）以及巴氏量表（Barthel Scale）進行評估及資料收集，於介入前(pre-test)、介入後兩週(middle-test)、介入結束後(post-test)、介入結束後兩週(post two-week test)進行評估及資料收集；並於pre-test及post-test進行唾液皮質醇（Salivary cortisol）的採檢及分析。
研究結果：實驗組在GDS的分數明顯比對照組改善(P<0.001)，且有維持保留效果至post two-week；實驗組比對照組個案在middle-test和post-test SPMSQ量表分數有顯著改善(P≤0.05)，在介入結束後兩週並沒有維持；在社交參與部份，兩組之間都沒有顯著差異，但在時間上於post-test和post two-week test出現顯著增加(P≤0.05)。
研究結論：本研究認為精油穴位指壓能有效改善失智老人的憂鬱情形和認知功能，且兩組介入方式對社交參與情形的改善有時間累積效果。

Background: Depression has become a common problem among elderly in long term care facilities, where elderly usually experience low mood and maladaptation due to their physical deterioration, environment changes, and low social engagement. Besides medicine therapy towards depression, multiple methods of alternative therapy were widely discussed in recent years, aroma-acupressure is one of the effective methods.
Design and Methods: This is an experimental study. Our subjects include sixty-two ≥ 65years old elderly in the long term care facility. All participants were randomized to experimental group and control group. The experimental group received lemon oil aroma-acupressure, on acupoint Hegu(LI 4), Shenmen(HT 7), Sanyinjiao (SP 6), Taixi (KI 3), whereas the control group received common massage. The study instruments are GDS-S, SPMSQ, ISE, and ADL. These instruments were all used in pre-test, middle-test, post-test, and post two-week test. We collected salivary cortisol samples at the pre-test and the post-test.
Results: The experimental groups’ GDS scores were significantly lower than the control group (P<0.001), and effectively maintained till the post two-week test. Comparing to the control group, the experimental groups’ SPMSQ scores were significantly changed (P≤0.05), but the effect did not maintain till the post two-week test. As for social engagement scores, there were no significant differences between the two groups, but both groups showed significant progress at both post-test and post two-week test (P≤0.05).
Conclusions: Our results suggested that aroma-acupressure was effective to improve depressed mood and cognitive function of dementia elderly. In addition, the intervention resulted in accumulated improvement of social engagement to our both sample group.

目 錄
中文摘要 I
英文摘要 II
目錄 III
誌謝 V
第一章 緒論
第一節　研究動機與重要性 1
第二節　研究問題 3
第二章 文獻查證
　　第一節　老年憂鬱與評估 3
　　第二節　老年憂鬱的治療 6
　　第三節　失智和憂鬱 9
　　第四節　社交參與 10
　　第五節　腧穴作用與穴位指壓技巧 13
　　第六節　治療憂鬱的穴位研究 15
　　第七節　精油運用於憂鬱 18
第三章　研究方法
　　第一節　研究架構 20
　　第二節　特殊名詞說明及定義 21
　　第三節　前趨試驗(Pilot study)研究設計、對象與場所 22
　　第四節　研究假設 23
　　第五節　研究工具 23
　　第六節　研究倫理考量 29
　　第七節　樣本數及統計方法 29

第四章　研究結果
第一節　前驅試驗結果與討論 30
　　第二節　研究對象之基本屬性 34
　　第三節　研究變項之分析比較 36
第五章　討論 43
第六章　結論與建議
　　第一節　結論 48
　　第二節　研究貢獻 50
　　第三節　研究限制與建議 51
參考文獻 53
附件一　GDS量表使用同意書 62
附件二　穴位指壓操作方式(protocal) 63
附件三　取穴準確度表 64
附件四　專家效度檢定表 66
附件五　IRB同意書 78
附件六　研究問卷 80

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