靈性照顧對安老所老人生活適應之探討

The Study of Relationship Between Spiritual Care and Life Adaptation in Retirement Home Residents

林佳慧(Chia-Hui Lin)

指導教授 ： 陳雅美

國立臺灣大學/公共衛生學院/公共衛生碩士學位學程/碩士(2015年)

https://doi.org/10.6342/NTU.2015.00161

摘要

研究背景與目的
　「靈性照顧」是長期照顧特殊的服務方式，已在國外老人照顧專業領域中受到關注及倡議，目前在國內老人機構的服務模式對此議題探討甚少，且機構式照顧大部分仍著重在生物醫療層面，忽略老年人的心理及靈性需求的滿足。而靈性照顧場域不僅在安寧病房的服務，而是需提早在長輩們身體健康時就開始著手，以因應未來高齡化社會老化人口的需求，因此靈性照顧實有探究之必要。故本研究之探討目的有三：（一）了解住民對靈性照顧在生活適應的感受與看法；（二）照顧服務者如何在生活上運用靈性照顧協助住民生活之適應；（三）從靈性照顧身、心、社會及靈性觀點，探討住民成功老化的關聯性。

研究方法
　　本研究為質性研究，研究對象針對佛教安養機構安老所的長者15人，工作人員5人共20人，從研究者事先建立的訪談摘要進行半結構式訪談，以Maslow需求層次理論為理論架構，並以樣板式分析法，建立分析架構進行本文分析。

研究結果
研究結果包括：
（一）老人居住的安養機構有佛教靈性的支持環境，能減少老人從原居住地移居至安養機構時的焦慮情緒，有助於靈性照顧的心理適應，其宗教資源的可近性及可及性，使老人增加參與宗教活動頻率，滿足靈性需求，進而提高社交網絡的機會，維持社會關係。佛教環境具有靈性及健康發展的雙重意義，有助於老人生活的適應。

（二）宗教繞佛活動提供老人健康促進方式，老人從靈性需求層面尋找到能增加運動以及身體保健的方法，也滿足其靈性需求。

（三）宗教師透過宗教義理為工具，傳播信仰的觀念，以教育者角度教育老人正向的思考與負面行為的規範，協助老人察覺靈性需求的成長，具有傳播宗教信仰的弘法者及教育者雙重角色。

（四）靈性照顧提供住民心靈沉殿及適應機構生活的照顧方式，而宗教為工作人員帶來便利性且正當性的工具與方法。

研究討論與建議
　　Maslow需求層次理論對安老所的老年人而言，靈性需求滿足不是最高層次的追求，老年人的需求是先透過高層次靈性需求的滿足而達成低層次需求滿足。透過靈性照顧老年人可以滿足其生理、安全、愛與隸屬、自尊、自我實現等層面的需求，朝向達成正向的成功老化目標一致。
依據研究結果，提出下列建議：（一）家屬能多陪伴老年人共同參與靈性休閒活動，協助老人獲得屬於親情的靈性關懷；（二）提供工作人員相關靈性照顧訓練，培養靈性服務的專業能力，給予個別化的靈性照顧；（三）舉辦增加靈性休閒活動，提高個人身體及心理健康，啟發心靈省思、解決靈性困擾。

關鍵字

靈性照顧 ； 生活適應 ； 質性研究 ； Maslow理論 ； 成功老化

並列摘要

Background and purpose：
Spiritual care has been an important concern in long-term care, but has received less attention in institutional care in Taiwan. Most of the Seniors’ long-term care institutions for older adults in Taiwan only focus on the basic needs of physiological care, and neglect their mental and spiritual needs.

　　The purpose of this study was：(a) to understand the spiritual needs of older adults living in a retirement home ; (b) to discuss the current situation with the staff on how to provide spiritual resources allowing them to turn to for help in times of crisis or concern ; (c) to discuss the relationship between the spiritual care and successful aging in retirement home.

Research method:
　　This qualitative study was based on the theory of Maslow's hierarchy of needs. Semi-structured interviews were conducted by a researcher following a written interview guide. In this study 15 elderly residents and 5 staff members who work in the Buddhist private retirement home were interviewed.

Findings:
Highlights from the study's findings included:
(a) The Buddhism building and environment of the institution served as a great support for spiritual care and reduced older adults' anxiety resulted from moving to the retirement home from their homes . A good accessibility to religious resources may increase the participation of religious activities and increase their social networks and social relationships with others among older adults. Through these activities older adults are more likely to meet their spiritual needs. The Buddhism environment also adds significant meaning to spirituality and the health of older adults living in the retirement home. .

(b) Through the ritual of walking around the Buddha, older adults were able to increase their physical activity and to maintain physical health as well as meeting their spiritual needs.

(c) Through Buddhism, the Buddhist nun served as a mentor of the older adults and was able to help older adults to think positively and to fulfill older adults' needs for spiritual care.

(d) Spiritual care can provide elder residents a source of calm and healthy life. Religion can be a good tool for providing spiritual care.

Discussion and Recommendations:
Spiritual needs are not considered priority in the theory of Maslow’s Hierachy Needs. In long-term care setting, older adults' spiritual needs should be considered while meeting older adults' basic needs and more advanced needs. Through spiritual care, older adults living in a retirement home can meet the needs of physiological, safety, love, 'esteem, and self-actualization, and move forward toward successful aging.

According to our study findings, we recommended:
(a) Families' acknowledgment of spiritual care can have a great influence on elder residents.

(b) Staffs' training in providing spiritual care should be strengthened.

(c) Spiritual care related activities are strongly recommended for institutionalized elders, which may improve their health both physically and psychologically.

並列關鍵字

spiritual care ； adaptation life ； qualitative study ； Maslow’s needs Hierachy ； successful aging

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