失智老人感官知覺刺激活動場所性能與設施特性研究

A Research on the Activity Place Performance and Facility Characteristic of Sensory Stimulation for the Demented Elderly

10.53106/101632122022030119001

黃耀榮(Yao-Rong Hwang)；張元玫(Yuanmay Chang)；葉明莉(Min-Li Yeh)；黃敬淳(Ching-Chun Huang)

失智症 ； 職能治療 ； 感官知覺刺激 ； 活動場所性能 ； Dementia ； Occupational Therapy ； Sensory Stimulation ； Activity Place Performance

建築學報

119期（2022 / 03 / 31）

1 - 22

繁體中文

以生活重建為導向的失智症照顧系統已成為未來的趨勢而凸顯職能治療的重要性，尤其是中度、重度失智症需要感官知覺刺激活動。本研究目的在調查失智老人照顧環境之感官知覺刺激活動需求及探討其活動場所性能、設施特性與相關影響因素。研究方法採用文獻回顧、問卷調查、皮爾森檢定統計分析，202人為研究對象，包含職能治療師、社工人員或照顧服務員，來自22所提供多元感官知覺刺激活動之照顧單位。研究結果呈現感官知覺刺激活動為視覺刺激、嗅覺刺激、聽覺刺激、觸覺刺激，活動場所性能包含安全性、便利性、可及性、熟悉性，但便利性因活動類型而有個別性需求。照顧單位也因規模大小、屬性、服務類型造成設施特性具有顯著差異。研究結果可提供照顧環境規劃感官知覺刺激活動場所之明確概念。

The orientation of life reconstruction has been the future trend for the caring system of dementia and highlighted the importance of occupational therapy. Especially, moderate and severe dementia need sensory stimulation activities. The purpose of this research was to survey the requirements of sensory stimulation activities in the caring environment for the demented elderly and to study the performance of activity places, characteristics of facility and related influence factors. Methodology of this research applied literature review, questionnaire, and Pearson statistics analysis. Two hundred and two persons, including occupational therapists, social workers and caregivers, were subjects from twenty-two dementia care facilities, in which supplied multiple sensory stimulation activities. The results of this research showed that sensory stimulation activities were visual stimulation, hearing stimulation, olfactory stimulation and tactile stimulation. Performance of activity places included safety, convenience, accessibility and familiarity, but convenience had individual requirement owing to activity type. The differences of facility characteristics between scale, attribute and service type of dementia care facilities were also significant. The results of this research can offer specific concept of planning sensory stimulation activity places in the caring environment.

1. 黃耀榮, Y. R.(2010)。建築物視障者引導概念與引導設施設計之適用性探討。建築學報，74，127-154。
   連結：
2. 蔡淑瑩, S. Y.,李美慧, M. H.,何明錦, M. C.,李曼萍, M. P.,陳鼎岳, T. Y.(2016)。高齡失智者室內居家環境設計準則之研究。建築學報，97，87-98。
   連結：
3. Alzheimer’s Association (2007). http://www.alz.org/
4. American Psychiatric Association(2007).American Psychiatric Association: Practice Guideline for the Treatment of Patients with Alzheimer’s Disease and Other Dementias.Arlington, Virginia:American Psychiatric Association.
5. Brawley, E. C.(2006).Design Innovations for Aging and Alzheimer's: Creating Caring Environments.Hoboken, NJ:John Wiley & Sons.
6. British Council for Offices(2007).Guide to Post-Occupancy Evaluation.British Council for Offices.
7. Building Code of Australia(2007).Design for Access and Mobility.Australian Standards Institution.
8. Clare, L.,Woods, R. T.(2004).Cognitive training and cognitive rehabilitation for people with early-stage Alzheimer’s disease: A review.Neuropsychological Rehabilitation,14,385-401.
9. Cohen, U.,Day, K.(1993).Contemporary Environments for People with Dementia.MilWaukee:University of Wisconsin-MilWaukee Press.
10. Cohen, U.,Weisman, G. D.(1991).Holding on to home: Designing environments for people with dementia.Baltimore:Johns Hopkins University Press.
11. Cohene, T.,Baecker, R.,Marziali, E.(2005).Designing interactive life story multimedia for a family affected by Alzheimer's disease: A case study.Proceedings of Premier International Conference for Human-Computer Interaction
12. Coltharp, W. J.,Richie, M. F.,Kaas, M. J.(1996).Wandering.Journal of Gerontological Nursing,22(11),5-10.
13. Cooper, B. A.,Ahrentzen, S.,Hasselkus, B. R.(1991).Post-occupancy evaluation: An environment-behavior technique for assessing the built environment.Canadian Journal of Occupational Therapy,58(4),181-188.
14. Eley, J.(2001).How do post-occupancy evaluation and the facilities manager meet?.Building Research and Information,29(2),164-167.
15. Graff, M. J.,Vernooij-Dassen, M. J.,Thijssen, M.,Dekker, J.,Hoefnagels, H. W.,Rikkert., G. M.(2006).Community based occupational therapy for patients with dementia and their care givers-randomised controlled trial.British Medical Journal,333(7580),1196-1201.
16. Graff, M. J.,Vernooij-Dassen, M. J.,Thijssen, M.,Dekker, J.,Hoefnagels, H. W.,Rikkert., G. M.(2007).Effects of community occupational therapy on quality of life, mood, and health status in dementia patients and their caregivers--A randomized controlled trial.Journal of Gerontology,62(9),1002-1009.
17. Heath, Y.(2004).Evaluating the effect of therapeutic gardens.American Journal of Alzheimer’s Disease and Other Dementias,19(4),239-242.
18. Heath, Y.,Gifford, R.(2008).Post-occupancy evaluation of therapeutic gardens in a multi-level care facility for the aged.Activities, Adaptation & Aging,25(2),21-43.
19. Hernandez, R. O.(2007).Effects of therapeutic gardens in special care units for people with dementia.Journal of Housing for the Elderly,21(1-2),117-152.
20. Heyn, P.,Abreu, B. C.,Ottenbacher, K. J.(2004).The effects of exercise training on elderly persons with cognitive impairment and dementia: A meta-analysis.Archives of Physical Medicine and Rehabilitation,85(10),1694-1704.
21. Kim, H. H.(2015).Effects of experience-based group therapy on cognitive and physical functions and psychological symptoms of elderly people with mild dementia.Journal of Physical Therapy Science,27(7),2069-2071.
22. Kim, J. S.,Jung, J. S.(2005).The effects of a folk play program on cognition, ADL, and problematic behavior in the elderly with dementia.TaehanKanhoHakhoe Chi,35,1153-1162.
23. Klages, K.,Zecevic, A.,Orange, J. B.,Hobson, S.(2011).Potential of Snoezelen room multisensory stimulation to improve balance in individuals with dementia: a feasibility randomized controlled trial.Clinical Rehabilitation,25(7),607-623.
24. Kumar, P.,Tiwari, S. C.,Goel, A.,Sreenivas, V.,Kumar, N.,Tripathi, R. K.,Gupta, V.,Dey, A. B.(2014).Novel occupational therapy interventions may improve quality of life in older adults with dementia.International Archives of Medicine,7,26-32.
25. Liu, Z. B.,Niu, W. M.,Yang, X. H.,Wang, Y.,Wang, W.G.(2010).Study on perfume stimulatingolfaction with volatile oil of Acorus gramineus for treatment of the Alzheimer's disease rat.Journal of Traditional Chinese Medicine,30(4),283-287.
26. McDonald, A.(2000).Planning academic library buildings for a new age: Some principles, trends, and developments in the United Kingdom.Advance in Librarianship,24,51-79.
27. Ministry of Health(1992).Multilevel care design guidelines.Vancouver, Canada:Ministry of Health.
28. Murray, A.(2001).Environmental Characteristics and Staff Ratings of Newer and Older Special Careunits for Dementia in British Columbia.Burnaby:Simon Fraser University Press.
29. National Collaborating Centre for Mental Health(2007).Dementia: A nice-scie guideline on supporting people with dementia and their carers in health and social care.UK:National Collaborating Centre for Mental Health.
30. National Council on Aging(1990).Standards and Guidelines for Adult Day Care.Washington D.C.:NCOA.
31. Ng, S.,Lo, A.,Lee, G.,Lam, M.,Yeong, E.,Koo, M.,Tsoi, S.,Chow, D.,Lau, O.,Fung, K.,Lai, A.,Fung, D.,Tam, A.,So, S.,Lau, V.(2006).Report of the outcomes of occupational therapy programmes for elderly persons with mild cognitive impairment (MCI) in community elderly centres.Hong Kong Journal of Occupational Therapy,16(1),16-22.
32. Norris-Baker, L.,Weisman, G.,Lawton, M. P.,Sloane, P.,Kaup, M.(1999).Assessing special care units for dementia: The professional environmental assessment protocol.Enabling environments: Measuring the impact of environment on disability and rehabilitation,New York:
33. Schaber, P.,Lieberman, D.(2010).Occupational therapy practice guidelines for adults with Alzheimer’s disease and related disorders.MD:The American Occupational Therapy Association Press.
34. Skovdahl, K.,Sörlie, V.,Kihlgren, M.(2007).Tactile stimulation associated with nursing care to individuals with dementia showing aggressive or restless tendencies: an intervention study in dementia care.International Journal of Older People Nursing,2(3),162-170.
35. Zur, B. M.(2011).The University of Western Ontario.
36. 宋惠娟, H. C.,Chang, A. M.,Abbey, J.(2006)。音樂治療在失智症老人躁動行為處置的運用。護理雜誌，53(5)，58-62。
37. 林碩彥, S. Y.(2009)。高雄市舊社區失智老人友善環境設計問題之初探。城市發展，7，30-47。
38. 邱銘章, M. J.,湯麗玉, L. Y.(2006).失智症照護指南.台北市=Taipei:原水文化=Yuan-shui Culture.
39. 高潔純, C. C.,林麗嬋, L. C.(2005)。機構失智長者的活動設計。護理雜誌，52(1)，61-65。
40. 曾建堯, C. Y.,王佳惠, C. H.,郭乃文, N. W.(2008)。失智症長期照護機構環境檢查量表之介紹。北市醫學雜誌，5(2)，193-207。
41. 黃耀榮, Y. R.(2015)。,台北市=Taipei:科技部=Ministry of Science and Technology。
42. 黃耀榮, Y. R.(2009)。環境設計之介入措施與情境治療─如何讓失智老人之照護環境成為支持性環境。輔具之友，25，23-31。
43. 黃耀榮, Y. R.(2019)。,台北市=Taipei:科技部=Ministry of Science and Technology。
44. 黃耀榮, Y. R.(2017).失智症日照中心設計規範研究.台北市=Taipei:伊甸社會福利基金會=Eden Social Welfare Foundation.
45. 靳燕玲, Y. L.(2013)。,台北市=Taipei:內政部建築研究所=Ministry of Interior。
46. 嘉義市(2011)。健康暨高齡友善城市網站。http://www.chiayi.gov.tw/。Chiayi City Government (2011). Health and Age-friendly City Internet.http// www.chiayi.gov.tw/
47. 衛生福利部(2017)。長期照顧服務機構設立標準。引用於 2017 年 06 月 03 日，取自https://www.mohw.gov.tw/dl-27903-b858e13c-9079-4354-8542-387d01303421.html。Ministry of Health (1992). Multilevel Care Design Guidelines. Vancouver, Canada: Ministry of Health. Ministry of Health and Welfare (2017). Standard of long-term care facility. from https://www.mohw.gov.tw/dl-27903-b858e13c-9079-4354-8542-87d01303421.html