社會中失能者未滿足需求之盛行率與其相關因素

Prevalence and Related Factors of Unmet Needs among the Disabled in the Community

莊坤洋(Kun-Yang Chuang) ； 陳育慧(Yu-Hui Chen) ； 曹愛蘭(Ai-Lan Tsao) ； 吳淑瓊(Shwu-Chong Wu)

《台灣公共衛生雜誌》 23卷3期 (2004/06) Pp. 169-180

https://doi.org/10.6288/TJPH2004-23-03-01

摘要

目標：瞭解ADL與IADL未滿足需求的盛行率，並探討可能影響未滿足需求的相關因素。方法：研究對象為設籍在台北縣三峽鎮、鶯歌鎮、新店市、樹林市及嘉義市，且為50歲以上的失能者進行訪視調查，共2141位。結果：ADL未滿足需求的比例最低為洗澡（4.0%），最高為室內走動（29.9%）。 IADL未滿足需求的比例最低為煮飯（1.3%），最高為打電話（48.3%）。45.7%的研究對象至少有一項ADL未滿足需求，56.7%至少有一項IADL未滿足需求。邏輯式迴歸分析影響ADL未滿足需求之相關因素顯示，控制其他變項後，失能者的居住地區、ADL失能數目均為預測ADL未滿足需求的重要因素。影響IADL未滿足需求之分析結果顯示，控制其他變項後，失能者的教育程度、居住地區、罹患疾病數目、IADL失能數目，以及照顧者的教育程度、照顧者身分，均為預測IADL未滿需求的重要因素。結論：在社區中老年失能者末滿足需求盛行率頗高，家庭照顧者往往無法滿足失能者。因此，如何利用照顧管理機制為失能者適當地規劃非正式及正式資源，提昇失能者接受的照護服務品質，以減少未滿足需求盛行率，將是末來政府在長期照護體系發展上須重視的問題，如此才能落實「在地老化」的照護觀念。

關鍵字

未滿足需求 ； 失能 ； 長期照顧

並列摘要

Objectives: To assess the prevalence of unmet needs in activities of daily living (ADL) and instrumental activities of daily living (IADL). Also, to identify the relevant factors of unmet needs. Methods: A total of 2141 disabled residents, age 50 or over, from 5 communities were interviewed regarding their ADL and IADL needs and unmet needs. Results: ADL unmet needs ranged from cooking (4.0%) to walking in the room (48.3%), and IADL unmet needs ranged from laundry (1.3%) to making phone calls (49.1%). Around 45.7% of respondents had at least 1 ADL unmet need, and 56.7% had at least 1 IADL unmet need. Multivariate analysis revealed that the location of residence, and the extent of disability were important predictors of ADL unmet needs. The predictors of IADL unmet needs were education, location of residence, number of chronic diseases, number of disabilities in IADL, caregiver’ s education, and relationship with the caregiver. Conclusion: The prevalence of unmet needs was generally high. In regard to system changes, increasing community-based care resources, and aggressive promotions to encourage its utilization may reduce the prevalence of unmet needs. Care management schemes could also be used to target the high-risk group and reduce their unmet needs.

並列關鍵字

unmet needs ； disability ； long-term care

參考文獻

Long-Term Care Insurance in Japan

Allen SM(1994).Gender differences in spousal caregiving and unmet need for care.J Gerontol.49,187-195.

Allen SM,Mor V(1997).The prevalence and consequences of unmet need. Contrasts between older and younger adults with disability.Med Care.35,1132-1148.

Barberger-Gateau P,Rainville C,Letenneur L,Dartigues JF(2000).A hierarchical model of domains of disablement in the elderly: a longitudinal approach.Disabil Rehabil.22,308-317.

Beland F,Zunzunegui MV(1999).Predictors of functional status in older people living at home.Age Ageing.28,153-159.