Impact of the Life Review Program on Elders with Dementia: A Preliminary Study at a Day Care Center in Southern Taiwan

生命回顧課程對失智症患者之影響：南台灣老人日間照護中心個案型先驅研究

10.1097/JNR.0b013e318228ced3

林儷蓉(Li-Jung Lin)；李冠逸(Kuan-Yi Li)；Carla E. S. Tabourne

生命回顧 ； 失智症 ； 日間照護 ； 生活品質 ； 休閒治療 ； life review ； dementia ； day care ； quality of life ； recreation therapy

The Journal of Nursing Research

19卷3期（2011 / 09 / 01）

199 - 209

英文

背景　生命回顧課程屬於懷舊療法的一種，旨為協助參與者得以在進行團體生命回顧的過程中找尋自我的價值，並強化其在社會中的自我存在感以及生活滿意度。目的　本先驅研究的目的在於檢視一個以台灣老人為對象之生命回顧課程，對於患有輕中度失智症的參與者，其在課程參與前後的生活品質自覺是否有所改變。其次則是探討參與者失智程度的輕重是否會影響課程的成效。方法　採單組前後測之前實驗設計，以立意取樣方式，篩選出七位符合資格之課程參與者，徵得其同意後，在每位受試者參加以休閒治療為手法的生命回顧課程之前後，接受生活品質問卷調查(SF-36)之個人訪談。結果　結果顯示，參與者的生活品質在身體健康及心理健康覺知上，於課程後有略為提升的趨勢，惟未達統計上的顯著水準。再以認知程度為區分，中度失智的參與者其在身體的自覺改善上略優於輕度失智的參與者，但亦未達顯著意義。實務應用　未來相關的研究應增加樣本數及延長介入方案的期間，並且採取多面向之生活品質調查方法，以加深研究之嚴謹程度。本研究也對生命回顧課程的前置準備及執行過程提出改善建議。

Background: Life review, a type of reminiscence therapy, assists participants to seek personal value in order to enhance social status and maintain a high quality of life (QOL).Purpose: This study aimed to examine the impact of an adaptive life review program (LRP) on perceived QOL in elders with mild to moderate dementia at a day care center and assess the effect, if any, of different cognitive impairment levels on intervention outcome.Methods: This pre-experimental design used a single group of seven subjects for pretest and posttest and purposive sampling at a 2-week interval. Researchers administered to each subject a 10-day therapeutic recreation program modified from Tabourne's (1991) LRP.Results: Posttest results found no statistically significant improvements. However, subjects reported higher mean scores of perceived QOL as measured by the 36-Item Short Form Health Survey. This finding indicated a trend of improving physical and mental health after the intervention. In addition, subjects with moderate cognitive impairment reported a higher improvement in physical health perception than did subjects with mild cognitive impairment.Conclusions/Implications for Practice: Future research should include a larger sample size and a longer period of intervention and adopt multiple dimensions of QOL measurements to increase research rigor. Suggestions from this study can be used to improve the LRP.

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