隨著人們對生活品質的重視,健康照護體系的政策制定者及服務提供者必須了解老年人的生活品質情形,尤其是失能者。然而,卻很少有研究是針對失能老人的生活品質及其影響因素進行調查。所以,本研究的目的在探討失能老人的生活品質及其影響因素,期能藉此研究結果提供健康照護人員在提供服務及擬定政策時之參考。本研究採用橫斷式描述性相關研究法,以立意取樣,選取台南縣市接受居家式照護或機構式照護模式的210位失能老人為研究對象。收案條件如下:(1)年滿65歲且日常生活活動功能有一項或以上需要協助之老人;(2)聽力及語言能力不影響溝通、表達者;(3)認知功能正常或輕度障礙者;(4)同意參與本研究計畫者。採用台灣簡明版世界衛生組織生活品質問卷來測量失能老人之生活品質,並以SPSS for Windows Release 14.0 套裝軟體進行描述性及推論性統計分析。研究結果顯示研究對象在整體的生活品質得分為45.73分(總分80分),屬於中等程度;以「社會關係」範疇的得分最高,「心理健康」範疇的得分最低。失能老人整體生活品質的顯著影響因素為年齡、婚姻狀況、教育程度、自覺健康狀況、慢性疾病數、憂鬱及自覺環境品質中的自尊與關懷因素,而三階層總解釋變異量為71.8%。生活品質之四個範疇的顯著影響因素:在生理健康範疇方面是年齡、自覺健康狀況、功能狀態、罹患慢性疾病數及憂鬱,三階層總解釋變異量為66.3%;心理健康範疇的顯著影響因素則為年齡、教育程度、自覺健康狀況及憂鬱,三階層總解釋變異量為67.7%;社會關係範疇的顯著影響因素為功能狀態、憂鬱、居住安排及自覺環境品質中的自尊與關懷因素,三階層總解釋變異量為52.2%;環境範疇的顯著影響因素則為教育程度、憂鬱及自覺環境品質中的自尊與關懷、資源可近性等因素,三階層總解釋變異量為56.7%。而憂鬱是失能老人生活品質的唯一共同之影響因素。由於,失能老人的生活品質是複雜的、多面向的概念,影響的因素眾多且分歧,期望本研究可提供更多失能老人的生活品質之相關實證基礎資料,並建議未來健康照護提供者能積極發展心理健康促進等相關照護計畫以提升失能老人的生活品質。
The advancement of medical technology, development of economic system, and a steadily increasing life expectancy had resulted in a growing elderly population in Taiwan. As individuals live longer, the issues of quality of life (QOL) is even more important especially for the disabled older adults. However, knowledge of QOL in this population as well as factors that influence quality of life of disabled elderly are yet, limited. Using a cross-sectional study design, this study examined the quality of life among disabled elderly in Southern Taiwan. Demographic distributions, bio-psychological health status, and perceived quality of environment, as predictors of quality of life were studied. 210 disabled elderly who were dependent in one and above of activities of daily living, aged 65 and over, be able to communicate, and cognitively intact, were included. After obtaining written consent from every participant, Taiwanese brief version of the World Health Organization Quality of Life (WHOQLO-BREF-TW) instrument was used to measure QOL in this study. Data was analyzed with descriptive statistics, t-test, ANOVA, Pearson correlation, and Hierarchical Multiple Regression using SPSS for Windows Release 14.0. The results of this study showed that the score for quality of life was 45.73, indicating a moderate level quality of life (total score 80). Among four domains, “social relationships’’ domain was the highest scored, while “psychological health’’ domain was the lowest scored. Age, marital status, educational level, perceived health status, number of chronic disease, depression, and “self esteem and caring” factor of perceived quality of environment were influent factors of overall quality of life, and 3 hierarchical variables explained 71.8% of the total variances. Age, perceived health status, functional status, number of chronic disease, and depression predicted 66.3% of the total variances in physical health domain of quality of life. Educational level, perceived health status, and depression explained 67.7% of the total variances in psychological health domain of quality of life. Functional status, depression, living arrangement, and “self esteem and caring” factor of perceived quality of environment predicted 52.2% of the total variances in social relationships domain of quality of life. Educational level, depression, “self esteem and caring”, and “resources accessibility” factors of perceived quality of environment predicted 56.7% of the total variances in environment domain of quality of life. Depression was the only common predictor on quality of life of disabled elders. QOL is a complex, multidimensional concept, which no consensus existed in the literature. The study results not only provide information for understanding quality of life among disabled elders in Southern Taiwan, but also generate information for designing mental health promotion program and policy to serve the elderly who have been disabled.