臺灣博碩士論文加值系統

本研究之目的在探討音樂治療對於安養機構中老人的睡眠品質與情緒狀態之效果。採實驗性研究設計(experimental design)，以彰化縣某二家公立安養中心的老人為研究對象，將60位老人以區域隨機分派(Block randomization)的方式，分配至「實驗組」及「控制組」各30人。實驗組實施音樂治療，於睡前播放個案自選的音樂卡帶30分鐘，連續實施兩週；控制組則戴耳塞。兩週後以「睡眠品質訪談表」、「流行病學研究中心憂鬱量表」及「情境焦慮量表」進行前、後測，以比較音樂治療介入前、後，老人的睡眠品質與情緒狀態是否得到有意義的改善；並以「音樂治療成效自我評量」來探討老人對音樂治療的主觀看法與感受。
相關資料以敘述性(次數分配、平均值、標準差、百分比)及推論性(t檢定、卡方檢定、Wilcoxon檢定、Mann-Whitney U檢定)統計分析，研究結果為：實驗組老人接受音樂治療後，其睡眠品質、憂鬱及焦慮狀態，皆明顯較控制組改善(P值＜.001)；分別有73﹪及93﹪的老人認為音樂治療對其睡眠及心情有幫助，且是合理可行的方案。本研究之音樂治療措施簡單、容易執行，由此研究結果，可提供臨床護理人員另一種改善老人睡眠品質與情緒狀態的非藥物療法。

The purpose of this study was to examine the effect of music therapy on sleep quality and emotional status for institutionalized elders. The design of this study was experimental. Sixty elderly persons who lived in two public institutions in Chang-Hua were selected. The subjects were assigned to either the experimental group or the control group by block randomization. Each group consisted of 30 clients. The experimental group received music therapy, listening to the music selected by themselves for 30 minutes before sleeping at night. The study period was 2 weeks. The control group was requested to wear earplugs. To understand the alteration of the elderly persons on sleep quality and emotional status before and after the music therapy, data based on the “Sleep Quality Index”, the “Center of Epidemiological Studies of Depression Scale (Iowa Short Form)” and the “State Anxiety Inventory” were collected at pre-test and post-test. In addition, the data of self-evaluation for music therapy were collected to understand the subjective opinions of experimental group.
Descriptive (frequency distribution, mean, standard deviation, percentile) and inferential (t test、χ2 test、Wilcoxon test、 Mann-Whitney U test) statistics were applied to analyze the data. The major findings were as follows: The experimental elderly group who received the music therapy showed significant improvement in sleep quality, lower depressive and trait anxiety state than the control group (p＜.001). Besides, 73﹪and 93﹪of the participants expressed the opinion that the music therapy was beneficial for their sleep quality and emotional status; they also thought that the music therapy was reasonable. The method of music therapy in this study was simple and easy to be used in clinical settings. The finding of this study could provide the elderly persons with another non-pharmacological therapy for improving the sleep quality and emotional status.

目 錄
中文摘要..................................................I
英文摘要..................................................II
目 錄..................................................IV
附 錄..................................................VI
圖表目次...................................................VII
第一章 緒論
第一節 研究動機.........................................1
第二節 研究重要性.......................................3
第三節 研究目的.........................................5
第四節 名詞定義.........................................5
第二章 文獻探討
第一節 睡眠生理.........................................8
第二節 睡眠品質........................................10
第三節 老年人的情緒狀態................................19
第四節 音樂治療........................................26
第三章 研究方法與過程
第一節 研究對象與場所..................................46
第二節 研究設計........................................47
第三節 研究問題........................................49
第四節 研究假設........................................49
第五節 研究工具........................................50
第六節 資料收集過程....................................54
第七節 資料處理與分析..................................54
第四章 研究結果
第一節 研究對象之人口屬性及生活習慣....................55
第二節 本研究各變項之描述性分析........................55
第三節 研究假設的驗證..................................61
第四節 本研究之其它發現................................66
第五章 討論
..第一節 音樂治療能有效改善實驗組老人之睡眠品質..........70
..第二節 音樂治療能有效改善實驗組老人之憂鬱狀態..........71
..第三節..音樂治療能有效改善實驗組老人之焦慮狀態..........73
..第四節..不同音樂類型對實驗組老人睡眠品質與情緒狀態之影響74
第六章 結論與建議
..第一節 結論............................................75
..第二節 護理上的應用....................................76
..第三節..研究限制與建議..................................78
參考資料..................................................80
中文部份..................................................80
英文部份..................................................83
附錄一 Psychiatric Screening Question....................94
附錄二 一般背景資料表....................................95
附錄三 睡眠問卷訪談表....................................97
附錄四 睡眠品質訪談計分標準..............................99
附錄五 憂鬱量表..........................................101
附錄六 焦慮量表..........................................102
附錄七 音樂治療成效自我評量表............................103
附錄八 錄音帶一覽表......................................104
附錄九 機構老人參與研究同意書............................105
附錄十 「睡眠品質訪談計畫表」問卷使用授權書..............106
附錄十一 隨機分派表......................................107
圖 表 目 次
圖2-1 音樂的生理作用.....................................30
圖3-1 研究設計圖.........................................41
表3-1 各量表的內在一致性信度分析.........................47
表3-2 資料分析方法.......................................51
表4-1 實驗組與控制組的人口屬性與生活習慣之差異分析.......53
表4-2 實驗組與控制組的人口屬性與生活習慣之差異分析(續)...55
表4-3 實驗組與控制組接受音樂治療前的睡眠品質及情緒狀態
之差異分析.........................................57
表4-4 實驗組睡眠品質與情緒狀態前、後測之差異分析.........58
表4-5 控制組睡眠品質與情緒狀態前、後測之差異分析.........59
表4-6 實驗組與控制組的睡眠品質及情緒狀態前後測改變量
之差異分析.........................................60
表4-7. 實驗組老人對音樂治療成效的自評結果.................61
表4-8 .音樂的種類對實驗組睡眠品質及情緒狀態成效之差異分析
..........................................................68

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