銀髮桌遊活動介入 對老人認知、人際關係及體適能之成效探討

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Title:	銀髮桌遊活動介入對老人認知、人際關係及體適能之成效探討 Effects of Board Games on the Cognitive Function, Social Relationship, and Functional Fitness of Older Adults
Authors:	賴柔秀
Contributors:	醫務管理系林秀碧張碩芳
Keywords:	老人認知老人人際關係老人體適能銀髮桌遊介入成效 Cognition of the elderly Interpersonal relationship of the elderly Physical fitness of the elderly Silver-haired board games Intervention effectiveness
Date:	2018
Issue Date:	2019-02-27 16:49:31 (UTC+8)
Abstract:	研究背景與動機：台灣面對高齡時代的來臨，人口老化伴隨認知障礙的風險愈趨嚴重，失智症目前尚無藥物可以有效控制或治癒，其照護的難度與龐大的照護成本將危及全球社會、經濟發展，特別是長期照護體系的負擔。因此，如何有效延緩失智的發生成為重要的研究議題。許多研究發現提升認知儲備(cognitive reserve；CR)，可以減緩老化所帶來的認知功能下降與大腦病理改變所引發的失智問題及其進展，而積極的運動、社交與複雜的心智活動有助於提升認知儲備。然而國內尚無提升大腦認知儲備以預防失智的實證研究。研究目的：本研究以銀髮桌遊為媒介，提供身體運動、認知動腦訓練與人際互動，以提升其老人認知、人際關係及體適能，達到延緩失智失能，讓高齡者能達到健康老化。研究方法：本研究採準實驗設計，採方便取樣，以台南市社區關懷據點185位55歲以上的健康、亞健康、衰弱的長輩為研究對象。實驗組有145人，控制組有40人參與研究。實驗組提供一期12周，每次兩小時，包含「運動」、「認知」、「社交」三大主軸活動介入，控制組則維持社區原有的活動型態。採用修訂版長谷川氏認知量表評估桌遊認知活動介入成效；以Kihon Check List問卷中的社會退縮、失智與憂鬱題項來評估人際互動活動成效；採用主觀和客觀的方法來評估運動介入成效，客觀的部分以老人功能性體適能，主觀的部分以Kihon Check List問卷中的獨立生活功能與運動功能來評估運動成效。比較兩組的介入前、後得分來實證銀髮桌遊運動、認知訓練與人際社交的健康促進活動，是否能有效提升長輩的認知功能、人際關係及體適能。介入後實驗組回收長輩有129人，回收率88.97%；控制組回收長輩有33人，回收率82.5%。研究結果：相對於控制組，桌遊認知活動能顯著提升實驗組老人的定向力、注意力、記憶力、語言能力等認知功能。桌遊人際互動活動能顯著改善老人人際關係的社會退縮、失智、與憂鬱狀況。桌遊運動活動介入能顯著提升老人上肢肌耐力、下肢肌耐力、下肢柔軟度、靜態平衡、心肺耐力，以及主觀評量的獨立生活功能、與運動功能都有顯著性的進步。結論：本研究發現桌遊活動的介入，可以有效的提升老人的認知功能、人際關係及體適能。此結果可作為社區活動安排之參考，有助於社區長輩利用桌遊活動來做認知功能、人際關係及體適能的訓練。 Research background and motivation: Taiwan is facing the advent of the old age, the ageing of the population is accompanied by a growing risk of cognitive impairment. Dementia currently has no drugs that can be effectively controlled or cured. The difficulty of care and the huge cost of care will jeopardize the global social and economic development, especially the burden of long-term care systems. Therefore, how to effectively delay the occurrence of dementia has become an important research topic. Many studies have found that increasing cognitive reserve (CR) can alleviate the decline in cognitive function caused by aging and the dementia caused by pathological changes in the brain and its progression. Active sports, social and complex mental activities help to increase cognitive reserves. However, there is no empirical study in Taiwan to improve brain cognitive reserve to prevent dementia. Research purposes: This study uses silver-haired board games as a medium. With the physical exercise, cognitive brain training and interpersonal interaction, improve the cognitive, interpersonal and physical fitness for the elderly, and delay the loss of mental disability. Make older people healthier. Research methods: This study adopts experimental design and facilitates sampling. The research data were selected from 185 healthy, sub-healthy and debilitated elders, over the age of 55, in the community care base in Tainan City. There were 145 in the experimental group and 40 in the control group. The experimental period is 12 weeks, two hours per week, including three major activities: "sports", "cognition" and "social". The control group maintains the original activity patterns of the community. Using the revised Hasegawa Cognitive Scale to assess the effectiveness of boarding cognitive activities; Evaluate the effectiveness of interpersonal interactions with the social withdrawal, dementia and depression items in the Kihon Check List questionnaire; Using subjective and objective methods to assess the effectiveness of exercise intervention. The objective part is the functional fitness of the elderly. The subjective part evaluates the effectiveness of exercise with the independent living function and motor function in the Kihon Check List questionnaire. Comparing the pre- and post-intervention scores of the two groups to demonstrate the health promotion activities of silver-haired board games, cognitive training and interpersonal social activities, can effectively improve the cognitive function, interpersonal relationship and physical fitness of the elders. After the intervention, the experimental group recovered 129 elders, the recovery rate was 88.97%; the control group recovered 33 elders, and the recovery rate was 82.5%.Research result: Relative to the control group, cognitive activities of table games can significantly enhance the cognitive function of the experimental group's orientation, attention, memory, and language ability. The interactive activities of board games can significantly improve the social withdrawal, dementia, and depression of interpersonal relationships among the elderly. The participation of board games can significantly improve the upper limb muscle endurance, lower limb muscle endurance, lower limb softness, static balance, cardio endurance, as well as subjective assessment of independent living functions, and sports functions have made significant progress. In conclusion: This study found the involvement of board games, it can effectively improve the cognitive function, interpersonal relationship and physical fitness of the elderly. This result can be used as a reference for community event arrangements. It helps community elders to use table games to do cognitive, interpersonal and physical training.
Relation:	電子全文公開日期：2023-07-31，學年度：106， 90頁
Appears in Collections:	[Dept. of Hospital and Health (including master's program)] Dissertations and Theses

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