臺灣失能者居家服務使用現況及其影響因素之探討

An Investigation on the Utilization and Prognostic Factors of Community Long-Term Care Service in Taiwan

李佳芬(Chin-Fen Lee)

指導教授 ： 周桂如

臺北醫學大學/護理學院/護理學研究所/碩士(2011年)

摘要

本研究目的主要探討失能者居家服務使用情況及探討影響居家服務使用情況模式之相關因素，其彼此間相關性。運用次級資料分析，資料來源為2007年由內政部主辦「居家服務補助使用者狀況調查」之資料。該資料為隨機取樣，該研究對象選自臺省各省縣市使用居家服務失能者，依據研究目的及假說擷取失能者等問卷資料。將所有符合收案條件者，全數納入研究，總計共2508名。研究方法橫斷式調查研究設計(cross-sectional study design)，資料分析包括描述性統計分析及t-test、邏輯斯迴歸分析法（Logistic regression）等推論性統計。依研究結果，茲將結論敘述如下：本文以內政部96年7月辦理「居家服務補助使用者狀況調查」為研究對象，樣本數計2,708人，研究發現：在基本資料年齡平均為75.10歲、以女性居多、一般戶居多、持有身心障礙手冊較多，婚姻為有偶或同居、喪偶居多；在家庭狀況方面以獨居者占24.8%，現同住人口數平均2.01人，主要照顧者以子女或配偶為主、家庭支出以未滿20000元居多，每月收入以大約剛好足夠及不符實際需要最多；在居家服務滿意度方面則以照顧服務員服務態度最高，使用居家服務後對身心改善則以心理健康居多。
以邏輯斯迴歸(Logistic Regression) 分析，發現與居家服務頻率預測模式的主要影響因素為「失能程度」、「親人同住與否」、「獨自穿脫衣服困難度」、「獨自處理掃地、洗碗、倒垃圾困難度」、「獨自處理獨自打電話困難度」及「生活上最主要各項費用之來源」；與居家服務時數的預測模式主要影響因素為「身分」、「失能程度」、「教育程度」、「住宅所有權屬」、「親人同住與否」、「是否患有慢性或重大疾病」、「獨自洗澡困難度」、「獨自起床、站立困難度」、「獨自坐汽車或火車困難度」、「獨自處理獨自掃地、洗碗、倒垃圾困難度」、「主要照顧者類型」、「家裡一個月的開支」、「平均每日照顧時間」｣等變項達統計學上顯著意義(P< .05)。藉由本研究結果，建議提供長期照護時，應充份了解失能者實際需要，提供彈性、獨立性照顧服務，提昇老人失能者生活品質。

關鍵字

居家服務

並列摘要

The aim of current study is to investigate the status of community long-term care service and possible factors affecting the utilization of such service in Taiwan. The utilization of home care services by targeted population of disabled elders initially assessed by Minister of Interior in 2007 were analyzed with a cross sectional research design and convenient sampling. 2508 subjects were interviewed out of 2,708 samples. The data were analyzed by descriptive statistical analysis, t-tests, and Logistic regression. Demographic analysis shows that the average age of these users is 75.10 years of age, mostly women 56%, most are from common families 41.7% , most of them are either physically or mentally 39.3% disabled. For family statues, most of them are married and live with their spouses, the average number of people living together is 2.01. 24.8% of them live alone. The major caregivers of those disabled aged are either their children or spouses. Most of them 52% have monthly expenditure of less than 20,000 NT dollars, and most of their monthly incomes are barely enough to cover their actual needs. As for degree of home service satisfaction, among different types of caregivers, the professional caregivers showed the best attitudes. People who receive home care service are mentally healthier. The predicting factors of home care service utilization frequency, according to logistic regression analysis, were “degree of disability ”, “stay with one’s relative living together ”, and “ability to put on clothes independently”, “ability to sweep the floor, clean the dishes and take out garbage”, “ the main source of living expenses” and “ Call difficulty ”. In addition, the predictors of home care service utilization time were “ welfare status ” , “level of education”, “ownership of residence”, “stay with one’s relative”, “suffer from chronic or major serious diseases”, “ability to shower independently”, “ability to stand or walk independently”, “travel by car independently”, “ability to sweep the floor, clean the dishes and take out garbage”, “type of caregivers”, “monthly household expenditure” and “average daily care time”.
Discussion:
According to this study, the suggestion of developing a simple and reliable evaluation tool for assessing the needs of long-term care service was made in order to provide appropriate and available services according t subjects’ needs. The government has to plan and implement “Service procurement system” as early as possible, so disabled elderly and their families are able to pay reasonably for long-term care service they need. The goal is to satisfy the needs of the elderly and improve their quality of life.

並列關鍵字

home care

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