森林療癒與體適能介入活動促進長者心理健康之效益評估

Abstract

高齡化趨勢下長者面臨各方機能退化，尤其心理健康受到的影響，對其自立生活造成威脅，為此，學者鼓勵大眾走進大自然，以接觸自然促進健康的研究應運而生。目前以森林療癒促進長者心理健康的研究，多以提升個體情緒為主，專注於認知功能的研究，尤其於各認知構面的效益仍須學者進一步研究。因此，本文旨在探討應用森林療癒介入於促進長者心理健康的可能性。本研究設計為組間前後測研究(between-subject and pretest-posttest design)，以51位65歲以上、認知功能正常(以蒙特利爾認知評估>23分為納入標準)的長者為研究對象。實驗方法採隨機對照試驗(randomized control trial)，將受試者分為森林療癒組(n=25)與高齡體適能組(n=26)。森林療癒組接受由森林療癒師或相關專業人員帶領以「與自然互動」為主軸，包含認識自然(認知)、連結身體(運動)、連結他人(社交)、認識自我(心理)的多元介入; 高齡體適能組則接受由專業體適能教練帶領有氧運動、核心肌群、功能性體適能等訓練，輔以飲食衛教與居家運動課表的多元介入。成效指標上，以中文版魏氏成人智力測驗第三版(Wechsler Adult Intelligence Scale, WAIS-III)與中文版魏氏記憶量表第三版(Wechsler Memory Scale, WMS-III)檢測認知變化，並以情緒狀態量表(Profile of Mood States, POMS)檢測情緒變化。研究結果顯示，經過2小時/次、共十二週的森林療癒介入，長者於認知功能的智力與記憶力方面均有顯著進步; 而經過2小時/次、共十二週的高齡體適能介入，長者於認知功能的智力與記憶力方面均有顯著進步，並於情緒的「活力-活動」構面有顯著提升。本研究為長者提供了促進心理健康的多元解方，進一步減緩人口老化對社會帶來的巨大衝擊。

As the population ages, elderly individuals face various functional declines, particularly in mental health, which threatens their independent living. Scholars have encouraged people to engage with nature to promote health, leading to research on forest therapy to enhance elderly mental health. Most studies focus on improving emotions, while the impact on cognitive function, especially across different cognitive domains, requires further research. This study aims to explore the potential of forest therapy interventions in promoting the mental health of the elderly. This research employs a between-subject and pretest-posttest design, involving 51 elderly individuals aged 65 and above with normal cognitive function (Montreal Cognitive Assessment score > 23). The study employs a randomized control trial, with participants divided into a forest therapy group (n=25) and a physical fitness group (n=26). The forest therapy group engaged in interactions with nature, led by forest therapists or related professionals, covering cognitive, physical, social, and psychological aspects. The physical fitness group participated in aerobic, core, and functional fitness training led by professional fitness coaches, supplemented by diet education and home exercise plans. Effectiveness was measured using the Chinese versions of the Wechsler Adult Intelligence Scale-III (WAIS-III) and the Wechsler Memory Scale-III (WMS-III) for cognitive changes, and the Profile of Mood States (POMS) for emotional changes. Results showed significant improvements in intelligence and memory for both groups after 2-hour sessions over 12 weeks. Additionally, the physical fitness group showed a significant increase in the "Vigor-Activity" domain of mood. This study offers diverse solutions to promote the mental health of the elderly, potentially mitigating the significant societal impact of population aging.