臺北市小型養護機構高齡住民自主性與生活晶質及其相關因素研究

Abstract

目的：了解臺北市小型養護機構高齡住民自主性與生活品質之預測因子。方法:以機構為單位，採「集束採樣」方式，問卷以背景變項、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蒐集資料，採面對面訪問的調查方式進行，共取得臺北市38家小型養選機構內意誠清楚、無失智(SPMSQ≧6分)、年齡≧65 歲，可溝通之351人(100%) 有效樣本。結果:研究對象整體「自主性」屬中等程度，其中以「人住決策者」、「日常生活功能」、「憂鬱程度」及「自覺健康狀況」為自主性主要的預測變項。「生活品質」中以「社會關條範疇」與「環境範疇」屬中上程度，而「心理範疇」與「生理範疇」屬中等程度，其中以「性別」、「年齡」、「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」及「自主性」為生活品質主要的預測變項。結論研究對象之背景變項及健康狀況可有效預測自主性，而背景變項、健康況及自主性亦可有效地區別預測生活品質四個範疇面，其中又以「自主性」對生活品質四個範疇面皆有預測力且影響力為最大。建議：重視高齡住民之異質性，提供不同程度之照顧措施，強化自主性照護，避免「廢用症候群」發生，使其保有自尊、自主及獨立性或享有生活品質為機構式照護之最終目的。

Objective: This research paper aims to find the influencing factors between autonomy and quality of life of aged residents in small-scale seniors' home in Taipei. Method: This research paper adopts “cluster sampling" methodology basiog organization as a unit.The way to collect data is through face-to-face interviews with using structured questionnaires，includingthe background variables questionnaire, Barthel Index, geriatric depression scale, perceived health status scale, perceived enactment of autonomy scale and WHOQL-BREF. Results achieved total 38 small-scale Seniors' horne in Taipei City, no dementia (SPMSQ≧6 points), age≧65 years aged or older whocan communicate of 351 (100%) effective sample. Results: The autonomy of the research subjects is moderate “ decision makers for living io small-scale seniors' home",“activity of daily living",“ depression degree" and perceived health status" have been fond to be major factors in accurate predictions. 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 “ 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. Suggestion:The ultimate goal of“deinstiutionalization" care is to keep the self-Implement,independence and individualism in the elders by valuing their diversities, providing levels of health caring systems and strengthening individualized caring policiesto prevent them from “disuse syndrome".