臺北市小型養護機構高齡住民自主性與生活品質之相關性研究

Abstract

本研究目的在瞭解臺北市小型養護機構高齡住民自主性與生活品質之相關性，採 橫斷式相關性研究，以集束採樣方式，研究對象為臺北市小型養護機構意識清楚、無失智(SPMSQ≧6分)，年齡≧65歲可溝通之高齡住民為研究對象，以背景變項問卷、巴氏量表、簡短老人憂鬱量表、自覺健康狀況量表、老人自覺自主性量表及生活品質量表等結構式問卷收集資料，採面對面訪問的調查方式進行，共收案351人。資料經處理與統計分析後，得重要結果如下: 一、 研究對象年齡平均為81.13歲，以喪偶者居多，多為不識字者，以子女決定入住養護機構者最多，而居住費用支付者以家人居多，平均入住養護機構時間為3.88年。研究對象平均罹患3.15個慢性病，前三名依序為高血壓、神經性疾病及糖尿病，有三分之二以上的人日常生活功能屬嚴重依賴至完全依賴型，有三分之二以上的人有輕度至中重度憂鬱情緒，自覺健康狀況皆屬「不好」的水準。 二、 研究對象的「自主性」屬中等程度，研究對象的背景變項與健康狀況能有效的預測其自主性，並可解釋自主性的總變異量達59.2%；其中以「入住決策者」、「日常生活功能」、「憂鬱程度」、「自覺健康狀況」為主要的預測變項。結果顯示，自己決策入住者相對子女決策入住者、日常生活功能及自覺健康狀況越好者，其自主性越高，而憂鬱程度越嚴重者，其自主性則越低。 三、 研究對象的「生活品質」中以「社會關係範疇」與「環境範疇」屬中上程度；而「心理範疇」與「生理範疇」只屬中等程度。研究對象背景變項、健康狀況、自主性可有效預測其生活品質，可解釋生活品質四個範疇的總變異量各別為64.5%、61.1%、52.9%、59.2%，其中以「性別」、「年齡」、「教育程度」、「機構居住時間」、「居住費用支付者」、「日常生活功能」、「憂鬱程度」、「自覺健康狀況」、「自主性」為主要的預測變項；在控制研究對象的背景變項及健康狀況下，「自主性」可以單獨有效的預測其生活品質，且單獨解釋其總變異量各別為6.4%、5.5%、11.4%、10.2%，可以看出自主性對生活品質的影響最主要在「社會關係」與「環境」兩範疇。

This research paper aims to find the correlation between Autonomy and Quality of life aged residents small-scale Seniors' home in Taipei through cross-sectional correlational study and cluster sampling. We studied people (SPMSQ≧6) aged 65 or older who can communicate of Small-scale Seniors' home in Taipei. Data was collected from 351 pepole through face-to-face interviews using structured questionnaires, including the Background Variables Questionnaire, Barthel Index, Geriatric Depression Scale, Perceived Health Status Scale, perceived enactment of Autonomy Scale and WHOQL-BREF . After data processing and statistical analysis, the significant results obtained are listed as below: 1. The average age of the research subjects is 81.13. Most of the subjects are widowed and illiterate, and sent to the small-scale seniors' home by their children, the fees paid to family members who are mostly. They have lived in the care facilities for an average of 3.88 years. The average subject suffers from 3.15 chronic diseases on average, the most common of which are hypertension, a neurological disorder, and diabetes mellitus, in order from affected. The daily living activities of more than 2/3 of the subjets are heavily or completely dependent; more than 2/3 of the subjects are either mildly, moderately, or severely depressed. Their perceived health status is not good. 2. The autonomy of the research subjects is moderate, and the background variables and health status of the research subject can be used to accurately predict their autonomy. The total explanatory variation of autonomy is 59.2%. “Decision Makers for Living in Long-Term Care Facilities”, “Activity of Daily Living”, “Depression Degree” and “Perceived Health Status” have been fond to be major factors in accurate predictions. The results show that compared to subjects who are sent to small-scale seniors' home by their children, subjects who decide to live in small-scale seniors' home on their own volition are less dependent in their of daily living activities, have a better perceived health status, and a hight autonomy. In addition, depression has on inverse relationship with subjects’ personal their autonomy.

3. The “Social Relations Category” and the “Environment Category” in “Quality of life” of the research subjects are above average, while their “Mental Category” and “Physical Category” are only at the moderate level. The background variables, health status, and autonomy of the research subject can be used to accurately predict their quality of life. The total explanatory variations of the 4 categories of are “Quality of life” are 64.5%, 61.1%, 52.9% and 59.2% , respectively. “Gender”, “Age”, “Educational Status”, “Living Time in Care Facilities”, “Payers of Living Expenses”, “Activity of Daily Living”, “Depression Degree”, “Perceived Health Status” and “Autonomy” are major predictoy fators. If the background variables and health status of the research subjects are controlled, “Autonomy” can be used solely to effectively predict the quality of life. The total explanatory variations of the 4 categories are 6.4%, 5.5%, 11.4% and 10.2% respectively. Autonomy can be seen the impact on quality of life in the most important "social relations" and "Environment" two areas.