失能者社會參與及其相關因素探討

「失能」對個體影響甚大，同時還可能帶來家庭與社會的負擔。失能者面臨疾病或創傷的衝擊後，往往使其社會參與受限，甚至使其日漸退縮，喪失生命活力。本研究目的旨在探討失能者人口學特性、疾病特性、憂鬱及社會支持等與其社會參與的關係。採橫斷性、結構性問卷調查法，實際研究場所及對象為高雄市某一醫學中心、兩家區域醫院之復健科門診及十二家長期照護機構之100位20歲以上失能者。測量工具內容包含人口學與疾病特性、台灣人憂鬱量表、社會支持量表、社會參與量表及巴氏日常生活功能量表。資料以描述性統計、t 檢定、皮爾森積差相關以及逐步迴歸法進行分析。結果發現失能者社會參與程度平均為中度；失能者年齡、居住狀況、教育程度及自我照顧功能對其社會參與有顯著影響；在社會參與的重要解釋因子部份，居住於長期照護機構、憂鬱及社會支持能解釋失能者社會參與44.8％之變異量，其中又以居住於長期照護機構具最佳解釋力。本研究結果可提供醫護人員執行失能者照護時，能瞭解影響失能者社會參與的相關因素，藉由早期發現並適時處理個案之憂鬱情緒、增進其社會支持，以避免失能者社會參與受限，促其成功返回社區。

關鍵字

失能；社會參與；憂鬱；社會支持

並列摘要

“Disability” has a huge impact on individuals and presents a burden to the families of the disabled and to society. Usually when disabled persons face illness or trauma, their social participation becomes greatly restricted; they often hold back and lose their vitality. This study aims to explore such characteristics as demography, illness, depression and required social support among persons with disabilities, as well as the relationship between which and their social participation. As for methodology, cross-sectional and structural questionnaire surveys were used, and the study objects were 100 disabled persons who were all more than 20 years old. They were chosen from the rehabilitation departments of one medical center and two regional hospitals, as well as from 12 long-term care institutions in Kaohsiung. Measuring tools included the Taiwanese depression Scale, the Social Support Scale, the Social Participation Scale and the Barthel Index. The collected data were analyzed by descriptive statistics, t-test, Pearson correlation, stepwise regression procedure, etc. The results showed average social participation at the middle level, with significant influence of such factors as: age, living status, educational level and self-care function. From the perspective of important explanatory factors in social participation, there was 44.8% of variance for disabled persons who are living in long-term care institutions and have depression and social support. Persons with disabilities who are living in long-term care institutions gave the best explanation. This study’s conclusions can be referred to by medical and nursing personnel so that they can understand the correlative elements between disabled persons and social participation. If their depression can be recognized earlier and be treated as soon as possible, social support can benefit them to a greater extent; if the restrictions on social participation can be avoided, they can return to the community more easily, quickly and successfully.