我國老人日間照顧服務品質之研究—服務使用者的觀點

A Study on Quality of Day Care Service for Elderly People - The Perspective of Service Users.

蔡惠雅(Hui-Ya Tsai)

指導教授 ： 詹火生

國立暨南國際大學/人文學院/社會政策與社會工作學系/博士(2016年)

摘要

以社區為基礎的「在地老化」照顧服務，是各國推動長期照顧政策的趨勢與目標，其中老人日間照顧服務迅速成長，儼然已成為我國社區照顧體系中不可或缺的重要服務項目之一。本研究以檢閱日間照顧及服務品質相關文獻為基礎，以「失能/失智的長者」做為研究的主體，採取服務使用者的觀點及積極正向的視角，聚焦在長者的能力、經驗與想望上，以立意取樣方式，針對桃竹苗地區5間日間照顧中心的20位直接服務使用者（長者）及6位間接服務使用者（家屬）進行深度訪談，據此瞭解服務使用者觀點的品質樣貌與內涵。
首先，本研究整理出服務使用者觀點的三個服務品質構面及十四個品質要項，其中「個人回應層面」，包含能力尊嚴、個別差異、自主自決、進步成長和回應要求等五個品質要項；「關係建構層面」包含溫暖氛圍、同儕互動、家庭連結、社會參與和重視團隊等五個品質要項；而「功能運作層面」則包含餐食交通、課程活動、醫療復健和環境設施等四個品質要項。其次，再就本研究所提出的日間照顧服務品質要項，與PZB服務品質模型及相關的照顧服務品質內容進行更深入的對話與討論，進而提出其差異與貢獻；再者，將本研究服務品質要項與現行日間照顧評鑑指標進行檢視與討論，瞭解服務使用者觀點的服務品質被重視的情形。
最後，回顧以服務使用者為主體的基本價值，依據研究結果與相關討論進行綜合歸納整理，針對理念、政府/政策及組織/實務三個方面，提出相關具體建議，期以厚實及提升日間照顧服務品質。

關鍵字

日間照顧 ； 長期照顧 ； 服務使用者 ； 服務品質 ； 評鑑指標 ； PZB模型

並列摘要

“Aging in place” care service based on community is the trend and goal of promoting long-term care policy in many countries. Among which, day care service for elderly grows rapidly and has become one of the indispensable service items in the community care system in our country. The research is based on reviewing related references of day care and service quality, using “elderly with disability/dementia” as the main body of the research, focusing on elderly’s ability, experience, and want with service users’ point of views and positive vision. With purposive sampling method, in-depth interviewing 20 direct service users (elderly) and 6 indirect service users (family members) of 5 day care centers in Taoyuan-Hsinchu-Miaoli region to understand the quality type and meaning of service users’ viewpoints.
Firstly, the research sorts out 3 service quality aspects and 14 quality elements of service users’ point of view. “Personal response aspect” consists of 5 quality elements, including ability and dignity, individual differences, autonomy and self-determination, improvement and progress, and responding to requests; “relationship-building aspect ” consists of 5 quality elements, including warm atmosphere, peer interaction, family connection, communal participation, and valuing the team; “function operation aspect” consists of 4 quality elements, including dieting and transportation, curriculum and activity, medical treatment and rehabilitation, and environmental facilities. Secondly, having deeper conversation and discussion on PZB service quality model and related content of care service quality in accordance with the day care service quality elements suggested by the research, and further suggest the differences and contributions. Thirdly, viewing and discussing service qualities of the research and the current evaluation indicators of day care to understand the condition of service quality of service users’ viewpoints being valued.
Finally, reviewing service-user-centered basic value and to conduct general induction-arrangement according to research results and related discussions, offering related practical suggestions targeting aspect, government/policy, and organization/practice these 3 aspects, expecting to elevate the service quality of day care.

並列關鍵字

day care ； long-term care ； service user ； service quality ； evaluation indicator ； PZB model

參考文獻

黃志忠（2014）。〈居家服務使用對老人家庭照顧者照顧負荷之緩衝性影響研究〉。《社會政策與社會工作學刊》，18(1)，1-43。

參考文獻

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