臺灣博碩士論文加值系統

背景：隨著國民平均餘命增加，高齡健康政策和服務的發展是各國政府至為重視及積極規劃的一環。台灣在2018年已進入世界衛生組織(World Health Organization, WHO)所定義的高齡社會，衛生福利部也持續關注社區亞健康高齡者的健康促進，並規劃高齡者延緩失能及失智之解決方案。其中，音樂療法在近幾年廣泛運用於高齡者的延緩失能及失智，然而大都聚焦在介入成效，鮮少研究從參與活動的社區高齡者之觀點來瞭解其經驗感受。
目的：本研究主要目的在透過焦點團體，來瞭解社區高齡者參與團體音樂活動的經驗歷程；並探討三層面的經驗歷程包括：(一)探討參加團體音樂活動的高齡者之經驗感受與歷程；(二)探討高齡者參與社區團體活動、團體音樂活動之動機與阻礙；以及(三)探討參加團體音樂活動的高齡者自覺獲益與健康改善情況。
方法：以焦點團體研究法進行研究，招募高雄市社區據點參與團體音樂活動的65歲以上高齡者為對象，採立意取樣方式，共邀請到22位高齡者參與，分為二個團體，進行焦點團體訪談並以半結構性大綱方式蒐集資料，以內容分析法進行資料的分析，呈現社區高齡者在參與團體音樂活動歷程的真實感受與經驗。
結果：本研究結果共分析歸納出六個主題：(一)快-快樂紓壓、(二)活-活化身體機能、(三)人-人際活水、(四)生-人生價值實現、(五) 動心所在、以及(六)收割三好。每個主題之下分別有次主題：(1)快樂紓壓的次主題有：開心感受及活動氛圍受佳評；(2)活化身體機能的次主題有：身體年輕化及體力進步看得見；(3)人際活水的次主題有：同儕支持-有人關懷鼓勵及被逗樂了；(4)人生價值實現的次主題有：助人為樂及成為更好的人；(5)動心所在的次主題有：健康的渴求、健健康的威脅感受以及社會參與的需要；以及(6)收割三好的次主題有：好眠-生活變彩色、好勇-健康行為的改變及好人生-展現自我存在感。
結論：本研究結果可協助照護者及相關健康專業人員瞭解社區高齡者對團體音樂活動的經驗、觀點及生命歷程，進而能回饋到活動課程設計，以提供符合社區高齡者活化身體機能之活動模組設計之參考，並提供後續辦理相關課程活動及政策之參考。

Background: As average life expectancy increases, Taiwan has become an aged society in 2018. The development of policies and services for the elders is one of the important active health plans among countries. The Ministry of Health and Welfare also began to emphasize on the promotion of subhealth for the elders in the community. The Ministry of Health and Welfare has solicited solutions and plans to slow down disability and dementia in Taiwanese elders. In recent years, music therapy has been widely implemented to delay disability and dementia in the elders.
However, most studies looked into the interventional effects of the therapy, and few studies have been conducted to understand the experience and feelings of the community-dwelling elders participating in the music activity.
Purpose: The main purpose of this research is to understand the experience of the elders in the community on participating in group music activities through focus groups. For this purpose, three levels of experience are discussed separately: (1) The experience of the elders participating in group music activities. (2) The motivations and obstacles of elders participating in community group activities and music activities. (3) The perceived benefits and health improvement of the elders participating in group music activities.
Methods: The participants of this study are the seniors over 65years old from the course of group music activities in Kaohsiung city by a purposive sampling method. A total of 22 elders were recruited and divided into two focus groups. A semi-structured guidelines as a tool was applied for data collection. Data were analyzed by content analysis. The outcome shows the true feelings of the elders during group music activities journey and their respective stories.
Results: There are four themes were analyzed and summarized: (1) fast-happy relief, (2) living-activating body functions, (3) people-interpersonal living pool, (4) life-realizing the value of life,(5) Where the heart is, and (6) reaping three good points.
The sub-themes of happy relief are "happy feelings, activity atmosphere and receiving praise."The sub-themes of activating body functions are "visible body rejuvenation and physical improvement."The sub-themes of interpersonal living pool are "someone cares, gives encouragement, and is amusing."The sub-themes of the value of life are "finding pleasure in helping others and becoming a better person." The sub-theme of where the heart are "the desire for health, the threat of health and the need for social participation."The sub-themes of reapingthree good points are "good sleep-life becomes colorful", "brave at heart-healthy behavior change" and "good life-showing a sense of self-existence."
Expected contribution: The finding of this study may help caregivers and allied healthcare professionals to understand the experience of group music activities, views and life course of the community elders. The findings also can provide a reference for the design of music activity modules that conform to the community elders to activate their bodily functions.

第一章 緒論 16
第一節 研究背景及重要性 16
第二節 研究目的與問題 19
第三節 名詞定義 20
第二章 文獻查證 21
第一節 老化所帶來的衰弱問題 21
第二節 我國長照政策之發展 24
第三節 台灣延緩失能失智相關政策 27
第四節 音樂律動活動與音樂治療 30
第五節 健康老化 37
第六節 焦點團體 40
第三章 研究方法 42
第一節 焦點團體訪談法 42
第二節 研究過程 44
第三節 研究對象 45
第四節 「音樂律動-(活化身體機能)開心動一動」方案 47
第五節 研究工具 52
第六節 研究資料分析 64
第七節 研究的嚴謹性 67
第八節 研究倫理 69
第四章 研究結果 72
第一節 參與者基本人口學屬性 72
第二節 經驗感受與歷程 73
第三節 參與團體音樂活動之動機與阻礙 88
第四節 自覺獲益與健康改善情況 95
第五章 討論 99
第一節 快活人生 99
第二節 社區高齡者的使用者經驗 103
第三節 團體音樂方案的深耕與人員培訓 104
第四節 長照2.0與健康老化的省思 107
第六章 結論與建議 109
第一節 研究結論 109
第二節 建議 111
第三節 研究限制 113
參考文獻 114
圖
圖一 研究步驟流程圖 126
圖二 個案篩選流程圖 127
圖三 曲目安排啟、承、轉、合之節奏 128
圖四 參與者經驗快活人生概念圖 129
 
表
表一 「音樂律動-(活化身體機能)開心動一動」模組評價指標 130
表二 逐字稿符號意義說明 131
表三 參與者基本人口學屬性 132
表四 社區高齡者團體音樂活動之經驗歷程主題表 133


 
附件
附件一 參與者同意書 136
附件二 110年度衛生福利部預防及延緩失能服務可使用方案一覽表 139
附件三 12週活動階段設計範例 146
附件四 曲目動作設計範例：防疫操 148
附件五 曲目動作設計範例：助眠穴神曲 151
附件六 84首曲目名稱 153
附件七 衛生福利部「預防及延緩失能照護方案及師資人才庫｣ 156
附件八 當次曲目安排範例 157
附件九 「日本MUSIC CARE協會」認證之音樂照顧中級指導士證書 159
附件十 預防及延緩失能照護創新方案，公告於衛福部網頁公文 160
附件十一 「衛福部金馬影展競賽」全國冠軍 161
附件十二 國健署預防及延緩失能輔導網絡計畫專家委員名單 162
附件十三 107年擔任衛福部國健署107年輔導衛生局所發展高齡友善議題多元評估計畫「社區健康評估」實地輔導專家感謝狀 163
附件十四 研究者發表團體音樂治療(照顧)相關文章四篇 164
附件十五 研究者發表三篇質性相關文章 165
附件十六 研究審視專家背景 166
附件十七 臨床試驗證明書(IRB)證明 167
附件十八 焦點團體紀錄 168

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