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系統識別號 U0026-1612201403021900
論文名稱(中文) 喜愛音樂對腦外傷患者口語記憶損傷之影響
論文名稱(英文) Effects of Pleasant Music on Verbal Memory in Patients with Traumatic Brain Injury
校院名稱 成功大學
系所名稱(中) 職能治療學系
系所名稱(英) Department of Occupational Therapy
學年度 103
學期 1
出版年 103
研究生(中文) 高琪鈞
研究生(英文) Chi-Chun Kao
學號 T76011018
學位類別 碩士
語文別 中文
論文頁數 102頁
口試委員 指導教授-蔡佩倫
口試委員-林克忠
口試委員-黃鈺婷
口試委員-李榮順
口試委員-馬慧英
中文關鍵字 音樂  腦外傷  口語記憶  功能性表現 
英文關鍵字 music  traumatic brain injury  verbal memory  functional outcome 
學科別分類
中文摘要 口語記憶損傷是腦外傷患者中最常見的後遺症之一,會對其日常生活、工作與社會角色造成影響,但迄今卻少有研究針對腦外傷患者之口語記憶缺失及其功能性表現進行相關探討,且此重要問題在臨床介入中亦經常被忽略。由於聆聽音樂在近年來已成為腦傷患者之認知復健的新興療法之一,但支持聆聽喜愛音樂對腦外傷患者記憶功能之效益的相關研究仍十分有限。根據情緒與警醒度假說(mood and arousal hypothesis)以及正向情緒之擴建理論(the broaden-and-building theory)的主張,聆聽喜愛音樂能夠誘發正向情緒並提升警醒度,可能可以進而改善其記憶表現。故本研究之目的首先為依照世界衛生組織之國際健康功能與身心障礙分類系統(International Classification of Functioning, Disability and Health),檢驗腦外傷患者之口語記憶損傷對其活動與參與兩層級之功能性表現的關聯性,其次則探討自選之喜愛音樂對腦外傷患者之口語記憶的影響。本研究採受試者內重複量測設計,共招募20位腦外傷患者,主要以聽覺口語學習測驗(Rey Auditory Verbal Learning Test)和d2注意力測驗檢驗患者在兩種不同情境(包括安靜與自選之喜愛音樂)中的口語記憶和注意力的表現;並以視覺類比刻度尺評量患者由音樂所引發之主觀情緒和警醒度的反應。此外,患者在安靜情境下另需完成行為記憶測驗第三版 (Rivermead Behavioural Memory Test-3)和日常記憶問卷 (Everyday Memory Questionnaire-13)分別評量其客觀與主觀的日常記憶功能(活動層級),以及延伸板格拉斯哥預後量表(Glasgow Outcome Measure-Extened)與腦外傷生活品質量表(Quality of Life after Brain Injury)評量其日常生活功能及生活品質(參與層級)。研究結果顯示,患者的口語記憶確有缺失,特別是在登錄歷程方面,並與其活動層級中之客觀的日常記憶表現達顯著相關。此外,患者在聆聽喜愛音樂之情境下,其口語記憶及注意力表現顯著優於安靜情境下的表現,但對其情緒及警醒度則無造成顯著影響。本研究的結果除支持腦外傷患者之口語記憶損傷主要影響其活動層級的表現外,並對聆聽喜愛音樂對腦外傷患者之口語記憶表現的效益提供初步的臨床實證,可協助臨床治療師對腦外傷患者發展有效的個別化治療策略,以提升其日常活動的功能。
英文摘要 The purposes of this study are, first, to examine the relationship between verbal memory impairments and functional outcomes in patients with TBI; and second, to investigate the effects of listening to pleasant music on the verbal memory in patients with TBI. In this within-subject repeated-measured study, 20 patients with TBI were recruited and their memory, attention, arousal level, and mood were separately tested under two conditions (pleasant music and silence) within one week. In addition, all patients were administered functional assessments. Results revealed that participants’ verbal memory and encoding process were significantly correlated to objective everyday memory in activity level. Besides, compared with silent condition, participants performed significantly better on tests of verbal memory and attention, but no significant effects on arousal level and mood were found. The findings first provide evidence that verbal memory impairments and encoding process deficits in patients with TBI are correlated to their functions of activity level, and suggest that listening to pleasant music offers a promising addition to the rehabilitation of patients with TBI and to enhance their daily functions.
論文目次 中文摘要i
英文延伸摘要iii
致謝x
目錄xi
表目錄xiv
圖目錄xv
第一章緒論1
第一節、研究動機1
第二節、研究目的4
第二章文獻回顧5
第一節、腦外傷患者概述5
第二節、腦外傷患者之記憶損傷7
壹、記憶損傷之類型7
貳、記憶歷程損傷11
參、腦外傷患者之記憶損傷與功能性表現之相關性15
肆、腦外傷患者記憶損傷之現行療法17
第三節、喜愛音樂與記憶訓練21
壹、音樂於復健治療之應用21
貳、喜愛音樂與認知功能23
參、相關理論與神經機制24
第四節、喜愛音樂應用於腦傷族群之記憶復健的相關研究26
第五節、文獻回顧總結29
第三章研究方法31
第一節、研究對象31
第二節、研究工具32
壹、基本資料表及篩檢工具32
貳、評估工具33
第三節、研究設備38
壹、音訊設備38
貳、喜愛音樂類型38
第四節、研究程序39
第五節、資料分析40
第四章研究結果41
第一節、人口學資料及各項測驗結果分析 41
第二節、口語記憶與功能性表現之相關性分析46
第三節、聆聽喜愛音樂對口語記憶之效益分析48
第五章討論52
第一節、腦外傷患者之口語記憶及記憶歷程損傷情形53
第二節、腦外傷患者之口語記憶損傷及功能性表現的相關性56
第三節、聆聽喜愛音樂對口語記憶之影響65
第四節、臨床應用及研究限制70
第六章、結論73
參考文獻74
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