[[alternative]]The Effect of Group-Based Horticultural Therapy Program on the Psychological Health in Type 2 Diabetes Mellitus

[[abstract]]統計顯示全世界約有2.85億的人口為糖尿病的患者，預估到2030年將會增加到4.3億人。而慢性疾病患者常伴隨著憂鬱情結。根據糖尿病與心理健康關係的調查研究顯示，第二型糖尿病患者普遍存在情緒困擾，負面心理狀態嚴重的影響了糖尿病患者的治療依從性和疾病預後。許多研究發現，透過園藝治療活動可以誘發正向情緒、並且增加自我價值及生命意義感，進而改善憂鬱情緒。本論文的最大目的是想藉由園藝治療活動，促進參與者心理健康進而做好自我照顧。本研究針對新北市某教學醫院新陳代謝暨內分泌科門診，共九位第二型糖尿病病患為研究對象，以「糖尿病園藝治療團體方案」同質性小團體的模式，安排每次90分鐘共六週的園藝治療活動。在六週園藝治療活動之後，發現成員在「台灣人憂鬱量表」平均總分由24.44降至5.56，在統計上有顯著的降低意義。台灣人憂鬱量表前後測顯示成員不論在情緒管理、肢體、記憶力、自信心、培養興趣、以及對生命的尊重等，都有顯著差異。由「園藝治療福址效益前後測問卷」、質性回饋、及深入訪談相互印證顯示，成員在情感成長方面，心情愉快、心靈寄託、及成就感之正向情緒，皆具顯著效益。在認知學習方面，園藝知能與嗜好培養的激發也具有顯著的進步。而社交關係方面，拓展並改善與家人社會的溝通表達及互動關係上均獲得改善，且極顯著願意做好自我照顧。因此本研究發現，藉由園藝治療活動可以引發第二型糖尿病病患提升情感成長、認知學習、及社交關係的正向循環並產生交互引動的連鎖效應，而達到促進對生命意義與生心理健康的福祉效益。本研究結果提供日後相關慢性病患者，心理照護上另一個選擇的模式。[[abstract]]There are estimated 285 millions of people suffering from diabetes in the world. The number will be expected increasing to 430 million in 2030. Type 2 diabetes mellitus is a chronic illness usually accompanied with depression. According to many research results, type 2 diabetes mellitus is an established risk factor for the development of depression. Meanwhile, prior researches revealed that horticultural therapy could help patients with chronic disease in psychophysical health. Thus, the main goal of my research tried to use a group-base horticultural therapy as activities to improve the psychological health of patients and take care of their life furthermore. The study was based on “Taiwanese Depression Questionnaire; TDQ”, “The efficacy of horticultural therapy evaluation form”, and qualitative research that were completed before and after 6 weeks of conducting horticultural activities. Nine diabetic patients from a medical center were enrolled in our study. According to TDQ test, the results shown that there was significantly reduction from 24.4 to 5.56 of clients. The emotional management, physical, memory, self-confidence, interesting, and self-esteem of clients were statistically and significantly improved. Our research were also found that the patients had significantly benefits in increasing interests in other things beside works, even feeling relaxed, feeling good about themselves, emotional control, and horticultural skills. However, although no significant difference in their social relation to their families was noted, but improved trend was noted practically. The results of our study suggest that a health care model for people who suffered from chronic illness, especially in their psychological well-being, could be helpful through horticultural therapy activities