| 摘要: | 背景:情緒及睡眠障礙一直是機構老人常見問題，失眠會導致白天精神疲倦，情緒起伏，也會影響專注力及生活功能，而長期失眠，更容易加劇內科疾病之嚴重度或引發憂鬱症的可能性。研究證實光照對於憂鬱及睡眠均有顯著影響，但文獻查證未有提出何種色溫、照度及時間，對於老年人的憂鬱及睡眠是有效的，故探討老年人合適的光照治療模式是本次研究的主要目的。另外，過去因受限於桌立式光源需固定姿勢，頭戴式光源外觀會造成受試者不適應，故本研究計畫將使用固定光源，並以手機APP設定照光強度及時間，於早晨使用高色溫高光照強度，隨著時間變化，慢慢調整成晚上低色溫低光照強度，並運用量表及儀器(腦波儀及腕動計)來評估受試者的睡眠及憂鬱改善程度，期待透過此次研究，可找出老年人的光照模式，並將光照治療推廣於各醫療院所及長照機構中。
目的:運用光照療法為介入方案，探討光照療法對於長照機構老人憂鬱及睡眠品質改善成效。
方法:本研究以意識清楚、無精神疾患且符合CPSQI大於5分以上、CES-D大於16分的長照機構老人為研究對象。以光照療法為介入措施，實驗組連續光照14天，對照組則以一般光照為主，使用中文版匹茲堡睡眠品質量表(CPSQI)、流行病學研究中心憂鬱量表(CES-D)，收集前測、介入14天後(後測一)、介入28天後(後測二)共3次資料分析。以CES-D為主觀憂鬱指標、CPSQI為主觀睡眠品質指標，與腦波儀、腕動計收集的睡眠參數進行分析，以廣義估計方程式(Generalize Estimating Equation,GEE)分析組別與時間交互作用，探討光照療法對長照機構老人的憂鬱及睡眠成效。
結果:實驗組與對照組相比較，實驗組在憂鬱、睡眠品質、腦波儀睡眠品質及腕動計睡眠參數(睡眠效率SE、睡眠總時數TST、醒來再入睡WASO、睡眠潛伏期SL)，於光照治療介入結束後均達統計顯著改善。
結論:光照療法可有效改善長照機構老人憂鬱程度及睡眠品質，可提供做為照護策略及參考。
Background: Mood and sleep disorders have always been a common problem for the elderly in institutions. Insomnia can lead to daytime mental fatigue, emotional ups and downs, and also affect concentration and life functions. Long-term insomnia is more likely to aggravate the severity of medical diseases or lead to the possibility of depression. Studies have confirmed that light has a significant effect on depression and sleep, but the literature review has not suggested which color temperature, illuminance and time are effective for depression and sleep in the elderly. Therefore, this study is to explore the appropriate light therapy mode for the elderly. the main purpose of.
Purpose: Using light therapy as an intervention program, to explore the effect of light therapy on depression and sleep improvement of elderly people in long-term care institutions.
Methods: This study selected elderly people in long-term care institutions with clear consciousness, no mental disorders, and with CPSQI greater than 5 points and CES-D greater than 16 points. Using light therapy as an intervention measure, the experimental group received continuous light for 14 days, while the control group received general light. A total of 3 data analyses were performed, including pre-test, 14 days after intervention (post-test 1), and 28 days after intervention (post-test 2). Using CES-D as subjective depression index and CPSQI as subjective sleep quality index,the sleep parameters collected by electroencephalography and wrist actimetry were analyzed, and the interaction between group and time was analyzed by Generalize Estimating Equation (GEE). To investigate the effects of light therapy on depression and sleep in elderly people in long-term care institutions.
Results: Compared with the control group, the experimental group showed depression, sleep quality, EEG sleep quality, and wrist actimetry sleep parameters (sleep efficiency SE, total sleep time TST, WASO after waking up, and sleep latency SL). Statistical significance was reached after phototherapy intervention.
Conclusion: Light therapy can effectively improve the depression and sleep quality of the elderly in long-term care institutions, and can be used as a nursing strategy and reference. |
