機構老年住民關懷感受量表之發展與測試

照顧者關懷被老年住民視為生活品質的核心條件之一，因應長期照顧機構住民對關懷之需，有需要發展合適的關懷量表供評值。雖然美國、台灣學者都曾發展過關懷量表，但並不適用於評量台灣長期照護機構老年住民所感受到來自專業與半專業照顧者的關懷。因此，有需要瞭解機構老年住民需要的關懷，並將此瞭解研擬一份具有文化敏感性，且適用於評量機構照顧者關懷程度的量表，以期能量化住民感受，進而量化機構照顧者的關懷行為。本研究採橫斷性描述性研究設計，自2012年6月至2013年3月共分成三個階段。第一階段依據質性研究結果及相關之關懷量表草擬一份機構老年住民之關懷量表，第二階段進行量表的內容效度檢核，第三階段針對250位機構老年住民進行關懷感受量表之心理計量測試。以探索性因素分析選取負荷量0.5以上的19個題目，並萃取出「受關切」與「安心」兩個因素，共可解釋老年住民感受的關懷構念達50.54%。總量表的α係數為0.92，「受關切」分量表的α係數為0.91，「安心」分量表的α係數為0.86；折半信度測得10題與9題之相關係數為0.88，顯示本量表具有良好的內在一致性。4週至6週間隔測量之兩個得分相關係數為0.85，顯示此量表具有良好的穩定性。本量表與關懷感受視覺類比計分表、生活品質及滿意度也具有顯著性相關，相關係數介於0.65至0.67 (p<0.01)，顯示此量表具有良好的收斂與同時效標關連效度。本量表擬定的題目簡短易懂，可測得老年住民感受到的照顧者關懷程度，可提供機構管理以及評鑑之指引，亦可提供訓練課程或評量介入成效之參考。

關鍵字

關懷感受；老人；長期照護機構；量表發展；心理計量

並列摘要

To meet the growing need for improved caring knowledge and skills in nurses and caregivers in long-term care facilities (LTCFs), a suitable caring scale is needed. Since currently available instruments for measuring caring, including instruments originally developed in either English or Chinese, have culturally inappropriate or insufficient for evaluating directed care providers in Taiwan, this study developed a scale for measuring the caring behaviors of caregivers as perceived by a Taiwan population of elderly residents of LTCFs. Another objective was to establish the psychometric characteristics of the scale. This cross-sectional descriptive study was performed in three stages from August, 2012 to February, 2013. In the first stage, an initial pool of items was obtained by reviewing the results of previous qualitative studies reported in the literature. In the second stage, item analyses of the caring scale were performed by a pilot survey of LTCF residents and consultations with elderly care experts. In the third stage, the caring scale, quality of life scale and well-being scale were administered to 250 respondents for psychometric evaluation. The 19-item, 2-dimension questionnaire developed in this study explained 50.54% of the variance in caring perceived by the respondents. Factor I, being concerned, included 13 items. Factor II, being relieved, included 6 items. Internal consistency and stability were supported by Cronbach’s α values and by split-half and 4- to 6-week test-retest Spearman correlation coefficients above 0.85. Convergent and concurrent criterion-related validity were supported by a Spearman correlation coefficient above 0.65. Thus, the psychometric qualities of the scale were acceptable. After the questionnaire was administered, surveys of the respondents showed that all scale items were easily comprehended. Therefore, the proposed scale can provide a useful reference for valuating training course, managing LTCFs, and establishing accreditation standards.