使用居家醫療老人生活品質之研究以南投縣埔里鎮為例

根據內政部統計處最新統計指標，老年人口比率今（2018）年3月底就達到14.05％正式邁入國際慣稱的「高齡社會」，去(2017)年粗出生率創下7年最低紀錄，平均餘命長期呈現上升趨勢，隨著高齡人口逐年增加未來的健保財務負擔將會是非常沉重的包袱。目前長照2.0新的服務項目「居家醫療照護整合計畫」提供患者連續性居家醫療與全人照顧，提升因失能或疾病特性致外出就醫不便患之醫療照護可近性，並改善現行不同類型居家醫療照顧片段式的服務模式，以提供病患整合性之全人照顧。因此將使用居家醫療老人生活品質做深入的研究和分析，是有其必要性，此為本篇論文的研究背景跟動機。本研究採取以立意取樣方式，邀請符合使用居家醫療資格本人5人及其家屬3人為受訪者，並使用質性研究半結構性的訪談進行資料的蒐集，做為本論文的研究方式。主要目的在了解使用居家醫療老人生活之現況及使用居家醫療對老人生活品質之影響。本研究發現使用居家醫療老人目前在生活品質上，就生理狀況、心理因素、生活自理、社會參與四個面向，確實有一定的成效，有效減輕使用服務者、使用服務者家屬經濟上和精神上的負擔。最後本論文以研究發現使用服務者家屬對於居家醫療團隊服務項目的需求，針對此需求就政策面、實務面，提出建議。

關鍵字

居家醫療照護整合計畫；長期照顧；生活品質

並列摘要

According to the latest statistics indicated by the Department of Statistics, Ministry of the Interior, the elderly population of our society reached 14.05% at the end of March this year (2018) and we’ve officially entered the internationally known "aged society". The crude birth rate of last year (2017) hit a record low in 7 years, while the average life expectancy has shown a long-term upward trend. As the senior population increases over time, the financial burden of national health care will be a very heavy burden in the future. The current “Integrated Home Care Program”, a new service project of Long-term Care 2.0, provides patients with continuous home care and holistic service to improve the accessibility to medical care of the patients disabled or hampered by diseases. This new approach is aimed to replace the existing model of fragmented home care services of various kinds, and provide patients with integrated holistic care. This research has done an in-depth study and analysis on the life quality of the elderly receiving the home care, as the background and motivation of this research paper. The purposive sampling has been used by interviews with 5 persons eligible for the home care and 3 family members of the 5, and the data have been collected through the semi-structured in-depth interviews in a qualitative approach as the research method. The main purpose is to understand the living status of the elderly receiving the home medical care and the impact on their everyday life. This research has concluded that the home medical care for the elderly does have produced positive results on the quality of life, in the aspects of physical conditions, psychological factors, self-care, and social participation, effectively relieving the economic and mental burdens of the home care receivers and their families. Finally, this paper has put forward suggestions based on the research findings.