從養護機構住民未滿足需求論台北榮家養護區之經營管理

The Long-tern Care Institutions Management in Taiwan: From the Taipei Venterans Home Resident’s Unmet Needs.

吳佩宜(Pei-Yi Wu)

指導教授 ： 陳家祥

元智大學/管理學院/管理研究所/碩士(2009年)

摘要

我國老人人口自1993 年達到聯合國世界衛生組織所訂之高齡化社會指標，已發展多元服務模式滿足失能老人之照護需求，但在現實的環境中，仍有許多身心功能障礙的老人，不得不選擇入住機構度過晚年。但是機構集體生活方式，對生活自理能力缺損的老人而言，對所提供的照護服務，是否能滿足其需求？由此，本研究目的為探討養護機構住民，於執行日常生活活動及工具性日常生活活動未滿足需求分佈情形，及未滿足需求與照護品質、憂鬱情緒之相關性。
本研究採立意取樣，個案來源為台北榮家養護區住民，符合收案標準之126 位榮民為研究對象，以結構式問卷一對一訪談老人，問卷內容包括住民屬性、照護品質、未滿足需求及憂鬱等量表。所收集的資料以SPSS12.0 套裝軟體，進行敘述性統計、推論性統計、皮爾森積差相關及多元迴歸進行分析。
本研究結果顯示，養護區住民在執行日常生活功能及工具性日常生活活動未滿足需求盛行率，以「部份需求未獲得滿足」59.5%佔最高、「完全滿足需求」為40.5%。老人於從事日常生活活動時，最需要他人協助的活動項目及盛行率依序為：洗澡（63.5%）、上廁所（25.4%）及上下床（19.0%）；最需要協助的工具性日常生活活動項目及盛行率依序為：洗衣服（88.9%）、煮飯（82.5%）、購買生活用品（73.8%）。以皮爾森積差相關分析照護品質與未滿足需求評估有顯著負相關，未滿足需求與憂鬱情緒有顯著與相關；多元迴歸分析中，在控制人口特質變數後，照護品質與未滿足需求具顯著負相關；未滿足需求與憂鬱情緒具顯著正相關。
此研究結果，可瞭解養護機構失能老人在未滿足需求之盛行率，藉由提昇工作人員及機構的照護品質，可改善住民未滿足需求之表達；在未滿足需求的情形減少下，可減低機構住民憂鬱情緒。此研究除了探討養護機構失能老人未滿足需求情形，並能提供機構經營管理之參考。

關鍵字

養護機構；未滿足需求；照護品質；憂鬱情緒；經營管理

並列摘要

The elderly population in Taiwan had already met the criteria of Aging society of World Health Organization (WHO) since 1993. There are multiple service models for the caring need of disabled elderly, but in real situation, many disabled elderly still need admitting into institutions during their old age. It is a question that could institutional care fulfill the need of the disabled elderly ? The objective of our study is to explore the “unmet need” of institutional residents during executing activities of daily living (ADL) and instrumental activities of daily living (IADL) , and the association between caring quality, depressive mood and unmet need.
Convenience sampling method was used and the participants are from the long-tern care residential of Taipei Veteran Home. One hundred and twenty six veterans joined the study program. The all received one to one interview by questionnaires which include characteristics of articipants, scales for quality of care, unmet need and depressive symptoms. SPSS 12.0 software for windows was used to perform descriptive statistics, analytic statistics, Pearson’s correlations and multiple regression analysis.
The result indicate that the majority response to “unmet need” during executing ADLs and IADLs are ”Partly unmet need”(59.5%) and “No unmet need”(40.5%). The most dependent activities in ADLs are bathing(63.5%)、using the toilet(25.4%) and transferring from bed (19.0%) and the most dependent IADLs are laundry(88.9%)、cooking (82.5%) and purchasing the daily necessities (73.8%). The Pearson’s correlation indicate significant negative correlation between caring quality and unmet need and significant positive correlation between unmet need and depressive mood. After adjusting the demographic covariance, caring quality could still negatively predict the unmet need; and unmet need could positively predict the depressive mood.
The conclusion is that the prevalence of unmet need among disabled elderly in long-tern care institutions could be reduced by improving the caring quality of institution and staffs. The depressive mood could be decreased by reducing the unmet need. The study emphaxize the importance to explore the unmet need among long-tern care institutions and it could provide implication for institutional manager.

並列關鍵字

long-tern care institutions；unmet needs；quality of care；depression mood；management

參考文獻

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