The Effects of Music Therapy on Psychological Distress and Functional Recovery in Patients With Stroke

目的：本三年期研究計劃旨在探討中風後多面向心理困擾、變化趨勢及心理困擾與功能 恢復之相關，並探討音樂治療介入對中風後心理困擾與功能恢復之改善成效。 方法：第一年以 140 位中風患者為研究對象，採縱貫性追蹤研究探討中風後二週、一個 月、三個月、六個月、九個月及十二個月心理困擾變化、影響因素及與功能恢復 之相關性，以作為第二、三年介入計畫之參考。研究工具包含：疾病嚴重度 （NIHSS）、社會支持量表、功能獨立量表（Functional Independent Measure, FIM） 及情緒與社會功能障礙量表（Emotional and Social Dysfunction Questionnaire, ESDQ）。第二、三年則採隨機試驗研究設計，針對具情緒與社會功能障礙高危險 性或貝克憂鬱量表評量具輕度憂鬱以上之 189 位中風患者，以區集排列隨機分派 方式將受試者分為：神經性音樂治療組、放鬆音樂治療組與等候治療對照組，以 探討不同音樂治療介入對心理困擾及功能恢復之改善成效；研究工具包含：腦波 訊號（EEG）、功能獨立量表（FIM）、復健參與度及情緒與社會功能障礙量表 （ESDQ）。 結論：研究結果有助於臨床實務更客觀及詳實評估腦中風患者情緒與社會功能障礙問題 及變化，了解不同類型的音樂對於個案生理及心理相關面向的影響差異。

The purposes of the three-year study are: (1) to describe the multidimensional and the trajectory of psychological distress among stroke survivors, and to explore the relationship between the trajectory of psychological distress and functional recovery during one year after stroke, as well as (2) exploring the effectiveness of music therapy on psychological distress and functional recovery among patients with high-risk of emotional and social dysfunction. Methods：The first year study will adopt longitudinal research design to explore the trajectory of psychological distress and functional recovery in two week, one month, three months, six months, nine months, and one year after stroke. The sample size will be 140. Research instruments include the NIHSS (for measuring disease severity), social support questionnaire, Functional Independent Measure (FIM), and Emotional and Social Dysfunction Questionnaire (ESDQ). The second and third year study will use randomized controlled trial to explore the effectiveness of music therapy on psychological distress and functional recovery. The subjects with high risk of emotional and social dysfunction measured by ESDQ or mild, moderate and severe depression subjects measured by Beck Depression Inventory II (BDI-II) will be recruited in this study. A total of 189 eligible subjects will be assigned to neurological music therapy group, relaxation music therapy group and waiting list control group by using block permuted randomization. The sample size will be 63 in each group. Research instruments include the ESDQ, EEG, FIM, and the participation of rehabilitation. Conclusions: Results from this proposed study will have benefits in assessing emotional and social dysfunctional dysfunction more accurately and understanding change patterns of psychological distress and functional status among patients with stroke. Also, the effect of different types of music therapy on psychological distress and functional status will be better understood.