本研究欲瞭解家庭內老人心理虐待的發生現況,探討加害者與被害者的互動狀況、照顧情境,以及家庭內老人心理虐待發生的相關因素。基於上述研究目的,本研究以情境脈絡模式為研究架構,主要採取量化研究方法,抽取中台灣177位正在使用居家服務的老人及主要照顧者,以面訪方式進行問卷調查,並且輔以質性訪談方式,訪問3位照顧者和3位照顧服務員,藉以補充量化之不足,其主要研究結果如下: 1.使用照護者精神虐待老人行為量表(CPEAB),在20項指標中,發現得分前三高的選項為「不願接納老人之意見」、「忽略老人要求」,以及「打斷老人注意力」。 2.老人心理虐待發生的危險因子,包含主要照顧者的人口特質變項,如藥物濫用問題、兒時受虐經驗,以及未來照顧意願,在情境脈絡中,則包含互動關係與家庭照顧壓力二個變項,都和老人心理虐待量表達到顯著相關,整體模式的解釋力為24.2%。 3.從質性資料中可以得知本研究老人的心理虐待行為包含了口語上且動作粗魯、不尊重老人作為一個人、孤立老人、不關心及對老人冷漠。 4.主要照顧者的壓力在情境脈絡下視為一個連續性的發展,包含影響照顧者的工作、感覺被綁在家裡、有經濟及健康上面的問題、心理的負荷感,以及最後和社會疏離。 5.心理虐待問題確實存在於台灣社會中,考量老人心理虐待發生的相關原因,需同時思考老人本身、主要照顧者本身,以及二者在情境脈絡下共同互動的結果而成,不再以單一原因來論。 最後,根據研究結果提出在政策上、實務上,以及未來學術方向上的建議,以供參考。
This study aimed to understand the elderly psychological abuse in the family, the relationship and caregiving context between the elder and caregiver, and the correlated factors in family. The main research method is quantitative method by using face-to-face surveys to collect data. A total of 177 samples are using home services completed this study in central Taiwan. The researcher also combined qualitative research by using in-depth interview, including 3 caregivers and 3 home helpers. The main findings of this research are as following: 1.Caregiver Psychological Elder Abuse Behavior Scale(CPEAB) was used to collect data, among the 20 indicators, “Refuse to accept his/her opinion” ,”Ignore his/her requests”, and ”Interrupting his/her” received the highest scores. 2.The risk factors for elder psychological abuse are caregivers’ characteristics, including substance abuse, abused as a child, and reluctance to care. In caregiving context, the interaction of the caregiver and elderly, and the pressure of caregiving are also the risk factors. All of variables accounted for 24.2%. 3.From qualitative data, psychological abuse of the elderly including verbal aggression with treat rough, not respect for the elder, social isolation, don’t care about the elder and treat cold. 4.Under the pressure of caregiving, caregivers may have problems with their work, feeling be tied at home, having physical illness, economic pressures, burden, and they will be isolated finally. 5.This study demonstrates that psychological abuse of the elderly is common among elder Taiwanese, three clusters of risk factors have been considered. The first and the second cluster relate to the personal characteristics of the elder and the caregivers, and the third cluster involves the caregiving context. According to the finding and conclusion, this study has suggestions for policy, practice, and further research.