臺北市小型養護機構高齡住民自主性與生活品質及其相關因素研究

目的：了解臺北市小型養護機構高齡住民自主性與生活品質之預測因子。方法：以機構為單位，採「集束採樣」方式，問卷以背景變項、巴氏量表、簡短老人憂鬱量表、自覺健康狀況量表、老人自覺自主性量表及生活品質量表等結構式問卷蒐集資料，採面對面訪問的調查方式進行，共取得臺北市38家小型養護機構內意識清楚、無失智（SPMSQ≧6分）、年齡這65歲，可溝通之351人（100%）有效樣本。結果：研究對象整體「自主性」屬中等程度，其中以「入住決策者」、「日常生活功能」、「憂鬱程度」及「自覺健康狀況」為自主性主要的預測變項。「生活品質」中以「社會關係範疇」與「環境範疇」屬中上程度，而「心理範疇」與「生理範疇」屬中等程度，其中以「性別」、「年齡」、「機構居住時間」、「居住費用支付者」「日常生活功能」、「憂鬱程度」、「自覺健康狀況」及「自主性」為生活品質主要的預測變項。結論：研究對象之背景變項及健康狀況可有效預測自主性，而背景變工頁、健康況及自主性亦可有效地區別預測生活品質四個範疇面，其中又以「自主性」對生活品質四個範疇面皆有預測力且影響力為最大。建議:重視高齡住民之異質性，提供不同程度之照顧措施，強化自主性照護，避免「廢用症候群」發生，使其保有自尊、自主及獨立性或享有生活品質為機構式照護之最終目的。

關鍵字

小型養護機構高齡住民；生活品質；自主性

並列摘要

Objective: This research paper aims to find the influencing factors between autonomy and quality of life of aged residents in small-scale seniors' home in Taipei. Method: This research paper adopts ＂cluster sampling＂ methodology basing organization as a unit.se organizations as a unit. The way to collect data is through face-to-face interviews with using structured questionnaires, including the background variables questionnaire, Barthel Index, geriatric depression scale, perceived health status scale, perceived enactment of autonomy scale and WHOQL-BREF. Results achieved total 38 small-scale Seniors' home in Taipei City, no dementia (SPMSQ ≥ 6 points), age ≥ 65 years aged or older who can communicate of 351 (100%) effective sample. Results: The autonomy of the research subjects is moderate. ＂decision makers for living in small-scale seniors' home＂ , ＂activity of daily living＂, ＂depression degree＂ and ＂perceived health status＂ have been fond to be major factors in accurate predictions. The “social relations category＂ and the ＂environment category＂ in ＂quality of life＂ of the research subjects are above average, while their ＂mental category＂ and ＂physical category＂ are only at the moderate level. ＂gender＂, ＂age＂, ＂educational status＂ , ＂living time in care facilities＂ , ＂payers of living expenses＂ , ＂activityof daily living＂, ＂depression degree＂, ＂perceived health status＂ and ＂autonomy＂ are major predictoy. Suggestion: The ultimate goal of ＂deinstiutionalization＂ care is to keep the self- Implement， independence and individualism in the elders by valuing their diversities, providing levels of health caring systems and strengthening individualized caring policies to prevent them from ＂disuse syndrome＂.