• Tidak ada hasil yang ditemukan

第七章 結論與建議 第一節 結論 第一節 結論

第三節 研究建議與限制

一、 本研究以北部單一之醫學中心忍之功能障礙患者為研究對象,故研究結果 無法推論到其他或中小型醫院之患者,建議未來能擴大收案其他醫院。

二、 收案對象散佈在北部各地區,受試者最初對參與意願都很高,由於中老年 人共病性高,且出門大部分需家人陪伴,持續的參與影響因素較高,所以 後續也因路途較遠、無家人陪伴,導致流失率高,而影響研究整體結果。

三、 本研究執行期間僅12週時間較短,對介入之傳統之站樁氣運動,相對時間 較短,若爾後氣功與認知障礙有關之主題,建議增長研究期限,對於認知 及心理健康方面的追縱成效將有更多的結果。

四、 站樁功為中醫養生之氣功,有調息、吐納、穩定情緒、健身之功效,方便 且簡易,若能有效規劃推展個長照或護理機構,提供住民及患者站樁氣功 運動,提升其認知、生理與生活品質。

五、 本研究另一發現在認知功能障礙中老年人,有陪伴者其參與率較高,相對 也會影響整體認知功能的改變,未來可針對此議題進一步探討。

六、 本研究站樁氣功數運動之一,對於認知功障礙中老年人的患者,認知、生 理功能與生理健康,均有正向的結果,建議認知功障礙中老年人及一般老 人均能長期、規律的進行站樁功氣功的運動,預防認知功下降促進身心健 康,未來護理之家或社區銀髮族為探討之對象。

參考文獻

中文部分

王玉芳(2014).意拳養生站樁功.台北市:新潮社文化。

台灣臨床失智症學會(2016).台灣老年人口比例.台灣臨床失智症學會全球資訊 網,http://www.tds.org.tw/ap/index.aspx.

Stermberg,R.J. (2015).認知心理學(第五版)(李玉琇、蔣文祁譯).台北市:雙葉 書廊(原作者出版於2010)

李作英、葉美玲(2005).氣功療法在健康照護上之應用.護理雜誌,52(3),65-70。

何鏡平(2013).王薌齋的大成拳.山西:山西科技技術。

林厚省(2013).氣功學(修訂一版).台北市:新潮社文化。

巫瑩慧、湯麗玉、陳達夫、邱銘章(2007).失智症亞太地區報告.Acta Neurol Taiwan.

許智翔、朱美綺、章美英(2017).八段錦對非何杰金氏症淋巴瘤患者之壓力、生 活品質免疫功能之成效.中西醫結合護理雜誌,25 (4) 1-19.DOI:10.6211 TTCMNA.NO4-2017-01

黃英哲. (2007).氣功運動對生理及心理影響之探討:腦波與心理量表之印證,

運動教練科學,(8). doi:10.6194/SCS。

張東寶(2013).大成拳筑基功.山西:山西科技技術。

傅中玲、陳正生、歐陽文貞、林克能、李光廷、宋惠娟(2015).失智症照護.台 北市:華杏出版機構。

陳真怡、林晏如、翁毓菁、袁素娟 (2015).健走介入對社區慢性病老人體適能 之影響.澄清醫護管理雜誌,11(1),39-42。

戴玉慈, 葉炳強, 黃貴薰, & 羅美芳(1999).住院年老病患的認知功能.台灣醫學, 3(3), 279-286. doi:10.6320/FJM.1999.3(3).03

50

英文部分

Ahlskog, J. E., Geda, Y. E., Graff-Radford, N. R., & Petersen, R. C. (2011). Physical exercise as a preventive or disease-modifying treatment of dementia and brain aging. Mayo Clin Proc, 86(9), 876-884. doi:10.4065/mcp.2011.0252

Alzheimer’s Disease International (2015). World Alzheimer Report 2015: The Global Impact of Dementia.The Global vioce on Dementia.Retrieved from https://

www.alz.co.uk/research/world-report

Brunetti, R., Del Gatto, C., & Delogu, F. (2014). eCorsi: implementation and testing of the Corsi block-tapping task for digital tablets. Front Psychol, 5, 939.

doi:10.3389/fpsyg.2014.00939

Chapman, S. B., Aslan, S., Spence, J. S., Defina, L. F., Keebler, M. W., Didehbani, N.,

& Lu, H. (2013). Shorter term aerobic exercise improves brain, cognition, and cardiovascular fitness in aging. Front Aging Neurosci, 5, 75.

doi:10.3389/fnagi.2013.00075

Carvalho, A., Rea, I. M., Parimon, T., & Cusack, B. J. (2014). Physical activity and cognitive function in individuals over 60 years of age: a systematic review.

ClinInterv Aging, 9, 661-682. doi:10.2147/CIA.S55520.

Cheng, S. T., Chow, P. K., Song, Y. Q., Yu, E. C., Chan, A. C., Lee, T. M., & Lam, J.

H. (2014). Mental and physical activities delay cognitive decline in older persons with dementia. Am J Geriatr Psychiatry, 22(1), 63-74. doi:10.

1016/j.jagp.2013.01.060.

de Paula, J. J., Malloy-Diniz, L. F., & Romano-Silva, M. A. (2016). Reliability of working memory assessment in neurocognitive disorders: a study of the Digit Span and Corsi Block-Tapping tasks. Rev Bras Psiquiatr, 38(3), 262-263.

doi:10.1590/1516-4446-2015-1879

Effect of Baduanjin Exercise on Stress、Quality of Life and Immune Function for

patients with Non-Hodgkin Lymphoma

Ellis, C., Grubaugh, A. L., & Egede, L. E. (2013). Factors associated with SF-12 physical and mental health quality of life scores in adults with stroke. J Stroke Cerebrovasc Dis, 22(4), 309-317. doi:10.1016/j.jstrokecerebrovasdis.2011.

09.007.

Fage, B. A., Chan, C. C., Gill, S. S., Noel-Storr, A. H., Herrmann, N., Smailagic, N.

, . . . Seitz, D. P. (2015). Mini-Cog for the diagnosis of Alzheimer's disease dementia and other dementias within a community setting. Cochrane Database Syst Rev(2), Cd010860. doi:10.1002/14651858.CD010860.pub2

Ferreira, L., Tanaka, K., Santos-Galduróz ,R.F., Galduróz, J.C.(2015).Respiratory training as strategy to prevent cognitive decline in aging: a randomized controlled trial. Clin Interv Aging.10, 593–603.10:593-603. doi: 10.2147 /CIA.S79560.

Gandek, B., Ware, J. E., Aaronson, N. K., Apolone, G., Bjorner, J. B., Brazier, J. E., Sullivan, M. (1998). Cross-validation of item selection and scoring for the SF-12 Health Survey in nine countries: results from the IQOLA Project.

Intern-ational Quality of Life Assessment. J Clin Epidemiol, 51 (11), 1171-1178.

Garcia-Pinillos, F., Cozar-Barba, M., Munoz-Jimenez, M., Soto-Hermoso, V., &

Latorre-Roman, P. (2016). Gait speed in older people: an easy test for detecting cognitive impairment, functional independence, and health state.

Psychogeriatrics, 16(3), 165-171. doi:10.1111/psyg.12133.

Huang, G., Shi, X., Davis-Brezette, J. A., & Osness, W. H. (2005). Resting Heart Rate Changes after Endurance Training in Older Adults: A Meta Analysis .Medicine

& Science in Sports & Exercise, 37(8), 1381-1386. doi:10.1249/01.mss.

0000174899.35392.0c.

Jeczminska, K., Kozmin, A., Krawiec, A., Jarnot, J., Dusik, J., Piwowarczyk, A., Krupka-Matuszczyk, I. (2008). Cognitive functions in patients with

schizophrenia and their correlation with anxiety. European Psychiatry, 23, S121-S122. doi:10.1016/j.eurpsy.2008.01.808.

Kemp, C. A. (2004). Qigong as a therapeutic intervention with older adults. J Holist Nurs, 22(4), 351-373. doi:10.1177/0898010104269313.

Kessels, R. P., van Zandvoort, M. J., Postma, A., Kappelle, L. J., & de Haan, E. H.

(2000). The Corsi Block-Tapping Task: standardization and ormative data. Appl Neuropsychol, 7(4), 252-258. doi:10.1207/s15324826an0704_8.

Kuo, T. A., Lin, C. J., Li, B. S., & Chang, S. L.(2012).Association of Cognitrone Visual Pursuit Abilities and Tachistoscopic Traffic Responses among Ages for Bus Drivers.

Ladawan, S., Klarod, K., Philippe, M., Menz, V., Versen, I., Gatterer, H., & Burtscher, M. (2017). Effect of Qigong exercise on cognitive function, blood pressure and cardiorespiratory fitness in healthy middle-aged subjects. Complement Ther Med, 33, 39-45. doi:10.1016/j.ctim.2017.05.005

Lan, C., Lai, J. S., Chen, S. Y., & Wong, M. K. (2000). Tai Chi Chuan to improve muscular strength and endurance in elderly individuals: a pilot study. Arch Phys Med Rehabil, 81(5), 604-607.

Lange, M., Rigal, O., Clarisse, B., Giffard, B., Sevin, E., Barillet, M., . . . Joly, F.

(2014). Cognitive dysfunctions in elderly cancer patients: a new challenge for oncologists. Cancer Treat Rev, 40(6), 810-817. doi:10.1016/j.ctrv.2014.03.003 Lee, J. E., Kim, K. W., Paik, N. J., Jang, H. C., Chang, C. B., Baek, G. H., . . . Gong, H. S. (2012). Evaluation of factors influencing grip strength in elderly koreans.

J Bone Metab, 19(2), 103-110. doi:10.11005/jbm.2012.19.2.103.

Lee M.S., Huh H. J., Jeong S. M., Jang H. S., Ryu H., Park J.-H., Chung H.T., Woo W.

H.(2003) Effects of Qigong on immune cells. The American Journal of Chinese Medicine,Vol. 31, No. 2, 327–335.

Liang, K. Y., & Zeger, S. L. (1986). Longitudinal analysis using generalized linear models. Biometrika, 73, 13–22

Litscher, G., Wenzel, G., Niederwieser, G., & Schwarz, G. (2001). Effects of QiGong on brain function. Neurol Res, 23(5), 501-505. doi:10.1179/0161641011011 98749

Manuello, J., Vercelli, U., Nani, A., Costa, T., & Cauda, F. (2016). Mindfulness meditation and consciousness: An integrative neuroscientific perspective.

Conscious Cogn, 40, 67-78. doi:10.1016/j.concog.2015.12.005

Matos, L. C., Sousa, C. M., Goncalves, M., Gabriel, J., Machado, J., & Greten, H. J.

(2015). Qigong as a Traditional Vegetative Biofeedback Therapy: Long-Term Conditioning of Physiological Mind-Body Effects. Biomed Res Int, 2015, 531789. doi:10.1155/2015/531789.

Metter, E. J., Conwit, R., & Fozard, L. J. (1997). Age-Associated Loss of Power and Strength in the Upper Extremities in Women and Men. Journal of Gerontology:

BIOLOGICAL SCIENCES,52A, No. 5, B267-B276.

Michele , I. S., Karen, M. P., & Anne, M. K. (2002). Prevalence of sarcopenia and predictors of skeletal muscle mass in healthy, older men and women. J Gerontol A Biol Sci Med Sci, 57(12), M772-777.

Miller, L. A., McIntire, S. A., & Lovler, R. L. (2011). Foundations of psychological testing: A practical approach(3rd ed.). Thousand Oaks, CA: Sage Publication.

Miller, S. M., & Taylor-Piliae, R. E. (2014). Effects of Tai Chi on cognitive function in community-dwelling older adults: a review. Geriatr Nurs, 35(1), 9-19. doi :10.1016/j.gerinurse.2013.10.013

Rantanen, T., Guralnik, J. M., Foley, D., Masaki, K., Leveille, S., Curb, J. D., & White,

54

L. (1999). Midlife hand grip strength as a predictor of old age disability. Jama, 281(6), 558-560.

Roberta ,E.R.,& Jones, C.(1998)The reliability and validity of a 6-minute walk test as a measure of physical endurance in older adults. Joural of Aging and Physical Activity,6.363-375.

Tanigawa, T., Takechi, H., Arai, H., Yamada, M., Nishiguchi, S., & Aoyama, T. (2014).

Effect of physical activity on memory function in older adults with mild

Alzheimer's disease and mild cognitive impairment. Geriatr Gerontol Int, 14(4), 758-762. doi:10.1111/ggi.12159

Tsai, Y.-K., Chen, H.-H., Lin, I.-H., & Yeh, M.-L. (2008). Qigong improving physical status in middle-aged women. Western Journal of Nursing Research, 30(8), 915-927.

Tsang, H. W. H., Tsang, W. W. N., Jones, A. Y. M., Fung, K. M. T., Chan, A. H. L., Chan, E. P., & Au, D. W. H. (2013). Psycho-physical and neurophysiological effects of qigong on depressed elders with chronic illness. Aging & Mental Health, 17(3), 336-348. doi:10.1080/13607863.2012.732035.

Tse, A. C., Wong, T. W., & Lee, P. H. (2015). Effect of Low-intensity Exercise on Physical and Cognitive Health in Older Adults: a Systematic Review. Sports Med Open, 1(1), 37. doi:10.1186/s40798-015-0034-8.

Tseng, C. N., Gau, B. S., & Lou, M. F. (2011). The effectiveness of exercise on improving cognitive function in older people: a systematic review. J Nurs Res, 19(2), 119-131. doi:10.1097/JNR.0b013e3182198837

Ware, J., Jr., Kosinski, M., & Keller, S. D. (1996). A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity.

Med Care, 34(3), 220-233.

Wen, C. P., Wai, J. P. M., Tsai, M. K., Yang, Y. C., Cheng, T. Y. D., Lee, M.-C., . . .

Wu, X. (2011). Minimum amount of physical activity for reduced mortality and extended life expectancy: a prospective cohort study. The Lancet, 378(9798), 1244-1253.doi:10.1016/s0140-6736(11)60749-6.

Wong, A. M., Lin, Y. C., Chou, S. W., Tang, F. T., & Wong, P. Y. (2001). Coordination exercise and postural stability in elderly people: Effect of Tai Chi Chuan. Arch Phys Med Rehabil, 82(5), 608-612. doi:10.1053/apmr.2001.22615

56

Dokumen terkait