臺灣博碩士論文加值系統

本研究目的在於探討纈草精油與穴位按摩對重症病患睡眠品質之成效，採類實驗研究設計，於台北市某醫學中心內外科成人加護病房選取符合收案條件的病患，共收取實驗組41人，對照組44人，總計85人。實驗組於收案後第2日晚上7-10點，進行神門、內關及湧泉穴之纈草精油穴位按摩，第1日則為觀察日，研究過程共2日；對照組則採標準治療。
研究進行時由護理人員定時於夜間進行睡眠觀察，運用Actigraphy測量睡眠時間，主觀睡眠以史丹福嗜睡量表(Stanford Sleepiness Scale, SSS)進行評估；同時運用心率變異測量儀測量病患按摩前後之心率變異。研究資料運用電腦統計軟體SPSS 12.0，以卡方檢定、獨立樣本t檢定比較兩組基本資料及睡眠品質之差異，相依樣本t檢定比較介入前後及心率變異之差異，皮爾森積差相關檢定連續變項間的相關性。
結果顯示施予纈草精油穴位按摩後，病患睡眠觀察之睡著時數增加，未睡時數減少；睡眠測量之睡眠總時間增加，清醒次數及清醒時間減少；主觀睡眠SSS等級下降；心率變異結果顯示施予纈草精油穴位按摩後病患副交感神經活性上升(低頻區/高頻區功率比值降低 )，平均心跳呈現下降。由此可知，藉由纈草精油穴位按摩可改善病患之睡眠時數及睡眠品質，同時可藉由副交感神經之刺激而達鎮靜效果。

The proposed of this study is to explore the effectiveness of valerian acupressure on sleep of ICU patients. This was an experiment design including 44 control subjects and 41 experimental subjects from medical and surgical intensive care unit of medical center in Taipei. The experimental group was applied with valerian acupressure on the acupoint of Shemen, Neiguan and Yungchuan at the second day on the evening between 7:00PM and 10:00PM. The first day was observation. The process of research was totally two days. Patients in the control group were applied standard treatment.
Research by nursing staff regularly observed on the night of sleep. Actigraphy measured of sleep time. Stanford Sleepiness Scale measured of subjects’ sleeping. Use of heart rate variability measurement instrument measured patients’ heart rate variability before and after the massage. The data were coded and analyzed by using SPSS 12.0 software. The statistical method included chi-square, t-test, and Person Correlation.
The result indicated that valerian acupressure: the observed patients’ sleeping hours were increased and unsleeping hours were reduced. Total sleeping time was increased. Awaking frequencies and time were reduced. Subjective sleep SSS grades were declined. Heart rate variability showed that massage after patients’ parasympathetic activity was increased. The average of heart rate was decreased. The results showed that valerian acupressure could improve the patients’ sleeping time and quality. Also, it could stimulate the parasympathetic of sedative effect at the same time.

第壹章 緒論
第一節 研究動機與背景…………………………….……………1
第二節 研究問題……………………………………….…………3
第三節 名詞界定……………………………………….…………3
第四節 本研究的意義………………………….…………………4
第貳章 文獻查證
第一節 睡眠與健康……………………………………….………5
第二節 影響睡眠的因素………………………….………………6
第三節 重症病患的睡眠問題……………………….……………8
第四節 重症病患的鎮靜治療………………………….…………9
第五節 睡眠品質之評估與測量……………………………..…11
第六節 心率變異性……………………………………..…….15
第七節 穴位按摩於促進睡眠之效果與相關研………..…….16
第八節 芳香療法及纈草精油之臨床使………………..…….20
第九節 芳香療法之相關研………………………………….22
第參章 研究方法
第一節 研究架構……………………………………..……….25
第二節 研究設計……………………………………..……….25
第三節 研究場所及對象……………………………….………26
第四節 介入處置…………………………………….…………27
第五節 研究工具………………………………………….……28
第六節 研究過程…………………………………….…………29
第七節 倫理考量……………………………………….………31
第八節 資料整理及分析………………………………………31
第肆章 研究結果
第一節 研究對象之基本資料…………………………………33
第二節 睡眠品質之分析………………………………………35
第三節 纈草精油穴位按摩按摩前後心率變異性變化之分析…39
第四節 影響睡眠品質之因素……………………………………41
第伍章 討論
第一節 影響重症病患睡眠因素……..……………………….42
第二節 纈草精油穴位按摩對客觀睡眠的影響……….………44
第三節 纈草精油穴位按摩對主觀睡眠的影響……….………45
第四節 纈草精油穴位按摩對心率變異的影響…….…………46
第五節 穴位按摩於重症單位推行之可行性……….…………47
第陸章 結論與貢獻
第一節 結論…………………………..………………………49
第二節 研究貢獻…………………….………………………49
第三節 研究限制及建議…………….………………………50
參考資料
中文參考資料……………………………………………………53
英文參考資料……………………………………………………55

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