摘 要
青少年睡眠障礙是一個全球性的公共衛生問題，不僅會影響學校成績，還會導致各種身體或精神障礙。失眠也被確定為大學生自殺念頭和行為的預測因素。彼拉提斯可有效改善睡眠質量，有益於睡眠障礙參數的學生，然而目前缺乏對失眠青少年族群的成效探討。本研究想驗證短期的墊上彼拉提斯運動對五專護理學生焦慮和睡眠質量的影響。採混合雙組前後測，以台灣南部的兩所護理學校專科學校進行非隨機準實驗設計，篩選有失眠且願意參與者，以N校為實驗組 (19人)，M校當對照組 (15人)。實驗組參加六次小組彼拉提斯課，每次 50 分鐘，對照組無額外的介入。一題開放性問題，以及兩組焦點訪談收集質性資料，並以主題分析取得本介入活動的可行與成效。參與者大多數是女性 (94.1%)，兩組實驗組平均年齡為16.40 歲，控制組為16.63 歲。實驗組8成學生參加 4次課程。失眠得分於後測和追蹤測時有顯著的組別與時間的交互作用 (p <, 新細明體,'Times New Roman';font-family:'新細明體',serif,'Times New Roman'">。焦慮得分上，在追蹤測時實驗組有繼續下降，但兩組前後測與追蹤測驗均無顯著差異。焦點訪談後的逐字稿以主題分析出三個主題，分別為「以呼吸理心情」、「建構身體知識」、「能反思調整」。本研究發現墊上彼拉提運動對失眠的護專青少年初步顯示有短期持續成效，然而樣本數、流失與群集效應，需謹慎推論。建議未來擴大招募有睡眠障礙的護專生，施以實體線上混成介入的彼拉提斯運動，採配戴式的睡眠生理監測儀以驗證對睡眠改善的成效。
關鍵詞：青少年、失眠、焦慮、彼拉提斯
Abstract
Sleep disturbance among adolescents is a global public health concern, affecting academic performance and increasing the risk of physical and mental health disorders. Insomnia has also been identified as a predictor of suicidal ideation and behaviors among college students. Previous studies suggest that Pilates exercise may improve sleep quality and duration; however, its feasibility and effectiveness have not been sufficiently examined in adolescents with insomnia. This study aimed to develop and evaluate the effects of a brief, mat-based Pilates program on anxiety and sleep quality among junior nursing college students with insomnia. A quasi-experimental design was conducted at two junior colleges of nursing in southern Taiwan, involving 34 students who reported recent insomnia symptoms. Eligible participants were purposely assigned to either an intervention group (n = 19) or a control group (n = 15). The intervention group participated in six weekly group Pilates sessions, each lasting 50 minutes and conducted at a moderate intensity, while the control group received no additional exercise intervention. Most participants were female (94.1%), with a mean age of 16.40 years in the intervention group and 16.63 years in the control group. Approximately 80% of participants attended at least four Pilates sessions. Mixed‑effects analysis revealed significant group‑by‑time interactions for insomnia symptoms at posttest and follow‑up (p < .05), whereas no significant effects were observed for anxiety. Qualitative analysis of focus‑group transcripts identified three central themes: practicing breathing for mental calm, embodied knowledge, and reflection and self‑regulation. Overall, the findings highlight the feasibility of implementing a six‑week, school‑based Pilates program and indicate short‑term sustained improvements in insomnia symptoms among junior nursing college students. Nevertheless, the results should be interpreted with caution due to cluster effects and participant attrition. Future research should expand participant recruitment, explore hybrid Pilates interventions combining in‑person and online formats, and incorporate wearable sleep‑monitoring devices to more precisely evaluate intervention outcomes.
Keywords: Adolescent, Insomnia, Anxiety, Pilates