養護機構住民生活品質及其相關因素之探討

柯麗媺

doi:10.6342/NTU.2004.01288

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養護機構住民生活品質及其相關因素之探討

Quality of Life and Related Factors among Elderly Residents in Long-term Care Facility

柯麗媺 , Masters　　Advisor：張媚　　

繁體中文 DOI： 10.6342/NTU.2004.01288

健康狀況；環境特性；生活品質；養護機構；住民；社會支持； environmental status ； health status ； nursing care facility ； Quality of life ； residents ； social support

Abstract │ Reference (504) │ Times Cited (8) │ Altmetrics

Abstract 〈TOP〉

本研究目的在瞭解養護機構住民生活品質及人口特性、環境特性、健康狀況及社會支持與生活品質的相關性。本研究採取橫斷式研究法，為描述性、相關性的調查研究，以立意取樣收集台北市五家立案養護機構，65歲以上老年住民，居住機構半年以上，認知弁鄍膨`（SPMSQ錯4題以下），能以國台語溝通者為研究對象，共141位老年住民。使用結構式問卷收集資料，研究工具包括簡短式智能測驗篩選工具、住民基本資料、健康狀況量表、社會支持量表、生活品質量表及環境特性量表。其中前四種量表是採與住民面對面訪談的方式收集資料，而環境特性量表是詢問住民所居住機構的主管來收集資料。所得資料以SPSS10.0 for Windows套裝軟體，應用次數、百分比、標準差、t檢定、單因子變異數分析、皮爾森積差相關及複迴歸等進行統計分析。
研究結果如下：
一、養護機構住民整體生活品質的平均得分為8.50，標準差為1.35，
    得分指標56.67%，其九個分量表的得分指標由高至低依序為『安
    全』層面，『自尊』層面，『自主』層面，『隱私』層面，『身體狀
    況』層面，『心靈安適』層面，『愉快』層面，『關係』層面，『有
    意義的活動』層面。
二、因經濟因素而入住的住民其整體生活品質得分顯著高於因家庭照
   顧因素，機構因素及不知道原因而入住的住民。沒有罹患慢性疾
   病住民的整體生活品質得分顯著高於有罹患慢性疾病的住民，且
   其中是否罹患中風、巴金森氏症及骨質疏鬆等疾病在整體生活品
   質的得分上亦有顯著差異，而其餘人口特性變項在整體生活品質
   得分並無顯著差異。
三、住民所居住機構之經營型態為私立小型機構者，其整體生活品質
    得分高於居住公辦民營機構者。所居住機構之服務類別為養護
    者，其整體生活品質得分高於安養、養護與長期照護者。機構的
    佔床率、護理人員與住民人數之比例、社工人員與住民人數之比
    例與住民整體生活品質呈正相關，而外籍與台籍照護服務員之比
    例與住民整體生活品質呈負相關。
四、住民自覺健康狀況及日常生活弁鉬P其整體生活品質呈現顯著正
    相關。
五、護理人員、照顧服務員、社工、室友提供的社會支持與住民整體
    生活品質呈現顯著正相關，而家人提供的社會支持與住民整體生
    活品質則無相關。研究對象與機構外的互動頻率與其整體生活品
    質呈現顯著正相關。

六、以逐步複迴歸方式分析發現，「日常生活弁遄v（Barthel 
    Index）、「照顧服務員的社會支持」、「進住機構的主要決定
    者」、「居住機構的時間」、「教育程度」與「社會福利身份別」 
    等變項為顯著的預測變項（p<.001），此六個變項可以解釋機
    構住民生活品質總變異量的79.6%。結果顯示當住民身體活動?
    能越好，來自照顧服務員的社會支持越多，居住機構的時間越
    長，教育程度越高，則其生活品質越好；且居住養護機構是自己
    決定者比他人決定者生活品質較好，一般戶較低收入戶及中低收
    入戶者有較好的生活品質。

本研究結果，可以幫助護理人員瞭解養護機構住民人口特性、環境特性、健康狀況及社會支持與生活品質之相關性，並可作為教學、研究與臨床照護計劃擬訂之參考，以提昇老人之生活品質。

關鍵詞：養護機構、住民、環境特性、健康狀況、社會支持、
        生活品質

Parallel Abstract 〈TOP〉

Abstract

This study explored long-term care facility residents’ subjectively perceived quality of life, and relationships among social-demographic, environmental status, perceived health status, social support and quality of life . This study adopted cross-sectional research design. This was a descriptive and correlational survey research. These purposive sampling were collected from five long-term care facilities in Taipei. The objects of the research are the elderly residents over 65,lived in facility over six months, cognitive function normal(SPMSQ error below 4 items), and also can express themselves in Chinese or Taiwanese .Totally, there are 141cases of these elderly residents. A structured questionnaire was used to collect data. Research measuring tools included short portable mental status questionnaire(SPMSQ),social-demographic variables, health status, social support ,quality of life, and environmental status. These questionnaires included social-demographic variables , health status, social support ,
and quality of life were used to collect data via face to face interviewing residents. Ask facility managers to collect environmental status data. Data were analyzed by using SPSS/Windows10.0 statistical software. The statistical methods included arithmetic mean, percentage, standard deviation, t- test, one-way ANOVA, Person’s product moment correlation coefficients, and stepwise multiple regression analysis.
This study were as followed ：
(1)The mean score of quality of life was 8.50 ,standardized deviation 
  was 1.35,index of mean score was 56.67%. Nine subscales for measuring 
  quality of life were, in the descending order, ”security’, ”dignity”, 
  ”autonomy”, ”privacy”, ”physical status” , ”spiritual well-being”,
  ”Enjoyment”, ”Relationships”, ”Meaningful activity”. 
(2)Residents moving into long-term care facility for economic factor had  
  higher quality of life score than housing care factor ,facility factor, and 
  unknown group. Residents don’t have chronic illness had higher quality 
  of life score than have chronic illness group, and then residents have 
  stroke ,parkinson’s disease, and osteoporosis were significantly different 
  in quality of life. The other social-demographic variables weren’t 
  significantly different in quality of life.
(3)Residents live in small profit facility had higher quality of life score 
  than non-profit facility . Residents live in facility of nursing type had

higher quality of life score than caring, nursing, long term care type.
  Facility ‘s occupancy rate ,nurses/residents ratio, and social worker
  /residents ratio were significantly positively related to quality of life
  ;foreign/local nurse assistant ratio were significantly negatively related 
  to quality of life .
(4)Residents perceived health status, and activities of daily living (ADLs)
  were significantly positively related to quality of life.
(5)Social support provided by nurses, nurse assistant, social 
  worker, roommate ,and frequency of interaction with outsides were 
  significantly positively related to quality of life ,and then social support 
  provided by family wasn’t significantly related to quality of life . 
(6)Stepwise regression showed that activities of daily living (ADLs), social 
  support provided from the nurse assistant, admission decision making, 
  length of stay, educational levels, and social economic status were the 
  significant predictors in quality of life(p<.001),which explained 79.6% of 
  the total amount of variance. When residents have better activities of daily 
  living (ADLs) ,accepted more social support from the nurse assistant, the 
  longer length of stay, the higher educational level, the better quality of life 
  he would feel. Residents self decided lived in facility had better quality of 
  life than the other people decided. Residents have higher social economic 
  status had better quality of life than those had lower social economic 
  status.

The results of this study could provide nurses the information about the relationships among social-demography, environmental status ,health status ,social support, and quality of life of the residents in the 
Long term care facility. The findings can also serve as references for teaching materials, research, and guidelines for planning interventions to promote elderly quality of life.

Key words：nursing care facility, residents, environmental status,
           health status, social support, Quality of life

Reference ( 504 ) 〈TOP〉

行政院衛生署（1995）．護理機構設置標準（修正版）。
連結：
行政院內政部統計處（2002）．中華民國九十一年臺閩地區老人狀況調查摘
連結：
王玉女（1998）．台灣地區養護機構服務品質現況及其問題．長庚護理，
連結：
成和玲、余伍洋（1993）．住院精神病患生活滿意度之探討．護理研究，
連結：
杜玉卿（2003）．護理之家老人的激能感受與其生活品質之相關探討．
連結：

Times Cited (8) 〈TOP〉

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