失能老人居家服務品質與生活品質關係之研究

Abstract

本研究的目的在於檢視居家服務之服務品質與失能老人生活品質之關聯，採用問卷調查的方式，以台北市及新北市共133位使用居家服務的失能老人為研究對象。研究工具包括自編服務品質問卷、WHO之生活品質問卷以及老人的基本資料與服務使用時數。所蒐集的資料，以描述性統計、t 檢定、單因子變異數分析、Pearson 相關及階層迴歸等統計方式進行資料分析。綜合分析研究結果發現如下：

一、失能老人對於居家服務品質的滿意度偏高，其中以可靠性及保證性的分數較高。 在生活品質中，老人對於自己的生活品質感受為中等，但對於身體健康偏不 滿意，其中，以社會關係分數最高，而心理狀態為最低。

二、失能老人基本屬性中，在服務品質方面，年齡較高、教育程度較高、每月平均花費越高的老人，對於服務品質的感受較低；在生活品質方面，年齡較低、教育程度較高、和配偶或兒女同住者、無主要照顧者、失能程度低、每週服務時數越多的老人，在生活品質的分數越高；其餘性別、宗教信仰、慢性病有無等3個變項則未造成老人在居家服務品質或生活品質感受之顯著差異或影響。

三、服務品質之可靠性及關懷性兩個構面與生活品質之環境因素構面有顯著相關。

四、多元迴歸分析發現，失能老人的基本屬性及對居家服務品質的滿意度對於其生活品質的生理健康與心理狀態並不具預測力。基本屬性變項共可解釋老人社會關係品質變異量的22.7％，其中以教育程度及每月平均花費的預測力達到顯著。階層迴歸分析則發現，基本屬性及對居家服務品質的滿意度共可解釋老人環境因素品質變異量的16.4％，進一步投入服務品質與失能程度的交互作用項之後，對環境因素品質的解釋變異量增加了6.9%，整個模式只有居住狀況及服務品質關懷性與失能程度的交互作用兩項對生活品質的環境因素構面有顯著預測力。

本研究最後根據研究結果針對政府及實務界提出各項建議，提供主管機關與相關服務機構作為未來政策規劃及服務之參考；服務機構有良好的居家服務品質，進而提昇老人生活品質，老人在社區中得以安享天年。The purpose of this study was to discuss the relationship between service quality and disabled elders’ quality of life. Questionnaire investigation was adopted and 133 frail elders who have home care service and live in Taipei City and New Taipei City were the study subjects. Self-arranged service quality questionnaire, WHO questionnaire for quality of life, basic information of the elders, and the hours that elders have home care service were the study tools. The collected data was analyzed through descriptive statistics, t-test, one-way ANOVA, Pearson correlation analysis, and hierarchical regression. The comprehensive analytical study results and findings are as follows:

1. The disabled elders’ satisfaction towards service quality was relatively high, where the scores of reliability and assurance were higher. For quality of life, the elders’ feeling towards their quality of life was averagely satisfied, but they were not satisfied with their health, where the scores of social relationship were the highest and the scores of psychological condition were the lowest.

2. For basic attributes of the disabled elders, significant difference was found regarding the elders’ feelings towards home service quality, as in relevant variables including age, education level, and average monthly expense. Significant difference was found regarding the elders’ feelings towards quality of life, as in relevant variables including age, education level, living condition, have main carer or not, degree of disability, and weekly home care service hours. Other variables including gender, religion, and have chronic diseases or not did not influence the elders’ feelings towards home care service quality or quality of life significantly.

3. The reliability and assurance of service quality was significantly related with the environmental factors of quality of life.

4. After finishing hierarchical regression, 22.7% of variance of elders- society relationship was explained by variables including age, education level, average monthly expense, living condition, have main carer or not, degree of disability, weekly home care service hours. After combining age, education level, average monthly expense, living condition, have main carer or not, degree of disability, weekly home care service hours, tangibility, reliability, and care with two interaction factors, service quality and degree of disability, 6.9% of variance of elders’ environmental factors could be explained.

Suggestions were provided for the government and related management and service organizations in accordance with the study result as the reference of future policy plan and service. If the service organizations provided good home care service quality, then the quality of life of elders could be promoted so that they could live happily in the community.