背景：對長者而言，旨在提高自尊和減少憂鬱的心理健康介入是很重要的。而魔術活動已有被運用於不同面向的健康促進。然則，對於魔術是否能有益於社區長者的心理健康，相關的訊息仍顯稀少。因此，本研究欲探討魔術介入計畫對於長者的自尊、憂鬱症狀和生活品質的潛在影響，以及自尊、憂鬱症狀和生活品質之間的相關性。方法：招募38位年齡在60到90歲的受試者，並隨機分配到魔術介入組或對照組。介入方法為進行每週兩次為長者設計的魔術介入活動，每次1.5個小時，共持續六週。在介入前後，評估並用重複測量變異數分析兩組受試者的羅森伯格自尊量表分數、簡易老人憂鬱量表分數和台灣簡明版世界衛生組織生活品質問卷分數。自尊分數和憂鬱症狀、以及憂鬱症狀和生活品質之間的相關性則用皮爾森相關係數分析。我們也進行了先驗的樣本數估計和後驗的統計檢定力分析。結果：魔術介入計畫顯著地提高了長者的自尊和減少了憂鬱，且有大的效果量；而對生活品質沒有明顯的影響。雖然幾乎所有的參與者在魔術介入後的自尊分數都有上升，但與介入後的憂鬱分數變化和生活質量分數的變化並沒有明顯的相關性，可能意味著六週的魔術介入計畫有其他因素會影響自尊和憂鬱狀態改善之間的相關性。結論：本研究中使用的魔術介入計畫有益於促進長者的心理健康。因此，利用魔術介入計畫以改善社區長者的自尊和憂鬱症狀似乎是一個有效的途徑。

Objectives: Mental health interventions intending to increase self-teem and reduce depression are important in older adults. Magic-based programs have been used to enhance well-being in several aspects of health. However, there is a paucity of information on whether conjuring can provide mental health benefits for the community-dwelling older population. Thus, this study aims to explore the potential benefits of a magic-based intervention program on self-esteem, depressive symptoms, and quality of life (QoL), and determine the relationship between self-esteem, depressive status, and QoL in older adults.
Methods: Thirty-eight participants aged 60-90 years were enrolled and randomly allocated to either a magic intervention group or a control group. The magic intervention program designed for the older adults was held for 90 minutes twice a week for 6 weeks. The scores of the Rosenberg Self-Esteem Scale (RSE), the15-item Geriatric Depression Scale (GDS-15), and the World Health Organization Quality of Life-BREF Taiwan version were measured and analyzed by repeated measure analysis of variance before and after the intervention in both groups. Pearson’s correlation coefficients were used to exam the relationship between self-esteem and depressive status, alone with the relationship between depressive status and QoL. A priori sample size estimation and a posteriori analysis for the achieved power level were conducted.
Results: The magic intervention program significantly raised self-esteem and reduced depressive symptoms simultaneously in the older adults with large effects, while there was no significant impact on QoL. Although moderate but significant negative correlations were noted between the scores of RSE and GDS-15 both before and after the intervention in the magic group, no significant correlation between self-esteem improvement and reduced depressive levels was observed.
Conclusion: The magic intervention program used in the present study was beneficial in promoting mental health in older adults. Therefore, using magic programs in the community-dwelling older population seems to be an effective avenue to improve their self-esteem and depressive status.

1. World Health Organization. Decade of healthy ageing: baseline report. World Health Organization; 2020.
2. World Health Organization. Promoting Mental Health; concepts, emerging evidence and practice. World Health Organization; 2004:310.
3. Moussavi S, Chatterji S, Verdes E, Tandon A, Patel V, Ustun B. Depression, chronic diseases, and decrements in health: results from the World Health Surveys. Lancet. 2007;370(9590):851-8. doi:10.1016/s0140-6736(07)61415-9
4. World Health Organization. Depression and Other Common Mental Disorders. World Health Organization; 2017.
5. World Health Organization. Mental Health of Older Adults [On-line]. https://www.who.int/news-room/fact-sheets/detail/mental-health-of-older-adults Accessed June 15, 2022.
6. Blazer DG. Depression in late life: review and commentary. J Gerontol A Biol Sci Med Sci. 2003;58(3):249-65. doi:10.1093/gerona/58.3.m249
7. Wicke FS, Güthlin C, Mergenthal K, et al. Depressive mood mediates the influence of social support on health-related quality of life in elderly, multimorbid patients. BMC Family Practice. 2014;15(1):62. doi:10.1186/1471-2296-15-62
8. Van der Weele GM, Gussekloo J, De Waal MW, De Craen AJ, Van der Mast RC. Co-occurrence of depression and anxiety in elderly subjects aged 90 years and its relationship with functional status, quality of life and mortality. Int J Geriatr Psychiatry. 2009;24(6):595-601. doi:10.1002/gps.2162
9. Feng L, Yap KB, Ng TP. Depressive symptoms in older adults with chronic kidney disease: mortality, quality of life outcomes, and correlates. The American Journal of Geriatric Psychiatry. 2013;21(6):570-579.
10. Ho C, Feng L, Fam J, Mahendran R, Kua EH, Ng TP. Coexisting medical comorbidity and depression: multiplicative effects on health outcomes in older adults. Int Psychogeriatr. 2014;26(7):1221-9. doi:10.1017/s1041610214000611
11. Sivertsen H, Bjørkløf GH, Engedal K, Selbæk G, Helvik AS. Depression and Quality of Life in Older Persons: A Review. Dement Geriatr Cogn Disord. 2015;40(5-6):311-39. doi:10.1159/000437299
12. Voros V, Martin Gutierrez D, Alvarez F, et al. The impact of depressive mood and cognitive impairment on quality of life of the elderly. Psychogeriatrics. 2020;20(3):271-277.
13. Rosenberg M. Conceiving the self. 1979;
14. Rosenberg M, Schooler C, Schoenbach C, Rosenberg F. Global self-esteem and specific self-esteem: Different concepts, different outcomes. American sociological review. 1995:141-156.
15. Orth U, Robins RW, Widaman KF. Life-span development of self-esteem and its effects on important life outcomes. Journal of Personality and Social Psychology. 2012;102:1271-1288.
16. Rosenberg M. Society and the adolescent self-image. Princeton university press; 1965.
17. Orth U, Robins RW, Roberts BW. Low self-esteem prospectively predicts depression in adolescence and young adulthood. J Pers Soc Psychol. 2008;95(3):695-708. doi:10.1037/0022-3514.95.3.695
18. Orth U, Robins RW, Trzesniewski KH, Maes J, Schmitt M. Low self-esteem is a risk factor for depressive symptoms from young adulthood to old age. Journal of abnormal psychology. 2009;118(3):472.
19. Association AP. Diagnostic and statistical manual of mental disorders (5th edition). American Psychiatric Publishing; 2013.
20. Sowislo JF, Orth U. Does low self-esteem predict depression and anxiety? A meta-analysis of longitudinal studies. Psychological bulletin. 2013;139(1):213.
21. Orth U, Robins RW. Understanding the Link Between Low Self-Esteem and Depression. Current Directions in Psychological Science. 2013;22(6):455-460. doi:10.1177/0963721413492763
22. Ruddy R, House A. Psychosocial interventions for conversion disorder. Cochrane Database Syst Rev. 2005;(4):Cd005331. doi:10.1002/14651858.CD005331.pub2
23. WHO Guidelines Approved by the Guidelines Review Committee. Guidelines for the Psychosocially Assisted Pharmacological Treatment of Opioid Dependence. World Health Organization; 2009.
24. Jiali He, Yiling Tang, Jingxia Lin, Guy Faulkner, Hector W H Tsang, Chan SHW. Non-invasive brain stimulation combined with psychosocial intervention for depression: a systematic review and meta-analysis. BMC Psychiatry. 2022;22(1):273. doi:10.1186/s12888-022-03843-0
25. Ramadan Abdel-Aziz H, AbdElkhalek Ahmed HA. The effect of group reminiscence therapy on self-esteem and emotional well-being of older adults. Central European Journal of Nursing and Midwifery. 2021;
26. Forsman AK, Nordmyr J, Wahlbeck K. Psychosocial interventions for the promotion of mental health and the prevention of depression among older adults. Health Promot Int. 2011;26 Suppl 1:i85-107. doi:10.1093/heapro/dar074
27. Lam MT, Lam HR, Chawla L. Application of magic in healthcare: A scoping review. Complement Ther Clin Pract. 2017;26:5-11. doi:10.1016/j.ctcp.2016.11.002
28. Wiseman R, Watt C. Achieving the impossible: a review of magic-based interventions and their effects on wellbeing. PeerJ. 2018;6:e6081. doi:10.7717/peerj.6081
29. Bagienski S, Kuhn G. The crossroads of magic and wellbeing: A review of wellbeing-focused magic programs, empirical studies, and conceivable theories. International Journal of Wellbeing. 2019;9(2)
30. Frith GH, Walker JC. Magic as Motivation for Handicapped Students. TEACHING Exceptional Children. 1983;15(2):108-110. doi:10.1177/004005998301500212
31. Bowman RP. The Magic Counselor: Using Magic Tricks as Tools to Teach Children Guidance Lessons. Elementary School Guidance and Counseling. 1986;21:128-138.
32. Stehouwer RC. Using Magic to Establish Rapport and Improve Motivation in Psychotherapy with Children. Psychotherapy in Private Practice. 1983;1(2):85-94. doi:10.1300/J294v01n02_10
33. Lyons M, Menolotto AM. Use of Magic in Psychiatric Occupational Therapy: Rationale, Results and Recommendations. Australian Occupational Therapy Journal. 1990;37:79-83.
34. Elkin DJ, Pravder HD. Bridging magic and medicine. The Lancet. 2018;391(10127):1254-1255. doi:10.1016/s0140-6736(18)30707-4
35. Kurzweil A. David Copperfield’s “Project Magic.”. Genii The Conjurors’ Magazine. 2003;66:16-18.
36. Spencer K. Hocus focus: evaluating the academic and functional benefits of integrating magic tricks in the classroom. Journal of the International Association of Special Education. 2012;13(1):87-99.
37. Hart R, Walton M. Magic as a therapeutic intervention to promote coping in hospitalized pediatric patients. Pediatric Nursing. 2010;36(1):11-6; quiz 17.
38. Ezell D, Klein-Ezell CE. MAGICWORKS (motivating activities geared-to instilling confidence-wonderful opportunities to raise kid's self-esteem). Education and Training in Developmental Disabilities. 2003:441-450.
39. Levin DM. Magic arts counseling: the tricks of illusion as intervention. Georgia School Counselors Association Journal. 2006;13:14-23.
40. Hines A, Bundy AC, Haertsch M, Wallen M. A magic-themed upper limb intervention for children with unilateral cerebral palsy: The perspectives of parents. Dev Neurorehabil. 2019;22(2):104-110. doi:10.1080/17518423.2018.1442372
41. Spencer K, Yuen HK, Jenkins GR, Kirklin K, Vogtle LK, Davis D. The 'magic' of magic camp from the perspective of children with hemiparesis. J Exerc Rehabil. 2021;17(1):15-20. doi:10.12965/jer.2040802.401
42. Yuen HK, Spencer K, Kirklin K, Edwards L, Jenkins GR. Contribution of a virtual magic camp to enhancing self-esteem in children with ADHD: A pilot study. Health Psychol Res. 2021;9(1):26986. doi:10.52965/001c.26986
43. Bisschop MI, Kriegsman DMW, Beekman ATF, Deeg DJH. Chronic diseases and depression: the modifying role of psychosocial resources. Social Science & Medicine. 2004;59(4):721-733. doi:https://doi.org/10.1016/j.socscimed.2003.11.038
44. Wiseman R, Watt C. Conjuring cognition: a review of educational magic-based interventions. PeerJ. 2020;8:e8747. doi:10.7717/peerj.8747
45. Yuen HK, Spencer K, Kirklin K, Edwards L, Jenkins GR. Contribution of a virtual magic camp to enhancing self-esteem in children with ADHD: A pilot study. Health psychology research. 2021;9(1):26986-26986. doi:10.52965/001c.26986
46. Cohen J. Statistical power analysis for the behavioral sciences. Routledge; 1988.
47. Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39(2):175-91. doi:10.3758/bf03193146
48. Sheikh JI, Yesavage JA. Geriatric Depression Scale (GDS): recent evidence and development of a shorter version. Clinical Gerontologist: The Journal of Aging and Mental Health. 1986;
49. Jongenelis K, Pot A, Eisses A, et al. Diagnostic accuracy of the original 30‐item and shortened versions of the Geriatric Depression Scale in nursing home patients. International Journal of Geriatric Psychiatry: A journal of the psychiatry of late life and allied sciences. 2005;20(11):1067-1074.
50. Chan AC. Clinical validation of the Geriatric Depression Scale (GDS): Chinese version. J Aging Health. 1996;8(2):238-53. doi:10.1177/089826439600800205
51. Rosenberg M. Conceiving the Self. Basic Books; 1979.
52. Blascovich J, Tomaka J. Measures of self-esteem. In: Robinson JP, Shaver PR, Wrightsman LS, eds. Measures of personality and social psychological attitudes. Academic Press; 1991:115-160.
53. Gray-Little B, Williams VS, Hancock TD. An item response theory analysis of the Rosenberg Self-Esteem Scale. Personality and Social Psychology Bulletin. 1997;23:443-451.
54. Robins RW, Hendin HM, Trzesniewski KH. Measuring global self-esteem: Construct validation of a single-item measure and the Rosenberg Self-Esteem Scale. Personality and Social Psychology Bulletin. 2001;27:151-161.
55. Schmitt D, Allik J. Simultaneous Administration of the Rosenberg Self-Esteem Scale in 53 Nations: Exploring the Universal and Culture-Specific Features of Global Self-Esteem. Journal of personality and social psychology. 2005;89:623-42. doi:10.1037/0022-3514.89.4.623
56. Huang I-C, Wu AW, Frangakis C. Do the SF-36 and WHOQOL-BREF measure the same constructs? Evidence from the Taiwan population. Quality of life research. 2006;15(1):15-24.
57. Yao G, Chung C-W, Yu C-F, Wang J-D. Development and verification of validity and reliability of the WHOQOL-BREF Taiwan version. Journal of the Formosan Medical Association. 2002;101(5):342-351.
58. World Health Organization. Programme on mental health : WHOQOL user manual, 2012 revision. World Health Organization; 1998. https://apps.who.int/iris/handle/10665/77932 Accessed June 15, 2022.
59. Gold MS, Bentler PM. Treatments of Missing Data: A Monte Carlo Comparison of RBHDI, Iterative Stochastic Regression Imputation, and Expectation-Maximization. Structural Equation Modeling: A Multidisciplinary Journal. 2000/07/01 2000;7(3):319-355. doi:10.1207/S15328007SEM0703_1
60. Gupta SK. Intention-to-treat concept: a review. Perspectives in clinical research. 2011;2(3):109.
61. Bennett DA. How can I deal with missing data in my study? Aust N Z J Public Health. 2001;25(5):464-9.
62. Danek AH, Fraps T, von Müller A, Grothe B, Öllinger M. It's a kind of magic—what self-reports can reveal about the phenomenology of insight problem solving. Original Research. Frontiers in Psychology. 2014;5doi:10.3389/fpsyg.2014.01408
63. Pelham BW, Swann WB. From self-conceptions to self-worth: on the sources and structure of global self-esteem. Journal of personality and social psychology. 1989;57(4):672.
64. Napora W. Do Ego-resiliency, Self-efficacy and Life Orientation Predict Self-esteem of Top World Magicians? An International Study. Psychological Thought. 2021;14(1):195-210.
65. Rissanen O, Pitkänen P, Juvonen A, Kuhn G, Hakkarainen K. Expertise among professional magicians: an interview study. Original Research. Frontiers in Psychology. 2014;5doi:10.3389/fpsyg.2014.01484
66. Leary MR. Sociometer theory and the pursuit of relational value: Getting to the root of self-esteem. European review of social psychology. 2005;16(1):75-111.
67. LEDDINGTON J. The Experience of Magic. The Journal of Aesthetics and Art Criticism. 2016;74(3):253-264. doi:10.1111/jaac.12290
68. Subbotsky E, Hysted C, Jones N. Watching films with magical content facilitates creativity in children. Percept Mot Skills. 2010;111(1):261-77. doi:10.2466/04.09.11.Pms.111.4.261-277
69. Subbotsky E. Curiosity and exploratory behaviour towards possible and impossible events in children and adults. Br J Psychol. 2010;101(Pt 3):481-501. doi:10.1348/000712609x470590
70. Ko HJ, Youn CH. Effects of laughter therapy on depression, cognition and sleep among the community‐dwelling elderly. Geriatrics & gerontology international. 2011;11(3):267-274.
71. Ganz FD, Jacobs JM. The effect of humor on elder mental and physical health. Geriatr Nurs. 2014;35(3):205-11. doi:10.1016/j.gerinurse.2014.01.005
72. Cacioppo JT, Hawkley LC, Thisted RA. Perceived social isolation makes me sad: 5-year cross-lagged analyses of loneliness and depressive symptomatology in the Chicago Health, Aging, and Social Relations Study. Psychology and aging. 2010;25(2):453.
73. Nagy E, Moore S. Social interventions: An effective approach to reduce adult depression? Journal of Affective Disorders. 2017;218:131-152. doi:https://doi.org/10.1016/j.jad.2017.04.043
74. Wiseman R, Houstoun W, Watt C. Pedagogic prestidigitation: using magic tricks to enhance educational videos. PeerJ. 2020;8:e9610.
75. Lee K-T, Wang W-L, Lin W-C, Yang Y-C, Tsai C-L. The Effects of a Magic Intervention Program on Cognitive Function and Neurocognitive Performance in Elderly Individuals With Mild Cognitive Impairment. Original Research. Frontiers in Aging Neuroscience. 2022;14doi:10.3389/fnagi.2022.854984
76. Nijs KA, de Graaf C, Kok FJ, van Staveren WA. Effect of family style mealtimes on quality of life, physical performance, and body weight of nursing home residents: cluster randomised controlled trial. Bmj. 2006;332(7551):1180-4. doi:10.1136/bmj.38825.401181.7C
77. de Medeiros MMD, Carletti TM, Magno MB, Maia LC, Cavalcanti YW, Rodrigues-Garcia RCM. Does the institutionalization influence elderly's quality of life? A systematic review and meta-analysis. BMC Geriatr. 2020;20(1):44. doi:10.1186/s12877-020-1452-0
78. Wang CC, Tzeng DS, Chung WC. The effect of early group psychotherapy on depressive symptoms and quality of life among residents of an apartment building for seniors. Psychogeriatrics. 2014;14(1):38-46. doi:10.1111/psyg.12037
79. Ristolainen H, Kannasoja S, Tiilikainen E, Hakala M, Närhi K, Rissanen S. Effects of 'participatory group-based care management' on wellbeing of older people living alone: a randomized controlled trial. Arch Gerontol Geriatr. 2020;89:104095. doi:10.1016/j.archger.2020.104095