背景：青少年在成長階段將面臨多種的壓力源，壓力調適的能力不足，可能導致成年後的生理或心理健康出現危害，甚而會有問題行為產生。漸進式肌肉鬆弛及深呼吸放鬆技巧已經證實對青少年心理層面的壓力紓解、憂鬱或焦慮的改善，有輕到中等程度的成效。過去研究發現，在漸進式肌肉鬆弛及深呼吸放鬆技巧的介入，所選擇的心理神經免疫學相關之生心理成效指標非常迥異，漸進式肌肉鬆弛及深呼吸放鬆技巧對相關生心理成效指標所產生的影響，仍有待釐清。且上述兩種介入，若以心理神經免疫學相關的生理指標作為成效探討，多數研究都是在實驗室或家中執行，青少年執行的遵從性可能受到影響。有鑑於青少年大部分時間多在學校學習，且相關壓力源多數與學校生活壓力息息相關，本研究透過以學校為本位之漸進式肌肉鬆弛及深呼吸放鬆技巧的介入訓練，期望對心理神經免疫學相關的生心理成效指標產生正面的影響，維持青少年的健康。
目的：驗證以學校本位，教導青少年學習簡易漸進式肌肉鬆弛及深呼吸放鬆技巧，探討介入前後對青少年生活壓力、知覺壓力及心理神經免疫學有關之生心理指標的影響，並比較簡易漸進式肌肉鬆弛及深呼吸放鬆技巧與沒有執行介入練習的情少年，其青少年生活壓力、知覺壓力及心理神經免疫學有關之生心理指標的成效。
方法：本研究採多組重複測量類實驗性設計，從台灣南部某技職高中，挑選該校三個皆為技藝資優班的班級學生。以班級為單位分派至實驗組一及二與控制組；三組皆接受4周的紓壓相關認知教育外，實驗組一亦接受簡易漸進式肌肉鬆弛之介入方案；實驗組二則接受深呼吸放鬆之介入方案。本研究在學期中進行，專業技能檢定考或月考前十天開始，每天早上和下午各進行十分鐘的紓壓技巧介入，持續進行十天，兩種介入分別於12周內，三個考前10天，共30天執行完成。心理層面以青少年生活壓力、知覺壓力及身體症狀；生理層面以取對數的髮絲皮質醇為介入成效指標。這些指標收集與測量時間，除取對數的髮絲皮脂醇與青少年生活壓力於介入前與方案結束後收集兩次資料外，其餘指標分別於介入方案前(前測T0)、第一次介入方案後(第一次後測T1)與介入方案結束後(第二次後測T2)收集三次資料。兩種紓壓技巧對生心理成效指標的影響，在比較三組同質性後，透過廣義估計方程式(Generalized estimating equation; GEE) 進行統計分析，驗證兩種紓鬆技巧分別對各種成效指標的組內及組間差異影響。
結果：共納入三個班級的高中生有132位，平均年齡在16.36歲(CG: 45人; APMR: 42人; DB: 45人)。不管是簡易漸進式肌肉鬆弛或者深呼吸放鬆之介入組，介入執行後皆顯著增加放鬆感受 (簡易漸進式肌肉鬆弛: p< .00；深呼吸放鬆: p< .00)。所有生心理指標與控制組比較並經過GEE調整干擾變項後，在心理指標上，僅簡易漸進式肌肉鬆弛介入組的身體症狀數目，於第一次後測(T1)到第二次後測(T2)之身體症狀數目的改變程度，平均降低5.1個(T2-T1: p= .04)身體症狀；在生理指標上，僅深呼吸放鬆介入組之取對數的髮絲皮脂醇濃度差異，達顯著降低0.26 pg/mg(T2-T0: p= .03)。
結論：以學校為本位的簡易漸進式肌肉鬆弛及深呼吸放鬆介入後，受試者皆自覺達到放鬆效果。但是，在與控制組比較下，心理效應出現在執行簡易漸進式肌肉鬆弛介入組，僅在介入過程第一次後測至第二次後測期間明顯改善身體症狀數目；生理效應則出現在執行深呼吸放鬆介入組，顯著降低取對數的髮絲皮質醇濃度。本研究是在學校環境中進行介入，雖然不同的放鬆技巧有其不同的生心理效應，但研究結果顯示，不管是簡易漸進式肌肉鬆弛及深呼吸放鬆介入後，對於心理神經免疫學有關之生心理指標是有益處的，其證據仍可做為往後研究的參考。建議未來可以擴大青少年群組，並延長介入的劑量與追蹤期間，透過隨機分派之實驗性研究以獲得更高等級之成果驗證。

Background: During the adolescent developmental phase, individuals encounter multiple stressors. Insufficient coping strategies may lead to potential physiological and psychological health problems in adulthood, potentially manifesting in unhealthy behaviors. Progressive muscle relaxation (PMR) and deep breathing (DB) techniques have been demonstrated to yield mild to moderate effects on relieving stress and improving depression and anxiety among adolescents. The literature on Psychoneuroimmunology (PNI)-based research revealed that these two techniques have very different physiological outcome indicators, and comparing their objective effects on stress relief is difficult. Furthermore, studies employing PNI-related indicators to assess the effectiveness of these interventions have mostly been conducted in laboratories or homes, potentially influencing adolescents' adherence to these interventions. Since adolescents spend most of their time in school, their stress sources are related to school life and learning. This study adopted a school-based approach for implementing PMR and DB techniques for evaluating the effectiveness of PNI-related indicators thereby contributing to the maintenance of adolescents' psychological and physiological health.
Purpose: To evaluate the effectiveness of school-based instruction in abbreviated progressive muscle relaxation (APMR) and DB relaxation techniques for adolescents. This study aims to determine the effects of these techniques on adolescents' life stress, perceived stress, and psychological and physiological indicators associated with PNI.
Methods: This study adopted a multiple-group repeated-measures experimental design and selected three “advanced skills” classes from a vocational high school in southern Taiwan. Each class was sorted into Experimental Group I, Experimental Group II, or the control group (CG). In addition to 4 weeks of knowledge training related to stress relief, Experimental Group I also received the APMR intervention program, and Experimental Group II received the DB relaxation intervention program during the semester. Starting 10 days before the monthly exam, a 10-minute stress-relief skills session was conducted every morning and afternoon for 10 days. The two interventions were implemented for three monthly exams for a total of 30 days spanning over 12 weeks. For the psychological indicators, adolescent life stress, perceived stress, and somatic complaints were used, while log-transformed hair cortisol concentration was used as a physiological indicator of intervention effectiveness. The collection and measurement time of these indicators. The hair cortisol and adolescent life stress data were collected twice, that is, before and after the intervention program. All other indicator data were collected three times: before the intervention program (pre-test or T0), after implementing the intervention for the first time (first post-test or T1), and after the end of the program (second post-test or T2). The effects of the two stress-relief techniques on various outcome indicators were statistically analyzed and tested through the generalized estimating equation (GEE) method.
Results: A total of 132 high school students were included in the three classes (CG: 45; APMR: 42; DB: 45), with an average age of 16.36 years. Both the APMR group’s and the DB group’s relaxation ratings increased significantly after the intervention (APMR: p < .00; DB: p < .00). After comparing all physiological and psychological indicators with the CG and adjusting for the confounding variables, only the somatic complaint count (SCC) in the APMR group changed significantly between the first post-test (T1) and the second post-test (T2), with an average reduction of 5.1 points (p = .04). In terms of the physiological indicator, only the DB group reduced the log-transformed hair cortisol concentration significantly by 0.26 pg/mg (T2-T0: p = .03).
Conclusion: The study found that 16 weeks of APMR and DB intervention programs implemented in a school setting significantly reduced the number of SCC and hair cortisol concentrations, respectively. Notably, adolescents in this study significantly reduced psychological and physiological stress related to PNI over one semester. Although this study was conducted in a school environment, and different relaxation techniques have different physiological and psychological effects, the results can still be used as a reference for future research. The frequencies of implemented stress relief techniques can be increased, and the duration of intervention periods may be considered for extension in the future. Furthermore, including various age groups of adolescents could enhance the study, and more robust evidence may be obtained through randomized experimental studies.

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