| Summary: | 碩士 === 國立陽明大學 === 臨床護理研究所 === 91 === The purpose of this research was to investigate the effects of Montessori-based activities on the agitation levels of institutionalized elderly with dementia. A quasi-experimental design was used. Sixty-seven elderly were chosen from dementia special care unit of two veteran homes and assigned to experimental groupⅠ(group Montessori-based activities), experimental groupⅡ(individual Montessori-based activities) and a control group. Based on their scores on the Mini Mental State Exam (MMSE), all subjects in each experimental group received the appropriate group or individual Montessori-based activities three days a week for a three months period. Each activity session included four categories providing sensory-stimulation, procedural movement exercise, memory training, and social interaction. The control group received their regular daily activity programs without the experimental intervention. Fifty-three subjects completed the program, giving a 18.5% dropout rate. The indicators used to determine the effects of Montessori-based activities included scores from the Cohen- Mansfield agitation inventory, records of agitation during activities, the level of patient care difficulty, and the positive emotions and the engagement behaviors noted during activities. SPSS/Windows version 10.0 was used to analyze all obtained data. Results showed the mean differences of the Cohen-Mansfield agitation inventory between pre-and post test in the two experimental groups were significant less than that in the control group. Experimental groupⅠshowed significant decreases aggressive behavior and physically non-aggressive behavior. Experimental groupⅡ showed a significant decreases physically non-aggressive behavior. During Montessori-based activities session, both the experimental groups exhibited significant decreases in the frequency of agitation and experimental groupⅡshowed significant decreases in aggressive behavior. Following Montessori-based activities, experimental groupⅠhad higher positive emotions score and both experimental group had elicited significantly greater levels of social engagement behaviors. There was no significant difference in the care difficulty score among the three groups. Only the duration of living in the institution was positively correlated with the caring difficulty change score at a significant level. No correlations of any significance were found among the effects of intervention and other demographic variables. This was a pilot study investigating the usefulness of the Montessori-based activities on institutionalized elderly with dementia in Taiwan. Although further research is recommended to better understand the potentials of Montessori-based activities, results indicate that caregivers providing Montessori-based activities for demented elderly would be beneficial.
Key words：dementia, agitation, long-term care facilities, activities programming,theory of Montessori.
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