失能老年人之自我管理行為與相關因素之探討

Self-management behaviors and related factors among the disabled elderly

丁于珊(Yu-Shan Ting)

指導教授 ： 徐慧娟

亞洲大學/健康學院/健康管理研究所/碩士(2009年)

摘要

中 文 摘 要
目的：本研究探討失能老年人對自我管理行為與相關因素之探討。方法：以面對面問卷調查訪問日間照護、醫院復健科門診與長期照護機構60歲以上之失能老人，訪問563人，符合慢性失能標準且完訪者為505人，完訪率89.7%。本研究自變項為社會支持、外在資源、健康情況和人口社經變項，依變項自我管理行為包括：運動和復健行為、飲食行為、靈性調適行為、與自我管理評價，並以邏輯式迴歸與複迴歸模式進行分析。結果：發現居住社區(OR=10.840)、醫護人員資源越多(OR=1.024)和親朋好友資源協助越多(OR=1.076)其運動或復健行為越多；社區環境資源越多(OR=1.168)、空間改善越少(OR=0.541)和認知功能越好(OR=1.115)，則注意飲食行為較多；女性(OR=0.306)、居住社區(OR=2.162)、社區環境資源較多(OR=1.073)、大眾媒體外在資源較多(OR=1.079)、ADLs失能項目越少(OR=0.897)者，靈性調適行為越多。居住在護理之家(β=-3.122)，醫護人員(β=0.205)、親朋好友資源越多(β=0.225)、社區環境(β=0.337)外在資源協助越多、空間改善愈多(β=0.622)、認知功能越好(β=0.218)者，自我管理評價越高。結論：外在資源的協助越多，失能老年人自我管理行為也越多。居住社區的失能老年人有較多自我管理健康的行為，顯示住機構的失能老年人較被動或自主性較低。建議未來應強化老年相關資源、社會支持和照護政策的投入，以提升失能老人的成功老化。
關鍵字：失能老年人、自我管理行為

關鍵字

失能老年人 ； 自我管理行為

並列摘要

Abstract
Purpose: This study aimed to investigate the self-management behaviors and related factors among disabled elderly. Methods: Data was collected by face-to-face survey from the day care, rehabilitation outpatient and long term care institution users who were aged 60 or over with physical disabilities. There were 563 persons interviewed, and 505 of them completed the survey, with completion rate of 89.7%. Self-management health behaviors included exercise and rehabilitation, dietary behavior, spiritual coping behavior and self-management evaluation. The predictors included demographic characteristics, health status, social support, assistive device use and home modification, and external resources. Logistic regression analysis was applied. Results: The disabled elderly who lived in the community (OR=10.840), had more support from the health care professionals (OR=1.024), more support from their family and friends (OR=1.076) would perform more exercise and rehabilitation. The disabled elderly who had more community environment resources (OR=1.168), less applied home modification (OR=0.541) and better cognition function (OR=1.115) performed diet management. Being female (OR=0.306), lived in the community (OR=2.162), having more community environment resource (OR=1.073), more media information (OR=1.079), and less physical disabilities (OR=0.897) were more likely to performed spirituality coping behavior. The disabled elderly who lived in nursing home (β=-3.122), had more support from health care professionals (β=0.205), more family and friends support (β=0.225), more community support (β=0.337), more applied home modification (β=0.622) and better cognition function (β=0.218), their self-management evaluation was better. Conclusions: The disabled elderly living in the community performed more self-management of health behaviors than the institutional elderly, which indicates the passive attitude or lower autonomy of the institutionalized elderly. External resource, social support, and health care management to self-management behaviors are suggested to improve successful aging.
Key word: disabled elderly、self-management behaviors

並列關鍵字

disabled elderly ； self-management behaviors

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