Title

護理之家服務現況與住民需求

Translated Titles

The Current Status and Needs of Residents in Nursing Home Facilities

DOI

10.6594/JTOTA.2002.20.08

Authors

羅鈞令(Jin-Ling Lo);黃小玲(Sheau-Ling Huang);毛慧芬(Hui-Fen Mao);蔡宜蓉(Yi-Jung Tsai);林惠冠(Huei-Guan Lin);李世代(Shyh-Dye Lee);張志仲(Jyh-Jong Chang)

Key Words

護理之家 ; 長期照護 ; nursing home ; long-term care

PublicationName

職能治療學會雜誌

Volume or Term/Year and Month of Publication

20卷(2002 / 11 / 01)

Page #

95 - 106

Content Language

繁體中文

Chinese Abstract

為因應老年人口的快速成長,近年來在政府政策性的鼓勵之下,護理之家之數量成長快速,然而其所提供的專業服務卻尚有待加強。本研究的主要目的是探討目前護理之家的服務內容,人力配置,以及在長期照護工作上所面臨的困難與需求,同時也了解護理之家住民的特性、問題與期望,以作為未來發展護理之家職能治療服務模式之依據。 台北與高雄地區共回家護理之家的護理與服務人員,以及住民每家各兩位接受了訪談。由訪談結果得知,目前護理之家的人力以護理與服務人員為主, 服務內容以基本日常生活照護、護理及醫療為主,住民的精神生活貧乏,缺少復健或刺激,以致住民關節僵硬或變形的情形普通、情緒不穩定且溝通困難。此外工作人員感到專業人力的支援不足,且由於老年人容易退化,以致工作成就感低、挫折感大。由住民訪談得知,住民的環境適應不良,生活內容貧乏, 生活沒有目標,多數均表示希望能夠早日回家或乾脆死了算了。 此外自88年12月至90年7月止,共有285位住民接受了下列評估:分別是巴氏量表(Barthel Index)、老年人生活功能量表(Geriatric Rating Scale)、MDS認知功能量表(MDS Cognitive Perfonnance Scale)、人際技巧評量(Interpersonal Skill Survey)、社會參與量表(Social Engagement Index)、活動參與(Activity InvoJvement)等。認知功能正常的住民並填答生活滿意度量表(Life Satisfaction Index - Z)。結果發現住民的認知功能大多受損,且其認知功能與日常生活功能、整體生活適應、人際互動技巧、社會參與及活動參與均有顯著的相關。但是相較於認知功能,住民的日常生活功能障礙的情形更為嚴重。除了老化與身心功能障礙的影響外,活動量嚴重不足亦可能是促使住民生活功能退化的原因。 為改善護理之家服務品質與住民的生活品質,應盡速修改護理之家設置標準,要求護理之家庭時有專長日常生活功能訓練典活動設計的職能治療師,協助護理及服務人員為住民設計個別化的照護計劃以及多樣化的團體活動,提供住民一個像家一樣的主活環境,以維護住民最大可能的健康或獨立。

English Abstract

Owing to the rapid growth of geriatric population, the number of nursing home facilities has increased sharply in the past few years as a result of the country's health care policy in developing long term care service for the elderly. Despite the increase of the number of these facilities, the service quality is still to be improved. The purpose of this study is to discuss the content of service, manpower and difficulties of long term care service provision as well as well as to understand the service quality is still to be improved. The purpose of this study is to discuss the content of service, manpower and difficulties of long term care service provision as well as to understand the characteristics of residents and their problems and expectation. It is hoped the results of this study can contribute to the development of occupational therapy service model in nursing home facilities. Care providers including nurses and caring aids and residents for 4 nursing homes (2 nurses, 2 care aids and 2 residents from each facility) in Taipei and Kaohsiung areas were inter-viewed. The results showed that the current manpower of nursing home mainly consisted of nurses and caring aids and the content of service focused on daily routine care and nursing care. The spiritual lives of the residents were rarely addressed and there was lack of rehabilitation program or environmental stimulation. Therefore, occurrence of joint contractures, emotional liability and communication difficulties were common. On the other hand, the caring personnel often felt that there was lack of backup support from other disciplines. In addition, due to the regressive nature of the geriatric poplation, poor work satisfaction and great frustration were commonly reported by the caring personnel. Interviews with the residents reflected adaptation problems, hopelessness, and lack of life quality. The majority of the residents stated their wills of returning home and thoughts of ending their own lives. In order to understand the characteristice of the residents, 285 residents from the four nursing homes received assessment during the period of December, 1999 to July, 2001 using the following tools : Barthel Index, Geriatric Rating Scale, MDS Cognitive Performance Scale, Interpersonal Skill Survey, Social Engagement Index and Activity Involvement. Residents who showed normal cognitive function further completed the Life Satisfaction Index-Z. The results showed that most residents exhibited cognitive impairment, and there was significant relationship between cognitive function and the following areas: self care function, adaptation, interpersonal interaction, social participation and activity participation. It is notable that the extremely low activity level may account for the regression of the daily function. To improve the service quality of nursing care and quality of life of their residents, the practice standard of the nursing homes should be revised as soon as possible and licensed occupational therapists should be included as one of the required professionals. Occupational therapists are specialized in daily function training and design of purposeful activities, thereby ensuring individualized care planning and adequate variety of activity arrangement. This may in turn provide the residents a more home-like living environment and maintain their greatest possible health and independence.

Topic Category 醫藥衛生 > 醫藥總論
Times Cited
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  3. 林梅珠(Mei‐Jue Lin);邵文娟(Wen‐Chuan Shao);王雅慧(Ya‐Hui Wang)(2013)。精神護理之家住民長期安置之生活經驗。護理暨健康照護研究。9(4)。282-289。 
  4. 黃秀玲(2007)。榮民護理之家服務品質與使用者滿意度之研究 --- 以某榮民醫院附設護理之家為例。亞洲大學長期照護研究所學位論文。2007。1-139。
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