[[alternative]]The Effectiveness of Music Fitness Care Program for Elderly in Long-Term Institutions

[[abstract]]背景：我國人口老化推行長期照護政策著重預防及延緩失能，降低社會醫療成本支出，有效且持續性維持健康狀態平衡及延緩功能退化為一重要議題。目的：本研究旨在驗證長照機構老人介入12週音樂體適能照護方案之「體適能」、「憂鬱程度」、「生活品質」有效性。方法：本研究採用類實驗研究，立意取樣兩組前後測量研究設計，針對北部某長期照顧機構老人，共招募55人，全程完成研究共計44人，其中實驗組22人，對照組22人，流失率20%,。實驗組每週進行3次，每次60分鐘，總計12週音樂體適能活動，對照組接受一般照護。兩組皆在介入前、第6週、第12週分別進行老人簡易體適能檢測、老人憂鬱量表(Geriatric Depression Scale, GDS-15)和台灣簡明版世界衛生組織生活品質調查(WHOQOL-BREF Taiwan Version)。收集資料以次數分配、百分比、最大値、最小值、平均數與標準差呈現描述性統計；與曼_惠特尼檢定(Mann-Whitney U test)、卡方(Chi-square Test)、魏氏檢定 (Wilcoxon Signed Rank test)、弗理曼二因子等級變異數分析(Friedman test)、麥內瑪關聯樣本檢定(McNemar's Test )等進行推論性統計。結果：12週音樂體適能照護方案介入後， 「體適能」部分：實驗組30秒屈舉次數提升 (Z=-4.032, P=.000)、抓背距離縮短 (Z=-3.970, P=.000)、坐姿體前彎距離縮短 (Z=-1.890, P=.001)、30秒坐立測試次數增加 (Z=-3.858, P=.000)、兩分鐘踏步次數增加 (Z=-2.549, P=.011)、椅子坐立繞物時間降低 (Z=-3.625, P=.000)，兩組比較30秒屈舉(U =97.50, P=.001)、抓背(U =104.50, P=.016)、30秒坐立測試(U =147.50, P=.025) ，達到顯著差異其中上臂肌力、肩關節柔軟度程度與下肢肌力實驗組進步幅度最大，對照組則無顯著差異；「憂鬱程度」部分：實驗組老人憂鬱量表(Geriatric Depression Scale, GDS-15)平均2.04+1.39分降低到.72+.88分(第12週)，組內三相比較達到顯著差異(χ2=-31.46, P=.000) ，對照組則無顯著差異，兩組比較皆未達到顯著差異；「生活品質」部分：實驗組台灣簡明版世界衛生組織生活品質問卷(WHOQOL-BREF Taiwan Version)整體生活品質(Z=-3.125, P=.002)、生理範疇(Z=-2.956, P=.003)、心理範疇(Z=-3.711, P=.000)、社會關係健康範(Z=-3.205, P=.001)、環境健康範疇 (Z=--3.753, P=.000) 皆提升且達到顯著差異，Mann-Whitney U兩組檢定第12週整體生活品質(U =139.00, P=.012)、生理範疇(U =159.00, P=.050)、心理範疇(U =86.50, P=.000)、社會關係健康範(U =90.50, P=.000)、環境健康範疇(U =150.50, P=.031)皆達到顯著差異，對照組則無顯著差異。結論：透過12週音樂體適能照護方案介入，可有效提昇「體適能」、「憂鬱程度」降低、「生活品質」達到整體性健康，建議未來採用縱貫式研究及加入質性研究，豐富研究結果且更具說服力。[[abstract]]Background: Population aging, our country performance of long-term care policy to prevent and delay disability, to reduce social medical costs, effective and sustained maintenance of health balance and delay of functional degradation is an important issue.Purpose: This research aims to verify the effectiveness of "physical fitness", "depression" and "quality of life" of music fitness care program for elderly in long-term institutions in the 12-week.Methods: The study used the dual group test-retest quasi-experimental research design, and it was assigned to the experimental group and the control group. There are totally 55 people in the experimental group and the control group. There were recruited from a long-term care institution in the north. The total number of studies completed was 44 people. Including to, the intervention group have 22 people respectively and control group have 22 people respectively. The intervention group participate was performed 3 times per week for sixty minutes each section for twelve weeks of musical fitness activities, and the control group received general care.Data were collected with physical fitness test and Geriatric Depression Scale (GDS-15) and the World Health Organization Quality of Life Questionnaire. (WHOQOL-BREF Taiwan Version)as the baseline, sixth week and the twelve week.Results: After the intervention of the twelve weeks music fitness program, the “functional fitness” part: the intervention group increased the number of arm curl in 30 seconds (Z=-4.032, P=.000),and shortened the back scratch (Z=-3.970, P= .000), the Chair sit-and-reach is shortened (Z=-1.890, P=.001), the number of chair stand tests for 30 seconds is increased (Z=-3.858, P=.000),and the number of steps test in two minutes increased (Z=-2.549, P=.011),the 8-fit up-and-go time is reduced (Z=-3.625, P=.000).Two groups compare arm curl in 30 seconds (U = 97.50, P = .001), back scratch (U = 104.50, P=.016), chair stand tests for 30 seconds (U = 147.50, P = .025). Significant differences were achieved in which the upper arm muscle strength, shoulder joint softness degree and lower limb muscle strength intervention group had the greatest progress. The control group showed no significant difference. The "Degree of Depression" part: the Geriatric Depression Scale (GDS-15) decreased from 2.04+1.39 points to .72+.88 points (twelve weeks) in the intervention group. The two groups comparison in the reached a significant difference (χ2=-31.46, P=.000).There was no significant difference in the control group, and no significant difference was found between the two groups. The "Quality of Life" section: Taiwan's concise version of the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF Taiwan Version) overall quality of life (Z = - 3.125, P = .002), physiological category (Z = -2.956, P =. 003), psychological category (Z=-3.711, P=.000), social relationship category (Z=-3.205, P=.001), environmental health category (Z=--3.753, P=.000) are all improved in the intervention group. Mann-Whitney U tested the overall quality of life (U = 139.00, P = .012), physiological category (U = 159.00, P = .050), psychological category (U = 86.50, P = .000), social relationship category (U = 90.50, P = .000) and environmental health (U = 150.50, P = .031). There is all achieve significant differences. There was no significant difference in the control group.Conclusion: Intervention of the twelve week music fitness care program can effectively improve the "Functional Fitness ", "Degree of Depression " and " Quality of Life " to achieve overall health. It is recommended to use longitudinal research and qualitative research in the future to enrich research. The result is more convincingly