運用休閒生命回顧課程協助輕中度失智症患者自我統整之研究

A Qualitative Study on the Ego-Integrity of Outpatients with Mild to Moderate Dementia through a Recreational Life Review Program

10.6222/pej.4604.201312.1312

林儷蓉(Li-Jung Lin)；李冠逸(Kuan-Yi Li)

休閒治療 ； 高齡者 ； 懷舊活動 ； Therapeutic recreation ； senior ； reminiscence

體育學報

46卷4期（2013 / 12 / 01）

459 - 474

繁體中文

目的：自我統整為人生最終階段需完成的主要任務，本研究旨為探討患有輕中度失智症的高齡者在接受八周休閒生命回顧課程的介入實施後對其自我統整的影響為何。方法：採質性研究法，針對十一位輕中度失智症患者進行介入活動，運用深入訪談與參與式觀察進行資料蒐集與分析。生命回顧課程以休閒治療為基本理論，協助輕中度失智長者在活動中回想過去之相關經驗，在治療師的引導下對過去各個人生階段進行評值。結果：大多數長者對於自己過往的各種社會角色皆給予正向肯定，至今仍努力維持其家庭角色，然而部份長者的動態人格則易受疾病（如失智症及身體機能退化等）影響產生失衡的現象，例如對現在的「我」有所懷疑、心理情緒失調及身體概念的失落。結論：休閒生命回顧課程可協助輕中度失智長者以輕鬆愉悅的方式回想過去之相關經驗，在適當的引導下失智長者也可進行自我統整工作，然而活動的選擇需考慮參與者個別經驗及其身體功能的可應用性。

Purpose: The purpose of the study was to probe the influences of review of each life stages on the participants' self awareness and self evaluation, participants were stimulated by a Life Review Program-Taiwanese version (LRP-TW). Methods: A qualitative study was in Chang Gung Dementia center, and 11 volunteers who are diagnosed with mild to moderate dementia were recruited. Data was collected by the videotaped observation and in-depth interview during and after the subjects attending an 8-week intervention. Results: The results provide a full understanding of the program dynamics, and the feedback from each participant during and after the program. It illustrates (a) the phenomenon of the program dynamics associated with participants' leisure experience and life events, (b) the meaning of the past leisure experiences and life events which are evaluated by the subjects selves, (c) the social role activities pattern and personality dynamics of the subject selves. Particularly, most participants formed a positive view of ”self” after the completion of self-integrity, and even one subject revealed that the program encourages her to be actively involved in later life; however, one subject despairs of self when she try to compare the past active role with current failure due to dysfunction of body. Conclusions: LRP-TW can easily trigger participants' past memory by applying old day photos and objects to motivating their interest in the group. Besides, the selected recreational activities should meet each participant's personal interest and physical functions.

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