護理之家老年住民心理社會適應歷程

Psychosocial Adaptation of the Elderly in the Nursing Home

林亭利(Ting-Li Lin) ； 毛慧芬(Hui-Fen Mao) ； 王素琴(Suh-Chin Wang) ； 胡名霞(Ming-Hsia Hu)

《長期照護雜誌》 21卷3期 (2017/12) Pp. 233-250

https://doi.org/10.6317/LTC.21.233

摘要

護理之家的老年住民，面臨老化、疾病、機構三層面的適應，且三者相互關聯。既有經驗研究較少區分三個層次，又忽略其變動的過程。老化研究常應用的理論，僵化老年的想像。因此本研究為質性分析，由健康本源模型的觀點，方便取樣4位受訪者之訪談資料與田野筆記，分析過程特別強調文化與個體的互動，理解老年住民的適應歷程，包含其如何因應變化及調適自己等面向。研究結果依據調適處境的方式，分為嚴以律己、接受現狀及聽天由命等三種適應類型。嚴以律己者，認為老就會生病，並嚴格執行健康行為避免生病，情感上無法完全接受自己住在護理之家，卻又自我疏離。接受現狀者面對老化與疾病都意識到轉變並接納，正向理解個人處境，又從限制中找尋因應方針。聽天由命者自覺老年生活比較好，僅關注疾病可以理解的部分，入住機構則是既來之則安之。此外本研究並由性別、教育程度及家的意義，討論住民敘事議題的異同。期盼多樣的適應樣態和友善環境，有助於人們在變老的過程中，適應良好。

關鍵字

護理之家 ； 老年人 ； 心理社會適應 ； 文化環境 ； 健康本源模型

並列摘要

Elderly residents in nursing homes are confronted with aging, disease, and institution adaptation issues. These three domains of adaptation issues are. The experiential literature rarely distinguished these three domains and ignored the dynamic processes of adaptations. In addition, the theories often applied in aging studies fossilize the aging imagination. This study observed the adaptation process of elder residents interconnected regarding how they coped with and adapted to the changing living environment of when they moved from their personal homes to a nursing home. A salutogenic model was utilized as the main analyzing model. The research methods included semi-structured interviews and participant observation with retrospective design. Four elderly nursing home residents were included by convenience sampling. Based on the current attitude to life, the elderly residents were grouped into three categories: ＂spurring themselves＂, ＂feeling comfortable＂, and ＂trusting to luck＂. Residents with the ＂spurring themselves＂ attitude conceptualize the elderly as often sick, adopted strict healthy behaviors to avoid illness, and were self-alienation and unable to emotionally fully accept their own lives in a nursing home. Residents who were feeling comfortable were aware of and accepted changing of aging and diseases, positively realized the personal situation, and were seeking for the coping resources from the restrictive environment. Residents who were trusting to luck thought that aging life is better, and only concerned with the parts of diseases which they were able to understand, and took things as they came about living in a nursing home. This study also discussed the similarities and differences between the residents' narrative topics in the gender, education level and the meaning of home perceptive. Women either with a relationship or not were becoming caregivers rather than men so families with illnesses would affect their life course. Resident whose education level is lower tier than the others had the different type of work before retirement, of the living arrangements, and of the leisure styles. Only the one, whose goal was back to her personal home, felt a homelike atmosphere; the others were not. However, they must live in the institution during the rest of their lives but only one of the residents positively perceived living in the nursing home. It is suggested that observing the types of adaptation of elderly residents and building a friendly institutional environment may facilitate elders to adapt well to a new environment and help the residents to succeed in the process of growing old.

並列關鍵字

nursing home ； elderly ； psychosocial adaptation ； cultural environment ； salutogenic model

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