透過您的圖書館登入
IP:44.200.82.195
  • 學位論文

長照機構住民生活品質影響因素探討-以新北市某長照機構為例

Factors Associated with Quality of Life in Long-term Care Residents: a case study in Taipei County

指導教授 : 蘇喜

摘要


臺灣正經歷人口老化的全球現象,為因應此現象,臺灣正積極發展長期照護產業,而長照相關議題也逐漸被國人重視。長照機構在社會上扮演著協助性的角色,當居家、社區服務不再足夠時,長期照護機構成為避免或延遲失能者入住護理之家的一種選擇。入住長期照顧機構的原因因人而異,在認知狀況正常的情況下,每個人都應有參與自身相關決定的權利。研究者認為除了提供完善的照護及服務外,尊重老年人選擇晚年生活方式的權利、提升老年人生活品質亦為重要的議題。因此本研究除探討人口特性、健康狀態對生活品質的影響外,加入入住因素與機構滿意度兩因子,探討對住民生活品質是否產生影響。 本研究以結構式問卷作為研究工具,包含基本資料、WHOQOL-BREF台灣版及機構滿意度量表,而健康狀態採用機構既有ADL、IADL分數做為資料來源。本研究為橫斷性研究,以結構式問卷作為研究工具,於2012年2~3月期間由研究者親自至採樣機構中進行問卷發放。因台灣之機構式照護住民分類較為模糊,為避免無法正確回答問卷,除了排除失智專區之住民外,透過機構中之社工、護理師等照護人員,排除安、養護、長照區無意識、意識不清、無法清楚以口語交談之住民,排除後符合選樣標準者共129人。因該機構之住民年紀偏高,獲得住民同意參與研究意願後,以面訪或從旁協助填寫問卷的方式進行資料蒐集。資料以Microsoft Excel 2010整理建檔後,以SAS 9.2及SPSS 18.0,應用次數分配、百分比、標準差、T-test、ANOVA、卡方分配、Fisher’s exact test、皮爾森積差相關及複迴歸分析進行統計分析。 本研究共回收100份研究問卷,其中以女性居多,年齡分布以81~80歲者居多,平均年齡為84歲,居住房型則大部分為單人房。安養區住民IADL平均值為11.96分,養護、長照區ADL平均值為60.31分。研究樣本之入住前同住對象大多為子女,其次為配偶,大多數入住原因為養老(退休)生涯規劃,入住主要決策者大多數為自己決定,大多數有參與入住決策。安養區機構滿意度得分平均值為40.10分,養護、長照區得分平均值為35.5分。整體生活品質兩題之平均得分介於3.66~3.98,生理範疇平均得分為15.79,心理範疇平均得分為15.17,社會關係範疇平均得分為15.31,環境範疇平均得分為16.61,生活品質總分平均為108.75分。 本研究結果顯示性別與是否參與入住決策間有顯著相關,女性參與決策高於男性。安養區男女健康狀況有所差異,女性比男性健康。總樣本中,不同的居住房型及不同入住主要因素之機構滿意度有所差異,單人房及雙人房滿意度皆比其他房型之滿意度高,因養老(退休)生涯規劃入住者之機構滿意度高於因專業照護需求考量入住者。而居住房型的不同也會有不同的生活品質,不同入住主要因素也會有不同的生活品質,單人房及雙人房之生活品質皆高於其他房行者,因養老(退休)生涯規劃入住者之生活品質高於因家庭照顧人力考量、專業照護需求考量入住者。入住主要決策者的不同及是否參與入住決策皆會有不同的生活品質,自己為入住主要決策者之生品質高於配偶或子女為主要決策者,而參與入住決策者之生活品質高於未參與者。研究樣本機構滿意度與生活品質總分呈現正相關,安養區亦呈現相同結果,而養護、長照區區住民之年齡與生活品質總分呈現負相關。以強迫進入法進行複迴歸分析,結果顯示長照機構住民生活品質可由居住房型、是否參與入住決策及機構滿意度進行預測,並有約50%的解釋力。

並列摘要


Reasons to stay in long-term care facility varies from person to person, and we think everyone who has normal cognitive ability has right to make decision that relevant to themselves. To enhance long-term care residents’ quality of life (QOL), first of all, we should try to find out factors that associated with quality of life. This study is interested in exploring the factors the affect the QOL of those living in the long-term care in Taipei County. We recruited all residents in the facility except residents who can’t speak clearly , with dementia or unconsciousness. We examined the residents’ QOL by the WHOQOL-BREF Taiwan version , and we recorded residents’ sociodemographic characteristics, health status (ADL, IADL), factors of accommodation, and satisfaction of services. Due to the residents age are higher than the normal. We conduct the data by Microsoft Excel 2010, and we analyzed the data by SAS 9.2 version and IBM SPSS Statistics 19.0 version. There were 100 residents that attend this study, and most of them are female. The average age were 84 and most of them lived in single room. The average IADL scores of retirement home subjects were 11.96, and the average ADL scores of residential care homes and long-term care subjects were 60.31. Most of the object that subjects lived with before accommodation were their children, and most of main reason of accommodation were retirement planning. Most of main decision-maker of accommodation was subjects themselves, and most of subjects attended the decision-making of accommodation. The average satisfaction scores of retirement home, residential care homes and long-term care were 40.10 and 35.5. The average scores of overall quality of life were 3.66~3.98, and the average scores were 15.79 in physical health domain, 15.17 in psychological health domain, 15.31 in social relationships domain, and 16.61 in environmental domain. The average scores of total quality of life were 108.75. We found that sex has correlation on attend the decision-making of accommodation or not, and health status might be influenced by sex in retirement home. Satisfaction of services and Quality of life might be influenced by room types and main reason of accommodation. Quality of life also might be influenced by main decision-maker of accommodation and attend the decision-making of accommodation or not. The results showed that there exists a positive correlation between satisfaction of services and Quality of life, and there exists a negative correlation between residential care homes and long-term care subjects’ age and quality of life. We used multiple entered linear regression analysis to validate the predictors of quality of life that we assumed. The results showed quality of life of long-term care residents could be predicted by room types, attend the decision-making of accommodation or not, and satisfaction of services.

參考文獻


73. 柯麗媺(2004)。養護機構住民生活品質及其相關因素之探討。未出版之,國立台灣大學護理學研究所。
72. 內政部戶政司(2011)。人口年齡分配。
75. 內政部戶政司(2011)。十五歲以上人口教育程度。
10. 許佩蓉、張俊喜、林靜宜、林壽惠、李世代(2006)。機構式長期照護綜論。台灣老年醫學雜誌,1(4),198-215。
25. 台灣版世界衛生組織生活品質問卷發展小組(2000a)。台灣版世界衛生組織生活品質問卷之發展簡介。中華衛誌,19(4),315-324。

被引用紀錄


羅慧文(2017)。從營運資源探討民間安養長照機構經營之困境〔碩士論文,中原大學〕。華藝線上圖書館。https://doi.org/10.6840%2fcycu201700613

延伸閱讀