探討音樂生命回顧課程對社區高齡者自我統整之影響

Abstract

臺灣以極快的速度邁入高齡時代，人口老化對國家經濟和醫療所造成的社會結構問題不容小覷，越來越多人關注高齡者的身心健康；本研究旨在探討音樂生命回顧課程對於社區高齡者自我統整的影響，採用質性研究之參與觀察法和深度訪談法，以受託於臺北市中山區某日間照顧中心的社區高齡者為研究對象，招募男性4位、女性8位共12位參與者，在2021年2月23日至4月月13日進行每週一次一小時，共八週的音樂生命回顧課程，過程中採完全參與式觀察集行資料收集，以探索音樂生命回顧課程中所觸動的生命事件內涵；再輔以深度訪談法了解課程對參與者自我統整的影響。研究結果發現音樂生命回顧課程在專業人員的引導下，可系統化的喚起參與者在不同生命階段中所發生的人、事、物，並進行一定程度的反思與評值；在計畫性的安排音樂與活動搭配下，音樂具有「引導」的功能，能夠與參與者的生命連結，勾起深層回憶並產生共鳴；最後在自我統整的結論是(一)需適應家庭角色的維持與轉變，喪偶迫使角色失衡需靠時間調適、(二)分化與創造多元社會的角色、培養興趣有利於老化適應、(三)關注身體的改變繼而努力維持自尊、(四)過度關注身體改變容易產生悲觀絕望的想法、(五)活動參與幫助重拾能力，找到自我存在的價值、(六)統整生命中的成就與失落，並延續對家庭、社會的關懷、(七)面對或逃避死亡的態度不一。研究建議未來研究對象可以增列不同照護需求的高齡者進行更深入的剖析，並關注課程其他面向的效益、搭配相關心理健康量表進行質量混合研究以獲取更確實之證據；在音樂團體帶領實務上，建議可以事先與參與者建立專業關係、延長活動時數、週數、限制人數以及使用舊物做輔助，強化活動內涵更能達到目標。As Taiwan’s older population grows dramatically, which affects social representation of national economics and medical care, as a result, more and more people care about physical and mental health of the elderly. This qualitative study explored the effects of a music life review program on ego-integrity of the community dwelling elderly through participant observation and in-depth interview. The study recruited 4 males and 8 females in total 12 participants of the community dwelling elderly people at a day care center in the Zhongshan district of Taipei. They participated in the program conducted once a week, and one hour for a session for total 8 sessions from February 23 to April 13, 2021. The researcher explored the meaning of life events inspired by a music life review program by participant observation and understood the effects of sessions on ego-integrity of the community dwelling elderly by in-depth interview. The results revealed a music life review program with professional leading triggers participants to review and evaluate every things happened in different life stage systematically. With designed music activities, music is a guide to trigger participants’ past memory connecting with their life events. The results of ego integrity are as follows:1. They need to adapt transition of family role, and it takes time when losing their love.2. They did something good for society, and developed interests for their ego-integrity in later life.3. Even they focus on physically deteriorating, they maintained self-esteem hard.4. Paying too much attention to physically deteriorating will cause depression.5. With participating the program, they can create and maintain self-esteem.6. They reviewed their achievements and disappointment in their life, and cared about family and society continuously.7. They held different views of death.For further research, this study suggests that researchers can dissect the study deeply by selecting the elderly having different needs for care as subjects and explore the effects of other factors with the mental health scale for accurate data in mixed methods. The professionals could build relationships with participants first, extend session times and limit the number of participants while conducting a program.