[[alternative]]Effects of elderly massage intervention on mental health, sleep quality, pain, heart rate variability and meridian energy value of male elderly

[[abstract]]目的：探討高齡按摩手法介入對男性高齡長者心理健康、睡眠品質、疼痛感、心率變異度及經絡能量值之影響。方法：招募44位無按摩習慣的男性高齡長者(年齡91.61± 4.68歲)，以立意取樣方式分成實驗組(n=23)與對照組(n=21)。實驗組進行每週1次、每次30至40分鐘，總共為期8週的按摩介入，對照組則無介入。兩組於實驗前後均進行各項檢測，心理健康以老人憂鬱量表(GDS-SF)評估，得分越高代表憂鬱程度越高。睡眠品質以匹茲堡睡眠品質量表(PSQI)評估，得分越高代表品質越差。疼痛感以「台灣版－簡易疼痛量表」(BPI-T)評估，使用0至10數字等級量尺，測量受測者在某一段時間裡，其疼痛強度及對日常生活的干擾情形，分數越高代表影響程度越高，共有11項指標。心率變異度以多頻道生理訊號記錄儀(TD3)測量，以SDNN為評估指標，數值越高代表自律神經系統的調節狀況較佳。經絡能量值以良導絡分析系統(PHCS-W2013)來測量，計算全身平均能量值，分數較高代表能量狀況較佳。所得資料先以Mann-Whitney U tests及Pearson Chi-Square tests檢視各項指標之同質性，再以Wilcoxon Sign-Rink tests來進行兩組於前後測變化之差異性，顯著差異定為p<0.05。結果：除了疼痛評感估中的1項指標呈顯著差異外，其餘項目在兩組間均具有同質性。經8週高齡按摩手法介入後，在心理健康方面，實驗組的老人憂鬱量表得分顯著降低(p<0.05)，對照組則無顯著差異。在睡眠品質方面，實驗組前後測值分別為6.74 ± 3.60分與5.57 ± 3.19分，呈顯著下降(p<0.05)，而對照組的前後測值分別為7.62 ± 4.14分與8.76 ± 3.42分，達顯著上升(p<0.05)。在疼痛感方面，實驗組共有3項指標分數達顯著下降，對照組則未達顯著差異。在心率變異度方面，實驗組及對照組的前後測均無顯著差異。在經絡能量值方面，實驗組的前後測分別為28.30 ± 4.12分與41.52 ± 7.19分，呈顯著提升(p<0.05)，對照組的前後測分別為30.71 ± 6.17分與30.29 ± 7.36分，無顯著差異。結論：8週高齡按摩手法具有提升男性高齡長者心理健康、提升睡眠品質、減少疼痛感、提升經絡能量值之效益，期望未來能提供運用於居家、社區、長期照顧機構等，照護長者時的健康促進與保健方法之參考。[[abstract]]Purposes: The purpose of this study is to investigate the effects of elderly massage intervention on mental health, sleep quality, pain, heart rate variability (HRV) and meridian energy value of the male elderly. Methods: Forty-four elderly males (aged 91.61 ± 4.68 years) without massage habits were recruited and were divided into the experimental group (EXP, n=23) and the control group (CON, n=21) by purposeful sampling method. The EXP group was given massage intervention once a week for 30 to 40 minutes each time for a total of 8 weeks, while the CON group didn’t receive any intervention. Both groups received several tests before and after the experiment. The mental health, sleep quality and pain indexes of the two groups were assessed by the Geriatric Depression Scale‐Short Form (GDS-SF), Pittsburgh sleep quality Index (PSQI), and Brief Pain Inventory-Taiwan (BPI-T), respectively. HRV was also measured by multi-channel physiological signal recorder (Tele-diagnosis, TD3) by SDNN index. Besides, the meridian energy value was measured by PHCS-W2013. The data were first examined by Mann-Whitney U-tests and Pearson Chi-Square tests for the homogeneity of the indicators, and then the differences of indicators between before and after experiment in the two groups were analyzed respectively by Wilcoxon Sign-Rink tests. The significant difference was set at p < 0.05. Results: All indexes showed homogeneity between the two groups except one of the pain scale indicators. After 8 weeks of elderly massage intervention, in terms of mental health, the scores of depression scale for the EXP group decreased significantly (p < 0.05), but there was no significant difference in the CON group. In terms of sleep quality, the scores of the EXP group were 6.74 ± 3.60 (before) and 5.57 ± 3.19 (after) respectively, showing a significant decrease (p < 0.05), while the scores of the CON group were 7.62 ± 4.14 (before) and 8.76 ± 3.42 (after) respectively, showing a significant increase (p < 0.05). In terms of pain indexes, the scores of three indicators for the EXP group decreased significantly, of which there was no significant difference for the CON group. In terms of HRV, there was no significant difference between before and after experiment in SDNN both in the two groups. In terms of meridian energy value, the scores of EXP group were 28.30 ± 4.12 (before) and 41.52 ± 7.19 (after) respectively, showing a significant increase (p < 0.05), while the scores of the control group were 30.71 ± 6.17 (before) and 30.29 ± 7.36 (after) respectively, showing no significant difference. Conclusions: Eight-week elderly massage can improve the mental health and sleep quality, reduce pain and improve meridian energy value in the male elderly. It is hoped that it can provide a reference for health promotion and health care methods used in home, community and long-term care institutions in the future