陳毓璟Yu-Ching Chen2019-08-122019-08-122017-06-??http://rportal.lib.ntnu.edu.tw:80/handle/20.500.12235/80500本研究的目的在以退化性膝關節炎為例，發展賦能志工擔任同儕教師，教導鄉村社區高齡者慢性病自我管理之教育方案與志工學習手冊。研究對象為服務於嘉義縣鄉村社區老人活動據點中之志工，年齡在50歲以上，至少有一年以上服務社區老人的經驗者。本研究運用行動研究方法，以質量並重的混合設計來記錄與分析方案發展流程。先以隨機抽樣，以問卷調查59位志工，探究其對此疾病的認知及協助老人疾病自我管理的意願與效能，藉以發展培訓方案與教材，並邀請11位專家進行教材合適性評估；再以立意取樣招募30位志工進行志工培訓與社區實際教學，以及教學成效前、後測評量與課程滿意度評量；最後進行志工和社區領導者焦點訪談，依其訪談結果作為賦能志工協助高齡者慢性病自我管理教育方案發展之改善依據。研究結果顯示，志工肯定本教育方案對自己健康的幫助，尤其是有罹患退化性膝關節炎的志工。志工優勢在於協助高齡者自我照顧的意願高、學習動機強、與高齡者溝通較為容易；缺點在於方案十分費時、培訓志工的留任率低、志工對協助高齡者疾病自我管理自信心不足、自我管理技能不夠熟練，以及低識字高齡者的教育較為困難。最後依此研究結果，提出志工教育方案包括課程與教育服務輸送之改善建議。In this study, combining the strengths-based perspective and chronic diseaseself-management model, used the method of action research to develop aneducational program and volunteer learning manual which aimed at improving thecapacity of community volunteers to assist older adults with knee osteoarthritis(OA) to care for them. The subjects were volunteers aged over 50 who had servedat least one year in community centers for the elderly in Chia-Yi County. By actionresearch method, this study used qualitative and quantitative mixed design to recordand analyzes this process. First, 59 volunteers were randomly selected to takequestionnaire to explore the community volunteers’ awareness of this disease andtheir willingness and effectiveness in assisting the elderly in self-management ofthis disease, so as to develop training programs and teaching materials and inviting11 experts to assess their appropriateness. Following, recruited 30 volunteersto carry out training and practical community teaching, as well as evaluatingeffectiveness before and after the training and evaluating curriculum satisfaction.The last conducted volunteer and community leaders’ focus group interview. According to the results of interviews revised the educational programs. The resultsshow that the strengths of volunteers are that the willingness to assist elderly peoplein self-management is high and the motivation for learning is also very strong. Itis easier for volunteers to communicate with elderly people. The disadvantages arethat the program is very time-consuming, the retention rate of trained volunteers islow, and volunteers are not self-confident in helping elderly people with knee OAto take care of themselves, skills of self-management are not very proficient, andthe teaching for the ill-literate elderly people is more difficult. Finally, suggestionsare put forward to improve the educational program, including improvements ofvolunteer’s training curriculum and delivery of educational services.志工教育方案鄉村社區慢性病自我管理volunteer’s educational programrural areachronic disease selfmanagement