高雄市社區照顧關懷據點對高齡者遠距口腔照護之需求評估

Tele-Dental Care for Independent Elderly People: A Needs Assessment of Community Care Centers in Kaohsiung

李貞儀(Lee, C.-Y.) ； 吳如惠(Wu, J.-H.) ； 杜哲光(Du, J.-K.) ； 張永源(Chang, Y.-Y.)

《福祉科技與服務管理學刊》 6卷3期 (2018/09) Pp. 239-252

https://doi.org/10.6283/JOCSG.201809_6(3).239

摘要

台灣預估將在2025年成為超高齡社會，對於各種醫療照護的需求將逐年增加，高齡者的口腔問題相當常見，在牙科照護長年來較受到民眾忽視之下，社區中亦缺乏口腔預防保健專業人員，使得高齡者的口腔健康促進困難重重。因此，尋求新策略以因應高齡者需求，有其迫切之必要性。本研究以網路問卷調查高雄市的社區照顧關懷據點對於遠距口腔照護之需求，共有94個據點完成問卷調查，回收率53.71%。結果顯示，據點工作人員觀察到社區高齡者有不少口腔困擾，但相對較少據點觀察到高齡者出現吞嚥困難相關的徵狀，據點普遍認為高齡者有高度的口腔照護需求，尤其是有服務輕度失能高齡者的據點，對於遠距口腔照護的需求較高，在執行遠距口腔照護的障礙性上也普遍認為障礙性偏高。本研究顯示，對社區高齡者進行口腔清潔與機能促進等衛教介入有迫切之需求，若是能排除據點場地、設備等障礙，以移動性和便利性更好的工具（例如平板電腦和智慧型手機）取代桌上型電腦，更有可能發展高齡者的遠距口腔照護服務。另一方面，為改善社區高齡者口腔照護人力問題，將遠距口腔照護服務納入醫療給付並採論人計酬制，是值得討論的方向。

關鍵字

在地老化 ； 社區照顧關懷據點 ； 遠距口腔照護 ； 需求評估

並列摘要

Population aging in Taiwan cannot be ignored. It is estimated that Taiwan will become a super-aged society (aged population ＞ 20%) in 2025. The demands for medical care will increase annually, including dental care. In Taiwan, people do not understand that good oral health can improve the management of chronic diseases, promote quality of life, and reduce recurrence and mortality. Oral health and dental care have long been ignored; caries, tooth loss, and edentulism are prevalent among elderly people. The lack of licensed paraprofessionals such as dental hygienists in the community makes the promotion of oral health almost impossible. Hence, a new strategy to cope with these demands is needed. This study aims to investigate the demand for tele-dental care among independently living elderly people in the community. We conducted an online survey from March to June in 2017 involving employees of community care centers in Kaohsiung City. Of the 216 community care centers in the city, 41 could not be contacted through e-mail or telephone because of temporary suspension. A total of 94 centers completed the questionnaire, giving a response rate of 53.71%. Statistical analyses were conducted using the independent t test, one-way analysis of variance, and Pearson's correlation. This study shows that community care centers, especially those that cater to elderly patients with mild disabilities, reported a high demand for oral hygiene and oral function promotion intervention among elderly people, as well as tele-dental care. However, the barriers for tele-dental care were also reported to be high. The need to provide oral health intervention for independently living elderly in the community is urgent. If the obstacles of site or equipment could be removed by using, for example, tablet PCs, iPads, or smart phones and apps, a tele-dental care model would be more feasible. Moreover, incorporating tele-dental care into a benefits package and adopting capitation payment is a possible solution.

並列關鍵字

aging in place ； community care center ； tele-dental care ； needs assessment