長期照護機構住民之工具性日常生活活動需求評估

Assessment of Instrumental Activities of Daily Living Needs among Residents in Long-term Care Facilities

張席熒(Hsi-Ying Chang) ； 李世代(Shyh-Dye Lee) ； 陳保中(Biau-Jung Chen) ； 謝清麟(Ching-Lin Hsieh)

《台灣老年醫學雜誌》 2卷2期 (2006/11) Pp. 116-129

摘要

有關老人工具性日常生活活動(IADL)需求之評估有其重要性，但是卻少有相關之評估。本研究目的在於瞭解長期照護機構老人住民IADL需求情形及其影響因子。研究主要評量工具爲「IADL需求量表」，其需求程度分級含括：IADL需求滿足且明顯無問題（等級Ⅰ）、需求滿足但有潛在問題（等級Ⅱ）、不確定（等級Ⅲ）及需求未滿足且有現存問題（等級Ⅳ）等四類。透過台北地區一所自費安養中心之173位老人住民接受問卷訪談進行IADL需求量表之觀測分析，結果發現：(1)研究觀測此類長期照護機構之老人其平均年齡約80歲，但身體功能仍大致良好；(2)僅少數老人呈現IADL需求有現存之問題(15%)，且其以輕勞動家務及財務管理等二項之現存需求較多（分別爲5.2%、4.0%）；(3)以多變數羅吉斯迴歸分析發現IADL需求有現存問題之相關因子，包含有婚姻狀況、居住地之生活機能等變項。由於此類照護機構之屬性偏向健康之老人住民爲主，故研究結果可視爲長期照護機構老人住民IADL需求之最低估計，這些數據有利於老人長期照護服務計劃之擬定，並提供更適切的照顧服務。

關鍵字

工具性日常生活活動 ； 長期照護機構 ； 老年人

並列摘要

In spite of its importance to the elderly in long-term care facilities, the needs for Instrumental Activities of Daily Living (IADL) have rarely been assessed. The purpose of this study was therefore to examine the status and related factors of IADL needs among residents in long-term care facilities. Measurement of IADL needs was based on the IADL Assessment Scale. The needs status was categorized into: needs met without apparent problem, needs met with potential problems, uncertainties, and needs unmet with current problems. We interviewed 173 elderly residents in a private domiciliary care facility in Taipei. Compared to residents in nursing homes with significant disabilities, residents in domiciliary care facilities usually do not have ADL impairments and require only custodial cares. We found that: (a) Mean age of the subjects was 80 years, and most of them were with good physical function. (b) Only a few subjects had current problems of the overall IADL needs (15%). (c) The results of multiple logistic regression analysis identified marriage and amenity of living as the variables correlated with the current problems of overall IADL needs.
In conclusion, the results obtained by our study may serve as the basic standards for assessing the IADL needs of the elderly residents in long-term care facilities. These results can also be consulted to facilitate better care service planning and provision.

並列關鍵字

instrumental activities of daily living IADL ； long-term care facility ； elderly