照顧⼀⼼：居家照顧服務對於中低收⼊者⽇常⽣活功能之影響

Abstract

有鑑於人口高齡化趨勢及失能人口增加，居家照顧服務需求也逐漸增加，然而，目前文獻仍缺乏居家照顧服務對於日常生活功能影響之相關研究，尤其是針對中低收入的族群。據此，本研究主要目的如下： (一) 瞭解研究對象之個別化居家照顧服務計畫。 (二) 透過觀察日誌，探討居家照顧服務對於研究對象日常生活功能之影響。 (三) 分析居家照顧服務對於研究對象日常生活活動量表分數之影響。本研究為個案研究法以及立意取樣方式篩選十名中低收入之個案，失能評估工具為日常活動功能量表 (ADLs) 和工具性日常活動功能量表 (IADL) ，統計方法為成對樣本T檢定。研究結果如下： (1) 照顧計畫根據個案CMS等級與家庭需求個別化訂定。 (2) 觀察日誌反應出居家照顧服務確實協助個案改善日常生活功能。 (3) 研究對象前測和後測時ADL及IADL分數皆無顯著差異。整體而言，透過質性觀察日誌評估，居家照顧服務確實能對於研究對象之日常生活功能產生助益；而從量性資料來看，居家照顧服務雖未能顯著提升研究對象之日常生活功能，但也能讓其達到日常功能維持及不退化的初步目標。

The increasing trend of population aging and disability, the need of home care service is gradually rising. However, limited studies have examined the impact of home care service on Activities of daily living (ADLs) and Instrumental activities of daily living (IADLs), especially for the low-income individuals. This studies were to (1) understand the individual-based home care service plan, (2) compare the differences between pre-and post- scores of ADLs and IADLs, (3) examine the impact of home care service through observation log. This study used a case study and purposive sampling to recruit 10 low-income cases. The results showed that (1) home care service was individually planned (2) Observation log showed that home care service can maintain participants' daily life. (3) There were no significant differences between the pre- and post- scores of ADLs and IADLs. In conclusion, from the observation of log, home care service can be beneficial for participants. From the quantitative results, although the scores of activities of daily living were significant changed, the home care service can achieve the initial goal of maintaining activities of daily living and prevent declining.