『高齡者模擬體驗課程』對長期照顧管理專員之老化知識及對高齡者態度與照護意願之成效探討

Effects of the “Elderly Simulation Program” on Aging Knowledge,Attitude toward Elders, and Intention to care of the Care Managers.

尤慧燕(Hui-Yen Yu)

指導教授 ： 陳桂敏

高雄醫學大學/護理學院/護理學系碩士班/碩士(2017年)

摘要

背景:
隨著人口結構改變，高齡化社會衍生出有長期照顧需求的家庭與日俱增，在『在地老化』（aging in place）的政策目標下，由照顧管理專員以個案管理的概念模式，擬訂照顧計畫並整合連結資源，以滿足不同程度失能長者之多元需求，使其保有自尊、自主之生活。
目的:
以「高齡者模擬體驗課程」為介入措施，探討照顧管理專員在老化知識、對高齡者的態度及照護意願之成效。
方法:
採類實驗性研究法，以高雄市長期照顧管理中心為實驗組，屏東縣市及台南市長期照顧管理中心為對照組，具有長期照顧管理中心實際執行個案評估及管理工作經驗至少3個月以上之照顧管理專員為收案對象，共收案77人: 實驗組(高雄市) 33人、控制組(台南市、屏東縣市) 43人，以自填問卷方式進行資料收集，完成研究者共76位。以「高齡者模擬體驗課程」為介入措施，兩組於課程進行前，皆須填寫前測三份問卷，爾後實驗組進行「高齡者模擬體驗課程」單次介入措施計六小時，對照組則無。兩組於課程介入後四週，再進行後測，並比較兩組差異。測量工具為「護理人員對老人照護知識量表」、「護理人員對老人態度量表」、「護理人員對老人照護意願量表」。
結果:
兩組間人口學資料僅在醫護相關工作年資有顯著差異（t = 3.15，p = .002)。實驗組與對照組比較於『高齡者模擬體驗課程』介入前、後之組內差異，雖無統計顯著性差異，兩組在老化知識問卷量表中，後測分數皆有比前測分數略高，而在『對高齡者照護意願量表』中，對老人照護意願題組，實驗組（n = 32）前測平均得分79.88分（SD =7.74），後測平均得分83.38分（SD =7.48）統計結果有顯著差異（t =37.82；p <.001 ）。控制組（n = 45）前測平均得分為79.27（ SD =7.09），後測平均得分80.63分（SD =7.69）， 統計結果有顯著差異（t = 43.36；p <.001 ）。但是在比較有無接受『高齡者
模擬體驗課程』兩組組間之差異皆無明顯改變差異（p > .05）。
結論:
經由「高齡者模擬體驗課程」介入措施，實驗組與對照組在老化知識、對高齡者的態度及照護意願之前、後測結果，並無統計上顯著改變，這有可能與本研究所使用的問卷量表不適用於照顧管理專員，且於介入課程後當下，未收集後測問卷結果，僅於介入四周後收集一次後測問卷未再於後續進行長期2-3次追蹤，無法進行多個時間點的比較，僅以一次的介入時間點要進行對態度及照護意願的改變較為困難。建議未來研究方向可以針對照顧管理專員研擬更適切的問卷量表以作為日後更深入之探討。

關鍵字

高齡者模擬體驗課程 ； 老化 ； 態度 ； 意願 ； 照顧管理專員

並列摘要

Background: As the demographic structure changes, a growing demand for long-term caregiving has become evident in Taiwan’s aging society. In line with the aging in place policy objective, caregivers employ the case management conceptual model to develop care plans and integrate resources. Meeting the diverse needs of senior citizens with disabilities at different levels of severity maintains their self-esteem and self-reliance.
Objectives: This study used the Elderly Simulation Program (ESP) as an intervention to investigate caregivers’ knowledge about aging, their attitude toward senior citizens, and their willingness to care.
Methods: This study employed a quasiexperimental method and recruited 77 caregiving professionals with at least 3 months of work experience in long-term care centers. The experimental and control group members were recruited from Kaohsiung City (n = 33) and Pingtung and Tainan cities (n = 43), respectively. Data were collected from the respondents’ self-administrated questionnaires, and 76 of the respondents completed the survey. Both groups were asked to undergo 3 pretests before the ESP intervention. Subsequently, the experimental group participated in the 6-hour long ESP, whereas the control group did not. Both groups were asked to take the posttest 4 weeks after the intervention for comparison. The 3 evaluating instruments comprised questionnaires concerning caregiving professionals’ knowledge regarding caregiving for senior citizens, their attitude toward senior citizens, and their willingness to care.
Results: The only significant demographic difference between the experimental and control groups was work experience in years (t = 3.15, p = .002). Although no significant difference between the two groups was evident in either pretest or posttest scores, both groups scored slightly higher in posttest than they did in pretest (aging knowledge questionnaires). For caregivers’ willingness to care for senior citizens, the experimental group (n = 32) scored 79.88 (SD = 7.74) and 83.38 (SD = 7.48) in the pretest and posttest, respectively, with a significance difference (t = 37.82; p < .001); whereas the control group (n = 45) scored 79.27 (SD = 7.09) and 80.63 (SD = 7.69) in the pretest and posttest, respectively, also with a significant difference (t = 43.36; p < .001). However, the intervention did not yield a significant difference in the overall scores between the two groups (p > .05).
Conclusion: The intervention did not significantly change either group’s pretest or posttest scores of knowledge concerning aging, their attitude toward senior citizens, and their willingness to care. This may be attributed to the following points: 1) the questionnaires used in this study were not applicable to caregivers, 2) the posttests were collected 4 weeks after the intervention rather than immediately afterward, and 3) this study did not conduct multiple long-term follow-ups of the participants’ attitudes and willingness to care in order to compare with multiple time points. Future research can develop questionnaires more suitable for caregivers for further investigation.

並列關鍵字

Elderly Simulation Program ； Aging ； attitude ； willingness ； Care Manager

參考文獻

中文部分

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