September 28,2005
休閒輔導諮商與治療
各位研究生好，
以下為本週作業的格式：
1. 所選疾病或狀況別，並以100字以內簡述其病因、發病率、人口....等相關資訊。
2. 選取五篇國內外相關科學期刊（至少三篇國外期刊），其中有應用休閒遊憩方式進行該疾病或狀況的改善，以APA或其他科學期刊citation方式列出這五篇期刊。
3. 每篇以100字內介紹該期刊內容。
Deadline: 10/5, pm 23:55.
以下為本週作業的格式：
1. 所選疾病或狀況別，並以100字以內簡述其病因、發病率、人口....等相關資訊。
2. 選取五篇國內外相關科學期刊（至少三篇國外期刊），其中有應用休閒遊憩方式進行該疾病或狀況的改善，以APA或其他科學期刊citation方式列出這五篇期刊。
3. 每篇以100字內介紹該期刊內容。
Deadline: 10/5, pm 23:55.
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回應文章 
憂鬱症
1. 病因：與癌症、愛滋病一同被預為二十一世紀危害人類健康的三大疾病之一，造成憂鬱症的三主要因素為生理、心理（如情感上不穩定、思考上有扭曲）及家庭人際因素（如家庭功能失調、孤獨沒朋友）。（Beck,1979）
2. 發病率、人口：約有1/5的人一生中有憂鬱的危險（Gilbert,2000），推估過去百年來罹病率增加十倍（黃宗正,2001）。
1. 陳惠美（民92）。遊憩治療對憂鬱症治療效果之研究。國科會專題研究計畫
NSC-91-2415-H-130-005，民國91年8月1日至民國92年7月31日。
內容：本研究以在台安醫院精神科接受治療的13位憂鬱症病患為研究對象，實驗共分為狀況評估、活動設計、治療前憂鬱程度測量、遊憩態度五部分。所接受的治療方式分別為戶外遊憩治療1位，運動療程1位，藝文活動2位，園藝活動1位，室內娛樂1位。受測者在實驗結束後對遊憩治療的效益認知、情感反應、行為傾向之前測分數均高於後測，顯示遊憩治療確實會增進參加者之正面休閒態度。
心得：
此實驗經過評估後才決定給與不同患者不同的遊憩活動，若在這樣的情形下是否會影響「研究結果第二點」的客觀性。或許同樣因為失戀而患憂鬱症的患者不見得皆認同運動治療是最有效的。
研究中僅提道執行治療四個月後，每月對患者的憂鬱成舵皆有顯著改善，但憂鬱症的復原期與觀察期應該屬長時間的研究觀察，若能提供後續的追蹤研究結果，我個人認為會更具研究價值與意義。
研究中並無提及抽抽樣方法，且不同的遊憩治療受測者人數僅一至兩人，好像有點不客觀。
2. 陳莉榛（民91）。藝術治療在憂鬱症的介入效果。東南學報，24民91.01頁
203-212。
內容：本研究主要以藝術治療為介入技術探討它對憂鬱症的助益情形，採個案研究方式，進行一週一小時共十次的藝術治療活動，期透過此介入了解個案的內心世界並尋找出改善之道。研究結果發現個案在曾氏心理健康量表的焦慮分數有輕微下降，顯示藝術治療的介入之影響是肯定的。
心得：雖然研究過程不夠客觀，但我依然覺得這是一個非常有意思的研究，因為將研究中收集的文獻與結果相對應，可以得到許多類似的映證。有趣的是，本研究重點不在用藝術「治療」憂鬱症，而是利用藝術的「介入」了解個案的內心想法近一步找出導致憂鬱的根源問題。雖然與老師要求我們收集的研究不盡相同，但卻有異曲同工之妙的道理，因為遊憩治療的方式廣泛，其中也包含了藝術應用這一種方式。能透過藝術的方式呈現口語表達不出的痛苦及傳達非言語所能權釋的感受確實是相當溫和且有效的方式之一。
3.Dieser,Rodney B（2002）.Effects of attribution retraining during therapeutic
recreation on attributions and explanatory styles of adolescents with
depression. .Therapeutic Recreation Journal, First Quarter 2002,
from http://www.findarticles.com/p/articles /mi_qa3903/is_200201/ai_n
9030983
Summary：The purpose of this study was to examine the effects of verbal persuasion based attribution retraining during therapeutic recreation on attributions and explanatory styles of 18 adolescents（aged14-17） with a clinical diagnosis of major depression. The Attribution Style Questionnaire was used to measure explanatory styles, and Attributions（locus of causality, stability, personal control, and external control.）were measured by the Causal Dimension Scale II.Twice a week the researcher met individually with participants and asked them the following open question：”Tell me one successful and unsuccessful therapeutic recreation activity you were involved in ……….”The control group received minimal verbal responses such as “good,” ”un-huh,”and”I see.” The experimental group received optimistic message, for example,”It sounds like the activity was successful because you put much effort into it. ”
Results from this study suggest that the attribution retraining verbal persuasion in a therapeutic recreation setting can have a significant effect on stability and personal control attributions.
My opinions：當一個人在憂鬱的時候，回應者若是能給予正面的回應將激發被諮商者的正向思想。以我自己為例，應該盡量避免對人或事太過主觀的批判或限於自己心中的判斷，因為最後終陷於痛苦的感覺而脫離不出而不自覺對別人產生敵意。
4.Richard Williams（2002）.Humor as a therapeutic recreation intervention.
Parks & Recreation, May 2002,from http://www.findarticles.com/p/articles/mi_m1145/is_5_37/ai_86505433
Summary：According to amount and quality of humor research, humor is not only a sunny disposition but also provides real psychological and physical benefits. For instance, exposure to humorous material appears to bolster the immune system, helping people with cognitive or learning impairments, and reduce pain during uncomfortable treatments or recovery from surgery. Additionally, humor can effectively treat both depression and anxiety which are among the most common characteristics of people seeking therapeutic recreation services. As long as we could avoid negative form of humor including sarcastic, racial and sexist which are contrary to therapeutic goals, humors would be a justifiable, inexpensive and appropriate tool for use in therapeutic recreation services.
My opinions：By our nature, humor seems plainly incompatible with depression, but according to this article, it does alleviate symptoms of depression. So, therapeutic recreation specialist should integrate humor into their programs in order to achieve therapeutic outcomes.
5. Gillispie, Charles（2003）. A Case Report Illustrating the Use of Creative Writing As A Therapeutic Recreation Intervention in a Dualdiagnosis Residential Treatment Center. Therapeutic Recreation Journal, Fourth Quarter 2003.
Summary：The purpose of this article is to present a case report on the use of creative writing as part of a comprehensive therapeutic recreation program in a dual-diagnosis, residential treatment center. Patty（匿名）, 24 year-old, single white female from California, was admitted into treatment with a preliminary diagnosis of Alcohol Abuse, Recurrent Major Depression and Impulse Control Disorder Because her primary therapist noted Patty's strong interest in literature and writing, and she also expressed some confidence in her ability to write poetry. They decided to choose creative writing as a therapeutic recreation intervention. The goal was to help Patty learn to use her interest in writing as an alternative to ineffective, self-destructive coping behaviors.
My opinions：從個案的進步可發現，造成憂鬱的成因可追溯至幼童時期的不好經驗，而這些不好的經驗或結果導致某些有憂鬱傾向的人在面對群眾或同儕時產生羞愧及不安感，以文字抒發心中的情感與藝術介入療法很相像，且個案從creative writing 中找到自信，進而願意和他人分享心得且產生互動，從團體中找到支持的力量。這又是另一個治療式遊憩的成功案例。
1. 病因：與癌症、愛滋病一同被預為二十一世紀危害人類健康的三大疾病之一，造成憂鬱症的三主要因素為生理、心理（如情感上不穩定、思考上有扭曲）及家庭人際因素（如家庭功能失調、孤獨沒朋友）。（Beck,1979）
2. 發病率、人口：約有1/5的人一生中有憂鬱的危險（Gilbert,2000），推估過去百年來罹病率增加十倍（黃宗正,2001）。
1. 陳惠美（民92）。遊憩治療對憂鬱症治療效果之研究。國科會專題研究計畫
NSC-91-2415-H-130-005，民國91年8月1日至民國92年7月31日。
內容：本研究以在台安醫院精神科接受治療的13位憂鬱症病患為研究對象，實驗共分為狀況評估、活動設計、治療前憂鬱程度測量、遊憩態度五部分。所接受的治療方式分別為戶外遊憩治療1位，運動療程1位，藝文活動2位，園藝活動1位，室內娛樂1位。受測者在實驗結束後對遊憩治療的效益認知、情感反應、行為傾向之前測分數均高於後測，顯示遊憩治療確實會增進參加者之正面休閒態度。
心得：
此實驗經過評估後才決定給與不同患者不同的遊憩活動，若在這樣的情形下是否會影響「研究結果第二點」的客觀性。或許同樣因為失戀而患憂鬱症的患者不見得皆認同運動治療是最有效的。
研究中僅提道執行治療四個月後，每月對患者的憂鬱成舵皆有顯著改善，但憂鬱症的復原期與觀察期應該屬長時間的研究觀察，若能提供後續的追蹤研究結果，我個人認為會更具研究價值與意義。
研究中並無提及抽抽樣方法，且不同的遊憩治療受測者人數僅一至兩人，好像有點不客觀。
2. 陳莉榛（民91）。藝術治療在憂鬱症的介入效果。東南學報，24民91.01頁
203-212。
內容：本研究主要以藝術治療為介入技術探討它對憂鬱症的助益情形，採個案研究方式，進行一週一小時共十次的藝術治療活動，期透過此介入了解個案的內心世界並尋找出改善之道。研究結果發現個案在曾氏心理健康量表的焦慮分數有輕微下降，顯示藝術治療的介入之影響是肯定的。
心得：雖然研究過程不夠客觀，但我依然覺得這是一個非常有意思的研究，因為將研究中收集的文獻與結果相對應，可以得到許多類似的映證。有趣的是，本研究重點不在用藝術「治療」憂鬱症，而是利用藝術的「介入」了解個案的內心想法近一步找出導致憂鬱的根源問題。雖然與老師要求我們收集的研究不盡相同，但卻有異曲同工之妙的道理，因為遊憩治療的方式廣泛，其中也包含了藝術應用這一種方式。能透過藝術的方式呈現口語表達不出的痛苦及傳達非言語所能權釋的感受確實是相當溫和且有效的方式之一。
3.Dieser,Rodney B（2002）.Effects of attribution retraining during therapeutic
recreation on attributions and explanatory styles of adolescents with
depression. .Therapeutic Recreation Journal, First Quarter 2002,
from http://www.findarticles.com/p/articles /mi_qa3903/is_200201/ai_n
9030983
Summary：The purpose of this study was to examine the effects of verbal persuasion based attribution retraining during therapeutic recreation on attributions and explanatory styles of 18 adolescents（aged14-17） with a clinical diagnosis of major depression. The Attribution Style Questionnaire was used to measure explanatory styles, and Attributions（locus of causality, stability, personal control, and external control.）were measured by the Causal Dimension Scale II.Twice a week the researcher met individually with participants and asked them the following open question：”Tell me one successful and unsuccessful therapeutic recreation activity you were involved in ……….”The control group received minimal verbal responses such as “good,” ”un-huh,”and”I see.” The experimental group received optimistic message, for example,”It sounds like the activity was successful because you put much effort into it. ”
Results from this study suggest that the attribution retraining verbal persuasion in a therapeutic recreation setting can have a significant effect on stability and personal control attributions.
My opinions：當一個人在憂鬱的時候，回應者若是能給予正面的回應將激發被諮商者的正向思想。以我自己為例，應該盡量避免對人或事太過主觀的批判或限於自己心中的判斷，因為最後終陷於痛苦的感覺而脫離不出而不自覺對別人產生敵意。
4.Richard Williams（2002）.Humor as a therapeutic recreation intervention.
Parks & Recreation, May 2002,from http://www.findarticles.com/p/articles/mi_m1145/is_5_37/ai_86505433
Summary：According to amount and quality of humor research, humor is not only a sunny disposition but also provides real psychological and physical benefits. For instance, exposure to humorous material appears to bolster the immune system, helping people with cognitive or learning impairments, and reduce pain during uncomfortable treatments or recovery from surgery. Additionally, humor can effectively treat both depression and anxiety which are among the most common characteristics of people seeking therapeutic recreation services. As long as we could avoid negative form of humor including sarcastic, racial and sexist which are contrary to therapeutic goals, humors would be a justifiable, inexpensive and appropriate tool for use in therapeutic recreation services.
My opinions：By our nature, humor seems plainly incompatible with depression, but according to this article, it does alleviate symptoms of depression. So, therapeutic recreation specialist should integrate humor into their programs in order to achieve therapeutic outcomes.
5. Gillispie, Charles（2003）. A Case Report Illustrating the Use of Creative Writing As A Therapeutic Recreation Intervention in a Dualdiagnosis Residential Treatment Center. Therapeutic Recreation Journal, Fourth Quarter 2003.
Summary：The purpose of this article is to present a case report on the use of creative writing as part of a comprehensive therapeutic recreation program in a dual-diagnosis, residential treatment center. Patty（匿名）, 24 year-old, single white female from California, was admitted into treatment with a preliminary diagnosis of Alcohol Abuse, Recurrent Major Depression and Impulse Control Disorder Because her primary therapist noted Patty's strong interest in literature and writing, and she also expressed some confidence in her ability to write poetry. They decided to choose creative writing as a therapeutic recreation intervention. The goal was to help Patty learn to use her interest in writing as an alternative to ineffective, self-destructive coping behaviors.
My opinions：從個案的進步可發現，造成憂鬱的成因可追溯至幼童時期的不好經驗，而這些不好的經驗或結果導致某些有憂鬱傾向的人在面對群眾或同儕時產生羞愧及不安感，以文字抒發心中的情感與藝術介入療法很相像，且個案從creative writing 中找到自信，進而願意和他人分享心得且產生互動，從團體中找到支持的力量。這又是另一個治療式遊憩的成功案例。
Posted by 19318002 林君容
at October 4,2005 17:19
1.所選疾病或狀況別，並以100字以內簡述其病因、發病率、人口....等相關資訊。
肢障：
中文定義：係指由於發育遲緩，中樞或周圍神經系統發生病變，外傷或其他先天或後天性骨骼肌肉系統之缺損或疾病而形成肢體障礙致無法或難以修復者。(衛生署，身心障礙等級，1991)
英文定義：Disability: Any restriction or lack (resulting from an impairment) of ability to perform an activity in the manner or within the range considered normal for a human being. (WHO,1980)
About six hundred people lived with disabilities in various types in the world. 80% live in the low -income countries.(WHO,2005)
Disabled people do not from a homogeneous group. For example, the mentally ill and the mentally retarded, the visually, hearing and speech impaired and those with restricted mobility or with so-called "medical disabilities" all encounter different barriers, of different kinds, which have to be overcome in different ways. (WHO,2005)
2.選取五篇國內外相關科學期刊（至少三篇國外期刊），其中有應用休閒遊憩方式進行該疾病或狀況的改善，以APA或其他科學期刊citation方式列出這五篇期刊。
1)Farias-Tomaszewski, S., Jenkins, S. R., & Keller, J. (2001). An evaluation of therapeutic horseback riding programs for adults with physical impairments. Therapeutic Recreation Journal.
內容：
Twenty-two adults with a variety of disabilities were participants in a therapeutic horseback riding program. Participants were assessed on the first day of riding class and again on the last day of class, 12 weeks later. At each of the testing intervals participants completed the Self-Efficacy 5-point scale (Sherer et al., 1982), Physical Self-Efficacy 6-point Scale (Ryckman et al., 1982), and during both the first and last riding class, rated on the level of confidence they exhibited while on the horse. Behavioral ratings were began at the inception of the mounting procedure, continued throughout the one hour lesson, and ended after the participant dismounted the horse and completed by two separate raters.
Physical self-efficacy and behavioral self-confidence were found to increase from pre-test to post-test while self-efficacy did not change over time. A small sample viewed themselves as having greater physical ability and displayed increased confidence in the presentation of their physical skills.
2)吳雅萍(2003)：極重度多重障礙學生運用輔助性科技之個案研究(碩士論文，彰化師範大學，2002)。全國博碩士論文資訊網，91NCUE0284006。
內容：一位因火災造成肢體障礙、視覺障礙與語言障礙的多重障礙學生成功運用輔助性科技的經驗。輔助性科技專業團隊包括職能治療師、物理治療師、語言治療師、與學校和基金會的合作，研究期間約十一個月，資料蒐集方式為訪談個案、母親、醫院單位、科技單位、學校系統等超過二十名的相關人員。
個案成功因素歸納為四個因素主題，即個案的因素、照顧者的因素、專業人員的因素、社會環境因素—輔具資源。
3)沈榮林(2003)：藝術教育治療團體對國小身心障礙資源班兒童(碩士論文，臺北市立師範學院，2002)。全國博碩士論文資訊網，91TMTC0616023。
內容：以台北市某國小身心障礙資源班五位高年級學生為研究對象，實施藝術教育治療團體輔導。主要以「行為困擾量表」及 「情緒障礙量表」作為前後測評量工具，另由研究者與家長、級任教師就成員偏差行為部分共同研擬一份「行為觀察記錄表」，再輔以活動歷程中之行為表現與作品分析，進行多向度三角交叉檢視，比較成員在團體介入歷程中及介入後行為改變狀況。
結果顯示研究對象在「自我關懷」、「身心發展」、「對研究者有禮貌」、「主動參與活動」、「整體能力」及「家庭生活」的困擾上有顯著的進步。藝術教育治療團體對國小身心障礙資源班兒童在團體歷程中之行為及藝術表現，有正向的影響。
4)Devine, M. A., & Lashua, B. (2002). Constructing social acceptance in inclusive leisure contexts: The role of individuals with disabilities. Therapeutic Recreation Journal.
內容：This study examined perceptions of people with disabilities to social acceptance and their leisure experience. Male (n = 4) and female (n = 10) ranged in age from 11-35 and individuals' disabilities included spinal bifida (n = 2), cerebral palsy (n = 5), orthopaedic disability (n = 2), muscular dystrophy (n = 1), and Down's Syndrome (n = 4) were participants in inclusive leisure programs in face-to-face interviews.
Overall, the data revealed participants with disabilities played a role in constructing social acceptance, either proactively or reactively, within inclusive leisure contexts. In addition, informants identified relationships between constructed acceptance and leisure frequency, friendship development, acceptance of differences, and leisure intentions. This study expands upon the understanding of the relationship between social acceptance and leisure experiences of people with disabilities by providing insight into their role while engaging in inclusive leisure programs.
5)Groff, D. G., & Kleiber, D. A. (2001). Exploring the identity formation of youth involved in an adapted sports program. Therapeutic Recreation Journal.
內容：The 11 youth sample consisted of adolescents with physical disabilities between the ages of 15-21 who were active participants in an after school adapted sports program, which operated in a large metropolitan area in the southeastern United States called the American Association of Adapted Sports Program (AAASP).
For 8 of the 11 individuals, participation in the adapted sports program seemed to provide an avenue through which they could develop an overall sense of competence in skills not associated with sports.All of the participants in this study reported that they were able to express a great deal of emotion through sport. Six of the individuals in this study reported being less aware of having a disability as during recreational activity and sport.
肢障：
中文定義：係指由於發育遲緩，中樞或周圍神經系統發生病變，外傷或其他先天或後天性骨骼肌肉系統之缺損或疾病而形成肢體障礙致無法或難以修復者。(衛生署，身心障礙等級，1991)
英文定義：Disability: Any restriction or lack (resulting from an impairment) of ability to perform an activity in the manner or within the range considered normal for a human being. (WHO,1980)
About six hundred people lived with disabilities in various types in the world. 80% live in the low -income countries.(WHO,2005)
Disabled people do not from a homogeneous group. For example, the mentally ill and the mentally retarded, the visually, hearing and speech impaired and those with restricted mobility or with so-called "medical disabilities" all encounter different barriers, of different kinds, which have to be overcome in different ways. (WHO,2005)
2.選取五篇國內外相關科學期刊（至少三篇國外期刊），其中有應用休閒遊憩方式進行該疾病或狀況的改善，以APA或其他科學期刊citation方式列出這五篇期刊。
1)Farias-Tomaszewski, S., Jenkins, S. R., & Keller, J. (2001). An evaluation of therapeutic horseback riding programs for adults with physical impairments. Therapeutic Recreation Journal.
內容：
Twenty-two adults with a variety of disabilities were participants in a therapeutic horseback riding program. Participants were assessed on the first day of riding class and again on the last day of class, 12 weeks later. At each of the testing intervals participants completed the Self-Efficacy 5-point scale (Sherer et al., 1982), Physical Self-Efficacy 6-point Scale (Ryckman et al., 1982), and during both the first and last riding class, rated on the level of confidence they exhibited while on the horse. Behavioral ratings were began at the inception of the mounting procedure, continued throughout the one hour lesson, and ended after the participant dismounted the horse and completed by two separate raters.
Physical self-efficacy and behavioral self-confidence were found to increase from pre-test to post-test while self-efficacy did not change over time. A small sample viewed themselves as having greater physical ability and displayed increased confidence in the presentation of their physical skills.
2)吳雅萍(2003)：極重度多重障礙學生運用輔助性科技之個案研究(碩士論文，彰化師範大學，2002)。全國博碩士論文資訊網，91NCUE0284006。
內容：一位因火災造成肢體障礙、視覺障礙與語言障礙的多重障礙學生成功運用輔助性科技的經驗。輔助性科技專業團隊包括職能治療師、物理治療師、語言治療師、與學校和基金會的合作，研究期間約十一個月，資料蒐集方式為訪談個案、母親、醫院單位、科技單位、學校系統等超過二十名的相關人員。
個案成功因素歸納為四個因素主題，即個案的因素、照顧者的因素、專業人員的因素、社會環境因素—輔具資源。
3)沈榮林(2003)：藝術教育治療團體對國小身心障礙資源班兒童(碩士論文，臺北市立師範學院，2002)。全國博碩士論文資訊網，91TMTC0616023。
內容：以台北市某國小身心障礙資源班五位高年級學生為研究對象，實施藝術教育治療團體輔導。主要以「行為困擾量表」及 「情緒障礙量表」作為前後測評量工具，另由研究者與家長、級任教師就成員偏差行為部分共同研擬一份「行為觀察記錄表」，再輔以活動歷程中之行為表現與作品分析，進行多向度三角交叉檢視，比較成員在團體介入歷程中及介入後行為改變狀況。
結果顯示研究對象在「自我關懷」、「身心發展」、「對研究者有禮貌」、「主動參與活動」、「整體能力」及「家庭生活」的困擾上有顯著的進步。藝術教育治療團體對國小身心障礙資源班兒童在團體歷程中之行為及藝術表現，有正向的影響。
4)Devine, M. A., & Lashua, B. (2002). Constructing social acceptance in inclusive leisure contexts: The role of individuals with disabilities. Therapeutic Recreation Journal.
內容：This study examined perceptions of people with disabilities to social acceptance and their leisure experience. Male (n = 4) and female (n = 10) ranged in age from 11-35 and individuals' disabilities included spinal bifida (n = 2), cerebral palsy (n = 5), orthopaedic disability (n = 2), muscular dystrophy (n = 1), and Down's Syndrome (n = 4) were participants in inclusive leisure programs in face-to-face interviews.
Overall, the data revealed participants with disabilities played a role in constructing social acceptance, either proactively or reactively, within inclusive leisure contexts. In addition, informants identified relationships between constructed acceptance and leisure frequency, friendship development, acceptance of differences, and leisure intentions. This study expands upon the understanding of the relationship between social acceptance and leisure experiences of people with disabilities by providing insight into their role while engaging in inclusive leisure programs.
5)Groff, D. G., & Kleiber, D. A. (2001). Exploring the identity formation of youth involved in an adapted sports program. Therapeutic Recreation Journal.
內容：The 11 youth sample consisted of adolescents with physical disabilities between the ages of 15-21 who were active participants in an after school adapted sports program, which operated in a large metropolitan area in the southeastern United States called the American Association of Adapted Sports Program (AAASP).
For 8 of the 11 individuals, participation in the adapted sports program seemed to provide an avenue through which they could develop an overall sense of competence in skills not associated with sports.All of the participants in this study reported that they were able to express a great deal of emotion through sport. Six of the individuals in this study reported being less aware of having a disability as during recreational activity and sport.
Posted by 休管研二 19318012 丘偉志
at October 7,2005 18:05
TOPIC：失智症( Dementia )
指喪失原本有的心智能力,如不認得家人(記憶受損),找不到路回家(空間能力受損),妄想家人想要偷他錢,有人想加害他…,該病多發生在65歲以上的老人,以女性居多,而失智症分為阿滋海默氏症占60%,血管性失智症則占20%-30%,其餘為腦部創傷等所產生.
中文期刊
篇 名： 機構失智長者的活動設計
Activities Programs for Institutionalized Elderly Patients with Dementia
作 者： 高潔純 林麗嬋
刊 名： 護理雜誌
卷期／年月：52:1 民94.02 頁61-65
關 鍵 詞： 機構; 失智症; 活動方案; 老人; 正式照顧者
Dementia; Activities programs; Elderly; Institution; Formal caregiver
內容:
失智長者被送往機構照顧後,機構的照顧者的活動規劃是很重要的.若失智者參加越多結構性活動安排,可以顯著降低問題行為,改善睡眠及減輕焦慮,增進自我表達與社交互動等,其中感覺運動治療的部分,使中、重度患者運用治療性玩偶,音樂、戲劇等感官治療可使其穩定情緒、平靜行為。
英文期刊
篇 名 Walking and Dementia in Physically Capable Elderly Men
作 者 Robert D Abbott, Lon R White, G Webster Ross, Kamal H Masaki, et al
刊 名 JAMA美國醫學協會
卷期／年月 Sep 22-Sep 29, 2004.Vol. 292, Iss. 12, p.447-1453
資料語文 英文
關鍵詞 Dementia, Walking, Older people, Men, Health risk assessment
內容: 主要在了解老人走路運動和未來得癡呆症的關連。將參予Honolulu-Asia Aging Study的8006人(71歲到93歲) (對象)，除去不合適的人選如抽菸、中途死亡、有其餘活動如工作、划船等等剩下的2257人(抽樣方法)，長期觀察其活動、收集資料，最後用統計學來分析資料數據,顯示老人多走路能夠明顯減少未來癡呆症的發生。
篇 名 Exercise plus behavioral management in patients with Alzheimer disease
作 者 Linda Teri, Laura E Gibbons, Susan M McCurry, Rebecca G Logsdon, et al
刊 名 JAMA
卷期／年月 Oct 15, 2003. Vol. 290, Iss. 15, p.015-2022
資料語文 英文
關鍵詞 Exercise, Caregivers, Patients, Alzheimer’s disease, Behavior disorders
內容：
為證明在家運動加上有特別訓練的看護照顧下，是否能有效減少失智症的病患在思想和行動上的遲緩和對人的依賴性?將利用廣告和醫生介紹的方式徵求患有失智症者，以隨機取樣的方式選取其中153個病患進行研究，運動治療方式有-有氧/耐力活動、力量、 平衡、靈活性訓練，利用觀察和評估的方式收取資料，資料經過不同專業人員開會確定無誤後分析資料，研究結果是運動加上有特別訓練的看護照顧下，能對失智症的病人身體和精神有所幫助。
篇 名 Capturing interests: Therapeutic recreation activities for persons with dementia
作 者 Ann M Kolanowski, Linda Buettner, Paul T Costa Jr, Mark S Litaker
刊 名 Therapeutic Recreation Journal
卷期／年月 Third Quarter 2001. Vol. 35, Iss. 3
資料語文 英文
內容：
以治療性休閒活動的相關學說，並輔以研究來證明治療性休閒活動對於失智症的有效性，研究對象為某兩家看護中心的住戶，除去不合適的人選，利用不同學說的方式來測試並收集資料，再利用mixed-model analysis來分析資料，本研究的缺點在於研究對象不多，但研究發現病人在經過有治療性休閒活動的治療後，比沒有的人發病的日子比較少。
篇 名
Participation in cognitively stimulating activities and risk of incident Alzheimer disease
作 者 Robert S Wilson, Carlos F Mendes de Leon, Lisa L Barnes, Julie A Schneider, et al
刊 名 JAMA
卷期／年月 Feb 13, 2002.Vol. 287,Iss. 6, p.42-748
資料語文 英文
關鍵詞 Alzheimers disease, Health risk assessment, Cognition & reasoning, Older people
內容：
為證明經常參予有認識力的休閒活動的人得失智症的機率比較低，研究對象為參予Religious Orders Study的人，除去不合適的人選，紀錄研究對象所參予的各種不同有認識力的休閒活動(如看報紙、看電視等等)，不同的活動有不同的記分方式，再利用random-effects regression models 來分析資料，研究結果顯示，經常參予有認識力的休閒活動跟降低得失智症的機率是有關聯的。
指喪失原本有的心智能力,如不認得家人(記憶受損),找不到路回家(空間能力受損),妄想家人想要偷他錢,有人想加害他…,該病多發生在65歲以上的老人,以女性居多,而失智症分為阿滋海默氏症占60%,血管性失智症則占20%-30%,其餘為腦部創傷等所產生.
中文期刊
篇 名： 機構失智長者的活動設計
Activities Programs for Institutionalized Elderly Patients with Dementia
作 者： 高潔純 林麗嬋
刊 名： 護理雜誌
卷期／年月：52:1 民94.02 頁61-65
關 鍵 詞： 機構; 失智症; 活動方案; 老人; 正式照顧者
Dementia; Activities programs; Elderly; Institution; Formal caregiver
內容:
失智長者被送往機構照顧後,機構的照顧者的活動規劃是很重要的.若失智者參加越多結構性活動安排,可以顯著降低問題行為,改善睡眠及減輕焦慮,增進自我表達與社交互動等,其中感覺運動治療的部分,使中、重度患者運用治療性玩偶,音樂、戲劇等感官治療可使其穩定情緒、平靜行為。
英文期刊
篇 名 Walking and Dementia in Physically Capable Elderly Men
作 者 Robert D Abbott, Lon R White, G Webster Ross, Kamal H Masaki, et al
刊 名 JAMA美國醫學協會
卷期／年月 Sep 22-Sep 29, 2004.Vol. 292, Iss. 12, p.447-1453
資料語文 英文
關鍵詞 Dementia, Walking, Older people, Men, Health risk assessment
內容: 主要在了解老人走路運動和未來得癡呆症的關連。將參予Honolulu-Asia Aging Study的8006人(71歲到93歲) (對象)，除去不合適的人選如抽菸、中途死亡、有其餘活動如工作、划船等等剩下的2257人(抽樣方法)，長期觀察其活動、收集資料，最後用統計學來分析資料數據,顯示老人多走路能夠明顯減少未來癡呆症的發生。
篇 名 Exercise plus behavioral management in patients with Alzheimer disease
作 者 Linda Teri, Laura E Gibbons, Susan M McCurry, Rebecca G Logsdon, et al
刊 名 JAMA
卷期／年月 Oct 15, 2003. Vol. 290, Iss. 15, p.015-2022
資料語文 英文
關鍵詞 Exercise, Caregivers, Patients, Alzheimer’s disease, Behavior disorders
內容：
為證明在家運動加上有特別訓練的看護照顧下，是否能有效減少失智症的病患在思想和行動上的遲緩和對人的依賴性?將利用廣告和醫生介紹的方式徵求患有失智症者，以隨機取樣的方式選取其中153個病患進行研究，運動治療方式有-有氧/耐力活動、力量、 平衡、靈活性訓練，利用觀察和評估的方式收取資料，資料經過不同專業人員開會確定無誤後分析資料，研究結果是運動加上有特別訓練的看護照顧下，能對失智症的病人身體和精神有所幫助。
篇 名 Capturing interests: Therapeutic recreation activities for persons with dementia
作 者 Ann M Kolanowski, Linda Buettner, Paul T Costa Jr, Mark S Litaker
刊 名 Therapeutic Recreation Journal
卷期／年月 Third Quarter 2001. Vol. 35, Iss. 3
資料語文 英文
內容：
以治療性休閒活動的相關學說，並輔以研究來證明治療性休閒活動對於失智症的有效性，研究對象為某兩家看護中心的住戶，除去不合適的人選，利用不同學說的方式來測試並收集資料，再利用mixed-model analysis來分析資料，本研究的缺點在於研究對象不多，但研究發現病人在經過有治療性休閒活動的治療後，比沒有的人發病的日子比較少。
篇 名
Participation in cognitively stimulating activities and risk of incident Alzheimer disease
作 者 Robert S Wilson, Carlos F Mendes de Leon, Lisa L Barnes, Julie A Schneider, et al
刊 名 JAMA
卷期／年月 Feb 13, 2002.Vol. 287,Iss. 6, p.42-748
資料語文 英文
關鍵詞 Alzheimers disease, Health risk assessment, Cognition & reasoning, Older people
內容：
為證明經常參予有認識力的休閒活動的人得失智症的機率比較低，研究對象為參予Religious Orders Study的人，除去不合適的人選，紀錄研究對象所參予的各種不同有認識力的休閒活動(如看報紙、看電視等等)，不同的活動有不同的記分方式，再利用random-effects regression models 來分析資料，研究結果顯示，經常參予有認識力的休閒活動跟降低得失智症的機率是有關聯的。
Posted by 休管研二19318007吳佳怡
at October 8,2005 16:03
1.心血管疾病。「心血管疾病」是心臟病與血管疾病的總稱。「心臟冠狀動脈疾病」(Coronary heart disease)專指供應心臟的血液減少而對心臟造成傷害。 心血管疾病的發生與季節有著密切關係，發病率與死亡率通常在冬天到達顛峰。通常50歲以上的中老年人是心血管疾病的高危險群。
2.
(1)王錦雲（民93）。居家行走運動計畫對心血管疾病危險群婦女危險因子及情緒狀態之影響。臺北醫學大學護理學系碩士論文。
(2) Manson, Joann E.; Greenland, Philip; LaCroix, Andrea Z.; Stefanick, Marcia L.; Mouton, Charles P.; Oberman, Albert; Perri, Michael G.; Sheps, David S.; Pettinger, Mary B.; Siscovick, David S.（2002）.Walking compared with vigorous exercise for the prevention of cardiovascular events in women. New England Journal of Medicine, Vol. 347 Issue 10, Pages 716-725
(3) Kristina Sundquist, Jan Qvist, Sven-Erik Johansson & Jan Sundquist（2005）. The long-term effect of physical activity on incidence of coronary heart disease: A 12-year follow-up study. Preventive Medicine Volume 41, Issue 1, July 2005, Pages 219-225.
(4) Chihya Hung, Bill Daub, Bill Black, Robert Welsh, Arthur Quinney, &Mark Haykowsky（2004）.Exercise Training Improves Overall Physical Fitness and Quality of Life in Older Women With Coronary Artery Disease. CHEST, Vol. 126, Issue 4, Oct2004, Pages 1026-1031.
(5) V.Mohan, K.Gokulakrishnan, R. Deepa, C. S. Shanthirani & M. Datta（2005）. Association of physical inactivity with components of metabolic syndrome and coronary artery disease—the Chennai Urban Population Study (CUPS no. 15).Diabetic Medicine, Vol. 22 Issue 9, Sep2005, Pages 1206-1211.
3.
(1)實驗設計以立意取樣方式篩選北部某社區及教學醫院35-64歲心血管疾病高危險群之婦女，經由醫師轉介個案，採隨機方式將個案分為運動組及對照組，運動組18人，對照組18人，兩組婦女於研究計畫前後，以運動測試、運動訓練、血液生化值及情緒狀態評估量表做為收集資料之測量工具，運動組參與為期八週的跑步機運動訓練，對照組則保持其原本生活方式。研究結果顯示，八週中等強度之跑步機運動訓練對於改善心血管疾病危險群婦女之血脂肪較不明顯，但對婦女身體組成、血壓及情緒狀態之改善皆有顯著的成效。
(2) 93,676 women were enrolled in an observational study as part of the Woman’s Health Initiative between 1994 and 1998. The duration, frequency and intensity of exercise and hours spent sleeping and sitting were documented along with a standard health questionnaire that included nutrition, smoking, anthropomorphics, family history and other behavioral and lifestyle factors. Primary end points were newly diagnosed coronary heart disease (CHD) defined as non-fatal MI or death and total cardiovascular events including coronary or carotid revascularization, CHF and stroke as of August 2000. The study cohort encompassed the 73,743 postmenopausal women age 50–79 years who were free of cancer and CVD at baseline. 345 women developed CHD and a 1551 one or more CV events. Increasing physical-activity scores has a strong and graded inverse relationship with risk of coronary and total CV events. The age-adjusted relative risk of CVD by quintile of energy expenditure from lowest (RR_1) to highest ranged from 2nd at 0.73 to 0.47 for the 5th (p_0.001 for trend), and remained strong after multivariate analysis. Walking and vigorous exercise were associated with similar risk reductions, and results did not vary according to race, age, or BMI. A brisker walk pace and less hours spent sitting also predicted lower risk. These prospective data indicate that both walking and vigorous exercise are associated with CV risk reduction in post menopausal women regardless of ethnic group and age.
(3) A national, random sample of 2,551 women and 2,645 men, aged 35–74, was interviewed in 1988 and 1989 and followed until December 31, 2000, with respect to CHD (Coronary heart disease) incident cases. Women and men hospitalized for CHD 2 years before the start of the study and those who rated their general health as poor were not included in the sample. Leisure-time physical activity was divided into four levels according to the frequency of physical activity. The relationship between leisure-time physical activity and CHD was studied in a Cox regression model, adjusted for sex, age, income, smoking, and BMI. When leisure-time physical activity increased, the risk of CHD decreased. Women and men who were physically active at least twice a week had a 41% lower risk of developing CHD than those who performed no physical activity (hazard ratio = 0.59, CI = 0.37–0.95), after adjustment for all the explanatory variables. The positive long-term effect of leisure-time physical activity on CHD risk among women and men remains even after accounting for income and other important CHD risk factors.
(4) Older women with coronary artery disease (CAD) have reduced peak aerobic power
(V˙ O2peak), muscle strength, and quality of life (QOL). Exercise interventions that can improve V˙O2peak and muscle strength may also result in an improvement in QOL. This study compared the effect of aerobic training (AT) or combined aerobic and strength training (COMT) on V˙O2peak, distance walked in 6 min, upper- and lower-extremity maximal strength, and QOL in 18 women (age range, 60 to 80 years) with documented CAD. After baseline testing, subjects were randomly assigned to AT (treadmill and cycle exercise, n _ 9) or COMT (treadmill and cycle exercise plus upper- and lower-extremity strength training, n _ 9), and each group exercised 3 d/wk for 8 weeks. Both AT and COMT resulted in a similar increase in V˙ O2peak, distance walked in 6 min, lower-extremity strength, and emotional and global QOL. COMT improved upper-extremity strength, and physical and social QOL, which was unchanged after AT. Older women with CAD should perform aerobic and strength training to attain optimal improvements in overall physical fitness and QOL.
(5) The Chennai Urban Population Study (CUPS) is an epidemiological study involving two residential areas in Chennai in South India. Of the total of 1399 eligible subjects (age≥20 years), 1262 individuals participated in the study. MS was diagnosed based on modified Adult Treatment Panel (ATP) III guidelines. Details about the physical activity were collected using questionnaire, which included job-related and leisure-time activities, and specific questions on exercise. We assessed the relationship between the grades of physical activity and the components of MS and coronary artery disease (CAD). Insulin resistance was calculated using the homeostasis assessment model (HOMA-IR). Prevalence of most of the components of MS (diabetes P< 0.001, obesity P =0.003, abdominal obesity P< 0.001 and hypertension P< 0.001) and MS per se (P < 0.001) increased significantly with decrease in physical activity. Physical inactivity is associated with the components of MS and CAD in this urban south-Indian population. Lifestyle changes focusing on increasing physical activity could help to prevent the exploding epidemic of MS and CAD in India.
2.
(1)王錦雲（民93）。居家行走運動計畫對心血管疾病危險群婦女危險因子及情緒狀態之影響。臺北醫學大學護理學系碩士論文。
(2) Manson, Joann E.; Greenland, Philip; LaCroix, Andrea Z.; Stefanick, Marcia L.; Mouton, Charles P.; Oberman, Albert; Perri, Michael G.; Sheps, David S.; Pettinger, Mary B.; Siscovick, David S.（2002）.Walking compared with vigorous exercise for the prevention of cardiovascular events in women. New England Journal of Medicine, Vol. 347 Issue 10, Pages 716-725
(3) Kristina Sundquist, Jan Qvist, Sven-Erik Johansson & Jan Sundquist（2005）. The long-term effect of physical activity on incidence of coronary heart disease: A 12-year follow-up study. Preventive Medicine Volume 41, Issue 1, July 2005, Pages 219-225.
(4) Chihya Hung, Bill Daub, Bill Black, Robert Welsh, Arthur Quinney, &Mark Haykowsky（2004）.Exercise Training Improves Overall Physical Fitness and Quality of Life in Older Women With Coronary Artery Disease. CHEST, Vol. 126, Issue 4, Oct2004, Pages 1026-1031.
(5) V.Mohan, K.Gokulakrishnan, R. Deepa, C. S. Shanthirani & M. Datta（2005）. Association of physical inactivity with components of metabolic syndrome and coronary artery disease—the Chennai Urban Population Study (CUPS no. 15).Diabetic Medicine, Vol. 22 Issue 9, Sep2005, Pages 1206-1211.
3.
(1)實驗設計以立意取樣方式篩選北部某社區及教學醫院35-64歲心血管疾病高危險群之婦女，經由醫師轉介個案，採隨機方式將個案分為運動組及對照組，運動組18人，對照組18人，兩組婦女於研究計畫前後，以運動測試、運動訓練、血液生化值及情緒狀態評估量表做為收集資料之測量工具，運動組參與為期八週的跑步機運動訓練，對照組則保持其原本生活方式。研究結果顯示，八週中等強度之跑步機運動訓練對於改善心血管疾病危險群婦女之血脂肪較不明顯，但對婦女身體組成、血壓及情緒狀態之改善皆有顯著的成效。
(2) 93,676 women were enrolled in an observational study as part of the Woman’s Health Initiative between 1994 and 1998. The duration, frequency and intensity of exercise and hours spent sleeping and sitting were documented along with a standard health questionnaire that included nutrition, smoking, anthropomorphics, family history and other behavioral and lifestyle factors. Primary end points were newly diagnosed coronary heart disease (CHD) defined as non-fatal MI or death and total cardiovascular events including coronary or carotid revascularization, CHF and stroke as of August 2000. The study cohort encompassed the 73,743 postmenopausal women age 50–79 years who were free of cancer and CVD at baseline. 345 women developed CHD and a 1551 one or more CV events. Increasing physical-activity scores has a strong and graded inverse relationship with risk of coronary and total CV events. The age-adjusted relative risk of CVD by quintile of energy expenditure from lowest (RR_1) to highest ranged from 2nd at 0.73 to 0.47 for the 5th (p_0.001 for trend), and remained strong after multivariate analysis. Walking and vigorous exercise were associated with similar risk reductions, and results did not vary according to race, age, or BMI. A brisker walk pace and less hours spent sitting also predicted lower risk. These prospective data indicate that both walking and vigorous exercise are associated with CV risk reduction in post menopausal women regardless of ethnic group and age.
(3) A national, random sample of 2,551 women and 2,645 men, aged 35–74, was interviewed in 1988 and 1989 and followed until December 31, 2000, with respect to CHD (Coronary heart disease) incident cases. Women and men hospitalized for CHD 2 years before the start of the study and those who rated their general health as poor were not included in the sample. Leisure-time physical activity was divided into four levels according to the frequency of physical activity. The relationship between leisure-time physical activity and CHD was studied in a Cox regression model, adjusted for sex, age, income, smoking, and BMI. When leisure-time physical activity increased, the risk of CHD decreased. Women and men who were physically active at least twice a week had a 41% lower risk of developing CHD than those who performed no physical activity (hazard ratio = 0.59, CI = 0.37–0.95), after adjustment for all the explanatory variables. The positive long-term effect of leisure-time physical activity on CHD risk among women and men remains even after accounting for income and other important CHD risk factors.
(4) Older women with coronary artery disease (CAD) have reduced peak aerobic power
(V˙ O2peak), muscle strength, and quality of life (QOL). Exercise interventions that can improve V˙O2peak and muscle strength may also result in an improvement in QOL. This study compared the effect of aerobic training (AT) or combined aerobic and strength training (COMT) on V˙O2peak, distance walked in 6 min, upper- and lower-extremity maximal strength, and QOL in 18 women (age range, 60 to 80 years) with documented CAD. After baseline testing, subjects were randomly assigned to AT (treadmill and cycle exercise, n _ 9) or COMT (treadmill and cycle exercise plus upper- and lower-extremity strength training, n _ 9), and each group exercised 3 d/wk for 8 weeks. Both AT and COMT resulted in a similar increase in V˙ O2peak, distance walked in 6 min, lower-extremity strength, and emotional and global QOL. COMT improved upper-extremity strength, and physical and social QOL, which was unchanged after AT. Older women with CAD should perform aerobic and strength training to attain optimal improvements in overall physical fitness and QOL.
(5) The Chennai Urban Population Study (CUPS) is an epidemiological study involving two residential areas in Chennai in South India. Of the total of 1399 eligible subjects (age≥20 years), 1262 individuals participated in the study. MS was diagnosed based on modified Adult Treatment Panel (ATP) III guidelines. Details about the physical activity were collected using questionnaire, which included job-related and leisure-time activities, and specific questions on exercise. We assessed the relationship between the grades of physical activity and the components of MS and coronary artery disease (CAD). Insulin resistance was calculated using the homeostasis assessment model (HOMA-IR). Prevalence of most of the components of MS (diabetes P< 0.001, obesity P =0.003, abdominal obesity P< 0.001 and hypertension P< 0.001) and MS per se (P < 0.001) increased significantly with decrease in physical activity. Physical inactivity is associated with the components of MS and CAD in this urban south-Indian population. Lifestyle changes focusing on increasing physical activity could help to prevent the exploding epidemic of MS and CAD in India.
Posted by 休管研二 19318008 徐培原
at October 10,2005 00:41
失眠症Insomnia
指個體無法控制自己的睡眠狀態，造成原因包括身體和情緒問題，如：疾病、日常壓力、焦慮，其中分為短期失眠及長期失眠，短期失眠是指暫時或少數幾天的失眠狀態，而長期失眠是指3星期以上的睡眠失調，且造成日常生活及工作的傷害。失眠症狀是晚上無法熟睡，經常醒來，早上精神不振，常打瞌睡，整天都會覺得很疲累。
From: http://www.hmc.psu.edu/healthinfo/i/insomnia.htm. 2005/10/10.
1. O'Connor, P. J., Breus, M. J., & Youngstedt, S. D. (1998). Exercise-induced increase in core temperature does not disrupt a behavioral measure of sleep. Physiology and Behavior, 64(3), 213-7.
內容摘要：本研究旨在調查睡前60-90分鐘的中低強度運動對體內溫度的影響，以8位身體健康（能承受最大運動量測試）男大學生（年齡：20.8 +/- 2.0歲）為實驗對象，每位參與者皆從事3種強度的腳踏車運動（中強度：60%VO2peak，低強度：持續不費力的踩踏板，休息：安靜地坐在腳踏車上），結果顯示，睡前從事中低強度運動比不運動的睡眠品質（睡眠時間、醒來次數、入睡時間、睡眠效果）差，體內溫度亦較睡前不運動高，指出睡前運動有抑睡眠，與過去研究不符。
2. King, A. C., Oman, R. F., Brassington, G. S., Bliwise, D. L., Haskell, W. L. (1997). Moderate-intensity exercise and self-rated quality of sleep in older adults: A randomized controlled trial. The Journal of the American Medical Association, 277(1), 32-7.
內容摘要：本研究旨在了解中強度運動訓練對坐式生活的老年人睡眠品質的影響，以29位女性和14位男性（50-76歲）為研究對象，參加者不排除患有心臟疾病、中風、骨骼肌肉疾病、中度失眠者，但每天飲酒量不能超過3份，過去半年內不得抽煙，BMI指數需小於40者，43位參加者被隨機分派到實驗組（參加16週中強度耐力運動訓練課程，每週4次，每次40-60分鐘，每週活動包括2次低衝擊有氧課程、2次快走或騎腳踏車）與控制組（維持個人生活型態），結果顯示，規律的中等運動強度有益於老年人的睡眠品質。
3. Youngstedt, S. D., O'Connor, P. J., Crabbe, J. B., & Dishman, R. K. (2000). The influence of acute exercise on sleep following high caffeine intake. Physiology and Behavior, 68(4), 563-570.
內容摘要：本研究以太極拳為介入方式，針對118位有中度失眠困擾且日常無活動習慣的老年人（年齡介於60-92歲）進行實驗，參與者貝隨機分至實驗組（太極拳組，每週3次，每次1小時，持續24週）與控制組（低衝擊運動組，包括呼吸、伸展及放鬆，每週3次，每次1小時，持續24週），結果顯示太極拳組老年人的睡眠品質有顯著提昇，而低衝擊運動組織睡眠品質無顯著改變。
*抱歉，其餘2篇盡快補上，請見諒，謝謝
指個體無法控制自己的睡眠狀態，造成原因包括身體和情緒問題，如：疾病、日常壓力、焦慮，其中分為短期失眠及長期失眠，短期失眠是指暫時或少數幾天的失眠狀態，而長期失眠是指3星期以上的睡眠失調，且造成日常生活及工作的傷害。失眠症狀是晚上無法熟睡，經常醒來，早上精神不振，常打瞌睡，整天都會覺得很疲累。
From: http://www.hmc.psu.edu/healthinfo/i/insomnia.htm. 2005/10/10.
1. O'Connor, P. J., Breus, M. J., & Youngstedt, S. D. (1998). Exercise-induced increase in core temperature does not disrupt a behavioral measure of sleep. Physiology and Behavior, 64(3), 213-7.
內容摘要：本研究旨在調查睡前60-90分鐘的中低強度運動對體內溫度的影響，以8位身體健康（能承受最大運動量測試）男大學生（年齡：20.8 +/- 2.0歲）為實驗對象，每位參與者皆從事3種強度的腳踏車運動（中強度：60%VO2peak，低強度：持續不費力的踩踏板，休息：安靜地坐在腳踏車上），結果顯示，睡前從事中低強度運動比不運動的睡眠品質（睡眠時間、醒來次數、入睡時間、睡眠效果）差，體內溫度亦較睡前不運動高，指出睡前運動有抑睡眠，與過去研究不符。
2. King, A. C., Oman, R. F., Brassington, G. S., Bliwise, D. L., Haskell, W. L. (1997). Moderate-intensity exercise and self-rated quality of sleep in older adults: A randomized controlled trial. The Journal of the American Medical Association, 277(1), 32-7.
內容摘要：本研究旨在了解中強度運動訓練對坐式生活的老年人睡眠品質的影響，以29位女性和14位男性（50-76歲）為研究對象，參加者不排除患有心臟疾病、中風、骨骼肌肉疾病、中度失眠者，但每天飲酒量不能超過3份，過去半年內不得抽煙，BMI指數需小於40者，43位參加者被隨機分派到實驗組（參加16週中強度耐力運動訓練課程，每週4次，每次40-60分鐘，每週活動包括2次低衝擊有氧課程、2次快走或騎腳踏車）與控制組（維持個人生活型態），結果顯示，規律的中等運動強度有益於老年人的睡眠品質。
3. Youngstedt, S. D., O'Connor, P. J., Crabbe, J. B., & Dishman, R. K. (2000). The influence of acute exercise on sleep following high caffeine intake. Physiology and Behavior, 68(4), 563-570.
內容摘要：本研究以太極拳為介入方式，針對118位有中度失眠困擾且日常無活動習慣的老年人（年齡介於60-92歲）進行實驗，參與者貝隨機分至實驗組（太極拳組，每週3次，每次1小時，持續24週）與控制組（低衝擊運動組，包括呼吸、伸展及放鬆，每週3次，每次1小時，持續24週），結果顯示太極拳組老年人的睡眠品質有顯著提昇，而低衝擊運動組織睡眠品質無顯著改變。
*抱歉，其餘2篇盡快補上，請見諒，謝謝
Posted by 運科研二 19310026 唐惠君
at October 10,2005 19:04
1.
Chow, Yvette.(2002). Case of an in-home therapeutic recreation program for an older adult in a naturally occuring retirement community (NORC).Therapeutic Recreation Journa,Second Quarter 2002.
The purpose of this case report was to describe the
implementation of an in-home therapeutic recreation (TR) program with a 91-year old female living in a naturally occurring retirement community (NORC) by a fourth-year TR student. Based on the assessment information gathered from the FACTR* and the NORC Therapeutic Recreation Assessment, the goals for Mrs. P targeted fine and gross motor skill improvement, increasing attention span, enhancing self-expression, and increasing selfinitiated interaction with the SRT*. At the end of the eight-week session, the SRT did an exit interview to discuss Mrs. P's feelings about the program. Her comments were, "It made me very happy to have a companion that encouraged and motivated me to do things I had never done before... it made me happy to know I was able to do things despite my age. My time was spent staring into space, and this program kept me occupied.... I like to make things."
2.
Bollin, Salli, Voelkl, Judith E, Lapidos, Carole.(1998).
At-Home Independence Program: A Recreation Program Implemented by a Volunteer. Therapeutic Recreation Journal, First Quarter 1998.
The purpose of this six week, in-home recreation program was to enhance the shared and independent recreation behaviors in the daily lives of the older adult with dementia and his caregiver.
Following the completion of the program, a project staff member asked Mrs. West to evaluate the program in terms of its impact on her knowledge about shared recreation activities, confidence in engaging Mr. West in shared recreation activities, time in shared in activities, degree of enjoyment in shared recreation activities, and Mr. West's time in independent recreation activities. Using a 5 point likert type scale (1 = strongly disagree, 5 = strongly agree), Mrs. West strongly agreed (i.e., "5") that the At-Home Independence Program had a positive impact on each of the five areas rated.
3.
Kunstler, Robin.(2002). Therapeutic recreation in naturally occuring retirement community (NORC): Benefiting "aging in place".
Therapeutic Recreation Journal, Second Quarter 2002.
A case report of an in-home TR program, offered to twelve participants in conjunction with nursing and social services in a NORC, is presented from conceptualization through recommendations.
The participants were also post-tested with the FACTR-type rating scale. Three showed improvements based on a comparison of the pretest and posttest. Ms. S became more articulate and responsive with others, and improved her ambulating and upper extremity manipulation. This may be attributed to her conversations with the student and her dancing to the music provided. Ms. E improved her strength and endurance after participation in exercise, and she improved her thought process and ability to deal with conflict appropriately as a result of the assertiveness training. Ms. P's interventions included arts and crafts to improve fine motor skills, as well as reminiscence to maintain cognitive functioning as observable outcomes.
This comprehensive professional service has the potential to make life-changing impact on quality of life of the older adult who is aging in place.
4.
Kunstler, Robin, Greenblatt, Fred, Moreno, Nereida.(2004)Aromatherapy and Hand Massage: Therapeutic Recreation Interventions for Pain Management .Therapeutic Recreation Journal, Second Quarter 2004 .
All participants were female, reflecting the composition of the residents of the facility. They received one-to-one sessions of aromatherapy and hand massage from a therapeutic recreation specialist.Three of the 4 participants (TS, DF, and AT) showed an immediate response at the initiation of the first intervention phase as indicated by level changes in between these phases (Figures 2-4). These same participants also had magnitude declines during the intervention phases suggesting that aromatherapy and massage was an effective pain management intervention for these participants.
TR can offer participants a choice of relaxation techniques that are carefully planned to increase their level of comfort and sense of control over their pain.
5.
Nour,Kareen, Desrosiers, Johanne, Gauthier, Pierre, Carbonneau,Helene.(2002). Impact of a home leisure educational program for older adults who have had a stroke (home leisure educational program).Therapeutic Recreation Journal, First Quarter 2002 .
To be eligible for the study, participants had to be aged 55 or over, be retired, live less than one hour's drive from the SGUI and not present communication problems or any major cognitive deficit that would make them unable to answer the questionnaires or follow the program
The program encourages and supports the individual to "self-manage" his/her leisure activities. It begins with a leisure questionnaire-"Individual profile in leisure" (Ouellet & Carbonneau, 1998) that generates a broad picture of the leisure activities done before the stroke, those still pursued, and activities the client wishes to begin. Interest, attitudes, frequency, and motivation regarding leisure and perceived barriers are also evaluated.
Results confirm that the intervention was successful and had the desired effects of enhancing total and physical quality of life. However, the effects appeared to be less important for the level of depression and psychological quality of life.
Chow, Yvette.(2002). Case of an in-home therapeutic recreation program for an older adult in a naturally occuring retirement community (NORC).Therapeutic Recreation Journa,Second Quarter 2002.
The purpose of this case report was to describe the
implementation of an in-home therapeutic recreation (TR) program with a 91-year old female living in a naturally occurring retirement community (NORC) by a fourth-year TR student. Based on the assessment information gathered from the FACTR* and the NORC Therapeutic Recreation Assessment, the goals for Mrs. P targeted fine and gross motor skill improvement, increasing attention span, enhancing self-expression, and increasing selfinitiated interaction with the SRT*. At the end of the eight-week session, the SRT did an exit interview to discuss Mrs. P's feelings about the program. Her comments were, "It made me very happy to have a companion that encouraged and motivated me to do things I had never done before... it made me happy to know I was able to do things despite my age. My time was spent staring into space, and this program kept me occupied.... I like to make things."
2.
Bollin, Salli, Voelkl, Judith E, Lapidos, Carole.(1998).
At-Home Independence Program: A Recreation Program Implemented by a Volunteer. Therapeutic Recreation Journal, First Quarter 1998.
The purpose of this six week, in-home recreation program was to enhance the shared and independent recreation behaviors in the daily lives of the older adult with dementia and his caregiver.
Following the completion of the program, a project staff member asked Mrs. West to evaluate the program in terms of its impact on her knowledge about shared recreation activities, confidence in engaging Mr. West in shared recreation activities, time in shared in activities, degree of enjoyment in shared recreation activities, and Mr. West's time in independent recreation activities. Using a 5 point likert type scale (1 = strongly disagree, 5 = strongly agree), Mrs. West strongly agreed (i.e., "5") that the At-Home Independence Program had a positive impact on each of the five areas rated.
3.
Kunstler, Robin.(2002). Therapeutic recreation in naturally occuring retirement community (NORC): Benefiting "aging in place".
Therapeutic Recreation Journal, Second Quarter 2002.
A case report of an in-home TR program, offered to twelve participants in conjunction with nursing and social services in a NORC, is presented from conceptualization through recommendations.
The participants were also post-tested with the FACTR-type rating scale. Three showed improvements based on a comparison of the pretest and posttest. Ms. S became more articulate and responsive with others, and improved her ambulating and upper extremity manipulation. This may be attributed to her conversations with the student and her dancing to the music provided. Ms. E improved her strength and endurance after participation in exercise, and she improved her thought process and ability to deal with conflict appropriately as a result of the assertiveness training. Ms. P's interventions included arts and crafts to improve fine motor skills, as well as reminiscence to maintain cognitive functioning as observable outcomes.
This comprehensive professional service has the potential to make life-changing impact on quality of life of the older adult who is aging in place.
4.
Kunstler, Robin, Greenblatt, Fred, Moreno, Nereida.(2004)Aromatherapy and Hand Massage: Therapeutic Recreation Interventions for Pain Management .Therapeutic Recreation Journal, Second Quarter 2004 .
All participants were female, reflecting the composition of the residents of the facility. They received one-to-one sessions of aromatherapy and hand massage from a therapeutic recreation specialist.Three of the 4 participants (TS, DF, and AT) showed an immediate response at the initiation of the first intervention phase as indicated by level changes in between these phases (Figures 2-4). These same participants also had magnitude declines during the intervention phases suggesting that aromatherapy and massage was an effective pain management intervention for these participants.
TR can offer participants a choice of relaxation techniques that are carefully planned to increase their level of comfort and sense of control over their pain.
5.
Nour,Kareen, Desrosiers, Johanne, Gauthier, Pierre, Carbonneau,Helene.(2002). Impact of a home leisure educational program for older adults who have had a stroke (home leisure educational program).Therapeutic Recreation Journal, First Quarter 2002 .
To be eligible for the study, participants had to be aged 55 or over, be retired, live less than one hour's drive from the SGUI and not present communication problems or any major cognitive deficit that would make them unable to answer the questionnaires or follow the program
The program encourages and supports the individual to "self-manage" his/her leisure activities. It begins with a leisure questionnaire-"Individual profile in leisure" (Ouellet & Carbonneau, 1998) that generates a broad picture of the leisure activities done before the stroke, those still pursued, and activities the client wishes to begin. Interest, attitudes, frequency, and motivation regarding leisure and perceived barriers are also evaluated.
Results confirm that the intervention was successful and had the desired effects of enhancing total and physical quality of life. However, the effects appeared to be less important for the level of depression and psychological quality of life.
Posted by 休管研二.19318003.黃秋蓉
at October 10,2005 22:27
更正第3篇的文獻內容
3. Li, F., Fisher, K. J., Harmer, P., Irbe, D., Tearse, R. G., Weimer, C. (2004). Tai chi and self-rated quality of sleep and daytime sleepiness in older adults: A randomized controlled trial. Journal of the American Geriatrics Society, 52(6), 892-900.
內容摘要：本研究以太極拳為介入方式，針對118位有中度失眠困擾且日常無活動習慣的老年人（年齡介於60-92歲）進行實驗，參與者貝隨機分至實驗組（太極拳組，每週3次，每次1小時，持續24週）與控制組（低衝擊運動組，包括呼吸、伸展及放鬆，每週3次，每次1小時，持續24週），結果顯示太極拳組老年人的睡眠品質有顯著提昇，而低衝擊運動組織睡眠品質無顯著改變。
4. Yoshida, H., Ishikawa, W., Shiraishi, F., & Kobayashi, T. (1998).Effects of the timing of exercise on the night sleep. Psychiatry and Clinical Neurosciences, 52(2),139-140.
內容摘要：本研究欲探討運動時間點對睡眠品質的影響，以5個無運動習慣的男大學生（21.0 +/- 0.7歲）為對象，其睡眠時間皆為23:30-7:30，在1-3週內完成3種運動時段（ME: 7:40-8:40，EE: 16:30-17:30，LEE: 20:30-21:30）介入，每次1小時的運動需包涵50分鐘的有氧運動和運動前後5分鐘的伸展操，每種運動時段包括3天，第一天為控制日，第二天為運度日，第三天為運動後日。結果顯示晚上運動提昇睡眠品質及減低日常精神不濟的效果比其他時間運動好。
3. Li, F., Fisher, K. J., Harmer, P., Irbe, D., Tearse, R. G., Weimer, C. (2004). Tai chi and self-rated quality of sleep and daytime sleepiness in older adults: A randomized controlled trial. Journal of the American Geriatrics Society, 52(6), 892-900.
內容摘要：本研究以太極拳為介入方式，針對118位有中度失眠困擾且日常無活動習慣的老年人（年齡介於60-92歲）進行實驗，參與者貝隨機分至實驗組（太極拳組，每週3次，每次1小時，持續24週）與控制組（低衝擊運動組，包括呼吸、伸展及放鬆，每週3次，每次1小時，持續24週），結果顯示太極拳組老年人的睡眠品質有顯著提昇，而低衝擊運動組織睡眠品質無顯著改變。
4. Yoshida, H., Ishikawa, W., Shiraishi, F., & Kobayashi, T. (1998).Effects of the timing of exercise on the night sleep. Psychiatry and Clinical Neurosciences, 52(2),139-140.
內容摘要：本研究欲探討運動時間點對睡眠品質的影響，以5個無運動習慣的男大學生（21.0 +/- 0.7歲）為對象，其睡眠時間皆為23:30-7:30，在1-3週內完成3種運動時段（ME: 7:40-8:40，EE: 16:30-17:30，LEE: 20:30-21:30）介入，每次1小時的運動需包涵50分鐘的有氧運動和運動前後5分鐘的伸展操，每種運動時段包括3天，第一天為控制日，第二天為運度日，第三天為運動後日。結果顯示晚上運動提昇睡眠品質及減低日常精神不濟的效果比其他時間運動好。
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at October 11,2005 14:10
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at December 13,2007 05:20
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at December 13,2007 16:29
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at December 15,2007 06:37
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Posted by Halo
at December 15,2007 07:28
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Posted by Jane
at December 15,2007 11:47
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at December 15,2007 11:47
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at December 15,2007 11:58
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at December 15,2007 14:19
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at December 15,2007 19:33
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at December 15,2007 19:33
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at December 15,2007 19:33
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at December 15,2007 19:34
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at December 15,2007 19:34
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at December 15,2007 21:29
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at December 15,2007 21:29
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at December 16,2007 00:16
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at December 16,2007 00:16
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at December 16,2007 02:28
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Posted by Heel
at December 16,2007 03:17
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Posted by Aron
at December 16,2007 04:56
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Posted by Aron
at December 16,2007 04:56
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at December 16,2007 04:56
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at December 16,2007 04:56
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at December 16,2007 08:38
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at December 20,2007 07:56
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at December 20,2007 07:56
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Posted by Dominic
at December 20,2007 07:56