本研究綜合研究者在精神科實習期間對失智症防治之經驗與觀察、及研究者以藝術治療服務認知減退年長族群之經驗，形成研究者對輕度知能減退（MCI）患者進行藝術治療介入性研究之動機。

研究目的為（1）參與藝術治療活動與否之MCI患者背景資料之比較，（2）比較參與藝術治療活動與否對MCI患者智能評估之成效，（3）比較參與藝術治療活動與否對MCI患者憂鬱情緒狀態之成效，（4）比較參與藝術治療活動與否對MCI患者工具性日常生活活動功能之成效。

本研究採立意取樣不等組前後測實驗設計。以藝術治療為主要介入策略，探討長期照顧機構中59位65歲以上，患有輕度知能減退之住民在十六週治療活動介入後，其整體認知功能之變化。

研究結果藝術治療對輕度知能減退患者整體認知功能成效為（1）針對智能項目評估有顯著效益，特別是語言能力分數。而其他分項分數，包括定向力、短期記憶能力，則有明顯進步；（2）針對憂鬱情緒狀態，有改善但未達顯著效益；（3）針對工具性日常生活活動能力分數，有提升但亦未達顯著效益。

盼望此研究結果能成為失智症防治策略暨未來藝術治療在與類似族群工作之參考。

This research was inspired by a systematic training program in which the researcher participated, the experience and research towards the prevention and treatment of dementia patients during the researcher’s internship in a psychiatric ward, and the researcher’s experience of using art therapy whilst working with a group of senior citizens who have cognition impairment.
The goal of this research is（1）the background data comparison of MCI patients with and without participation in art therapy activities，（2）a comparison of whether participation in art therapy activities has an effect on the cognition assessment of MCI patients，（3）a comparison of whether participation in art therapy activities has an effect on the depression status of MCI patients，（4）a comparison of whether participation in art therapy activities has an effect on the Lawton’s IADL of MCI patients.
The purpose of this research is to use art therapy activities as the main intervention treatment, to see the change of the overall cognitive functions of a control group over a period of sixteen weeks. This control group consists of 59 residents of a nursing home. These residents are aged 65 years old and over and have mild cognitive impairment.
The results of this research demonstrate（1）a significant improvement in the overall cognition assessment areas, especially in language, and an improvement in other sub-areas including time and space orientation and short term memory,（2）an improvement in the depression status, and（3）improvement in the Lawton’s IADL score.
The researcher wishes that this research will provide an alternative strategy for both the prevention and treatment of dementia groups, and the use of art therapy to work with similar groups.

第一章 緒論…………………………………………………………1
第一節 研究動機……………………………………………………1
一、 緣起………………………………………………1
二、 年長族群認知疾患議題……………………………………2
三、 藝術在失智症治療中所扮演之角色………………………3
四、 年長者藝術治療之本土經驗………………………………4
五、 藝術治療與失智症早期介入之嘗試………………………5
第二節 研究目的與待答問題………………………………………7
一、 研究目的……………………………………………………7
二、 待答問題……………………………………………………8
第三節 名詞釋義……………………………………………………8
一、 藝術治療……………………………………………………8
二、 輕度知能減退………………………………………………9
三、 整體認知功能………………………………………………9
第二章 文獻探討……………………………………………………11
第一節 藝術治療之理論背景………………………………………11
一、 藝術治療之意義與發展……………………………………11
二、 藝術治療之取向……………………………………………15
三、 藝術治療中有關媒材使用與活動設計之理論……………20
第二節 輕度知能減退之臨床意義…………………………………40
一、 輕度知能減退之發展………………………………………40
二、 MCI之意義…………………………………………………42
三、 MCI與失智症預防之關聯…………………………………46
第三節 藝術治療在老年族群的應用………………………………49
一、 老年族群議題………………………………………………50
二、 老年藝術治療特質…………………………………………52
三、 老年藝術治療要點…………………………………………61
第三章 研究方法……………………………………………………64
第一節 研究設計……………………………………………………64
第二節 研究對象……………………………………………………65
一、 研究對象來源………………………………………………66
二、 研究對象特質………………………………………………68
第三節 研究工具……………………………………………………68
一、 基本資料收集………………………………………………69
二、 簡短式智能評估量表（MMSE）……………………………69
三、 老年憂鬱量表（GDS）…………………………………… 72
四、 工具性日常生活活動量表（Lawton’s IADL）……… 73
第四節 藝術治療活動設計………………………………………… 73
一、 活動時間…………………………………………………… 74
二、 活動地點…………………………………………………… 74
三、 活動內容…………………………………………………… 74
第五節 研究程序…………………………………………………… 75
一、 「實驗處理前」階段……………………………………… 77
二、 「實驗處理」階段………………………………………… 78
三、 「實驗處理後」階段……………………………………… 79
第六節 資料處理和分析…………………………………………… 79
一、 資料收集和分析…………………………………………… 79
二、 資料分析…………………………………………………… 80
第四章 研究結果與討論…………………………………………… 81
第一節 參與藝術治療活動與否MCI患者背景資料之比較……… 81
一、 數值資料比較………………………………………… ……81
二、 類別資料比較……………………………………………… 85
第二節 比較參與藝術治療活動與否對MCI患者智能評估之成效…………………………………………………………………………92
一、 實驗組與對照組智能評估改變情形……………………… 92
二、 實驗組與對照組智能評估各分項分析探討……………… 94
三、 實驗組與對照組智能評估改變之意義…………………… 98
第三節 比較參與藝術治療活動與否對MCI患者憂鬱情緒狀態之成效…………………………………………………………………………100
一、 兩組實驗前後GDS平均分數比較……………………………100
二、 實驗組於實驗前後其GDS平均分數比較……………………101
三、 對照組於實驗前後其GDS平均分數比較……………………101
第四節 比較參與藝術治療活動與否對MCI患者工具性日常生活活動功能之成效……………………………………………………………………………102
一、 兩組於實驗前後IADL平均分數比較…………………………102
二、 實驗組IADL前、後測平均分數自己比較……………………103
三、 對照組IADL前、後測平均分數自己比較……………………104
第五節 綜合分析與討論…………………………………………… 105
一、 MCI患者智能評估分析探討……………………………………105
二、 MCI患者情緒狀態分析探討……………………………………106
三、 MCI患者工具性日常生活活動功能分析探討…………………107
第五章 結論與建議………………………………………………………109
第一節 結論………………………………………………………………109
一、 參與藝術治療活動與否對MCI患者智能評分之影響…………109
二、 參與藝術治療活動與否對MCI患者憂鬱情緒狀態之影響……113
三、 參與藝術治療活動與否對MCI患者憂鬱情緒狀態之影響……113
第二節 建議………………………………………………………………114
一、 臨床實務建議……………………………………………………115
二、 研究設計建議……………………………………………………117

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