Loading...
|
Please use this identifier to cite or link to this item:
https://nccur.lib.nccu.edu.tw/handle/140.119/154586
|
Title: | 入住長期照顧機構高齡者生活適應之初探 An Exploration of the Adaptation to Life of the Elderly in Long-term Care Institutions |
Authors: | 陳昱潔 CHEN, YU-JIE |
Contributors: | 王明聖 Wang, Ming-Sheng 陳昱潔 CHEN,YU-JIE |
Keywords: | 機構 老人 生活適應 長照 社工 Long-term Care Elderly Institutions Adaptation |
Date: | 2024 |
Issue Date: | 2024-12-02 11:29:20 (UTC+8) |
Abstract: | 如今人口老齡化和家庭結構的變化,長期照護機構需求增加,這些機構旨在提升老人生活品質,提供身心照護。然而,老人入住機構時常伴隨自身健康狀況與壓力,影響其生活適應。長期照護機構不僅提供基本護理,還應關注老人情緒和心理需求等跨專業關係,透過促進積極情緒和社交關係,幫助他們應對壓力並提高生活適應能力,確保他們在晚年能享有尊嚴且有意義的生活。 本研究探討高齡者在長期照護機構中的生活適應及品質,尤其關注家屬支持、自我效能、機構環境和社交支持四個面向的影響。現有研究多著重於結構性問題和客觀指標,缺乏對高齡者主觀感受的深入探討。本研究將通過田野調查,結合區位生態理論,深入探討高齡者在機構中的日常生活經驗,並分析健康狀態、家屬支持、機構環境等因素對其生活品質的影響,目的在提升高齡者在機構中的生活適應及幸福感。 田野調查在台北市私立住宿式機構進行,透過參與式觀察與深度訪談,探討入住長期照護機構的老人在生活適應方面的情況。研究包括對養老院環境的觀察,如設施、活動和社交互動,並對老人、院長、社工、護理師等相關人員進行訪談,以了解老人生活適應的多面向因素,並分析社會支持、機構環境和傳統孝道觀念對生活適應的影響。 研究發現,各類照護機構的不同與長輩自身身心狀況明顯影響長者生活適應,特別是家庭與機構之間的溝通不暢、住機構費用高昂,且人力不足導致照護質量下降,無法時刻顧及每位長輩的心情,因而影響長者生活適應。除此之外,失智長者的行為問題衍生出法律議題,需制定個性化照護計劃和提供心理支持。通過政策優化和資源整合,可提升照護品質,減輕家庭負擔,改善長者生活適應。 With the aging population and changes in family structures, the demand for long-term care facilities has increased. These institutions aim to enhance the quality of life for the elderly by providing physical and emotional care. However, when elderly individuals move into these facilities, they often face health conditions and stress that can impact their adjustment to life there. Long-term care institutions should not only offer basic nursing care but also address the emotional and psychological needs of the elderly, fostering positive emotions and social relationships to help them cope with stress and improve their adaptability, ensuring they can enjoy a dignified and meaningful life in their later years. This study explores the adaptation and quality of life of the elderly in long-term care institutions, focusing on the impact of self-efficacy, family support, social support, and institutional environment . Existing research often emphasizes structural issues and objective indicators, lacking a thorough exploration of the elderly's subjective experiences. This research uses field investigations combined with ecological theories to delve into the daily life experiences of elderly individuals in these institutions, analyzing how factors such as health status, family support, and institutional environment affect their quality of life. The goal is to enhance the adaptation and well-being of the elderly in these facilities. The field study was conducted in private residential institutions in Taipei City, utilizing participant observation and in-depth interviews to examine the adaptation of elderly residents to life in long-term care institutions. The research includes observations of the care environment, such as facilities, activities, and social interactions, and interviews with elderly residents, directors, social workers, and nurses to understand the multifaceted factors affecting adaptation and analyze the influence of social support, institutional environment, and the concepts traditional filial piety on life adjustment. The study found that differences among various types of care institutions and the elderly's physical and mental conditions significantly affect their adaptation to life in these settings. Issues such as poor communication between families and institutions, high costs of care, and inadequate staffing leading to decreased care quality impact the residents' adaptation. Additionally, behavioral issues among individuals with dementia raise legal concerns, necessitating personalized care plans and psychological support. Policy optimization and resource integration can improve care quality, alleviate family burdens, and enhance elderly residents' adaptation. |
Reference: | 王文芳、陳玉敏(2004)。家屬安治老人於長期照護機構之經驗。長期照護雜誌,8(3),327-344。 王卿蘭(2005)。老人長期照護機構服務品質與生活品質之研究-以台北縣為例。國立台灣大學公共衛生學院醫療機構管理研究所。碩士論文 北區老人之家(2007)。內政部北區老人之家96年度院民生活滿意度調查報告。台北內政部 行政院全球資訊網(2022)。 吳淑瓊(1998)。老人長期照護政策評估。誰來照顧老人研討會論文集。P.59-67 宋寶安(2006)。老年人口養老意願的社會學分析。吉林大學社會科學學報。4,p.90-97 李佩琦(2009)。國小離婚單親兒童社會支持與生活適應之研究。(未出版碩士論文)。國立台北教育大學 李晶(2009)。孝道文化與社會和諧。中國社會出版社 李依芹(2010)。護理之家老人的社會支持之探究〔碩士論文,中山醫學大學〕。華藝線上圖書館。 汪中華(2012)。老人養護型機構服務滿意度與生活滿意度之研究: 以內政部彰化老人養護中心為例。亞洲大學社會工作學系碩士論文。 周煌明 (2000)。老人問題探討。復興崗學報, 69, p.1-28. 林千立(2008)。老人寂寞之相關因素探討。(未出版之碩士論文)。國立政治大學 林雅萍、張曉雲(2018)。應用過渡理論探討老人遷居至長期照顧機構生活適應之相關及影響因素。澳門護理雜誌, 16(1-2), 14-19。 邱美汝、陳玉敏、李月萍 (2007)。長期照護機構老人的生活適應及影響因素。實證護理, 3(2), 119-128。 邱美汝、陳玉敏、李月萍(2007)。長期照護機構老人的生活適應及影響因素。實証護理,3(2),119-128。 98 施麗紅(2010)。老人入住長期照顧機構行為初探—以自我決定理論析之。社區發展季刊132期 張立山、談宜芳(2012)。老人養護機構有關生活環境空間與設施設備之研究。內政部建築研究所研究報告 張瓊文(2022)。田野調查:實作、專題與轉化的學習路徑。中華民國地理學會會刊,(69),45-62。 梁明皓 (Liang, M. H.)、魏惠娟 (Wei, H. C.)、郭書馨 (Kuo, S. H.) (2020)。高齡者自我效能、自尊對憂鬱傾向之影響:雲林縣兩沿海鄉鎮的現況。福祉科技與服務管理學刊, 8(2), 100-116。 郭詩伶 (Shih-Ling Kuo) 、余慶仁 (Ching-Len Yu) 、張素嫻(Su-Hsien Chang) (2012)。提升長期照顧機構長者如廁能力之研究。護理暨健康照護研究, 8(3), 169-178。 陳子萱、李百麟、黃誌坤、龔玉齡(2015)。老人孤寂感、生活適應與生活滿意關係之探討。危機管理學刊, 12(1), 1-10。 陳文偉(2007)。桃園縣老人福利機構經營模式差異性之探討。元智大學資訊社會學研究所碩士論文。 陳玉敏(2000)。長期照護機構老人之適應問題。護理雜誌,47(6),71-75。https://doi.org/10.6224/JN.47.6.71 陳明珍(2002)。養護機構老人之生活適應過程研究。未出版碩士論文。暨南大學 陳明真(2002)。養護機構老人之生活適應過程研究。(未出版碩士論文)。國立暨南大學 陳彥仲、王璽權(2016)。華人孝道觀念與高齡者世代間居住安排之決策。人文與社會科學簡訊17(3):32-37。 陳琇惠 (2012)。老人社會支持與生活滿意度之研究-以南投縣為例。人文社會科學研究, 6(4), 100-127. 陳鳳音(2002)。機構式長期照護的品質及其相關影響因素 [博士論文, 國立臺灣大學衛生政策與管理研究所]. 湯澡瑛(2008)。探討中高齡長者入住機構意願之影響因素〔碩士論文,亞洲大學〕。華藝線上圖書館。 曾秀雲、呂以榮、江瑞月(2019)。探討老年家庭照顧圖像:夫妻入住機構的日常生活實踐。台灣老年醫學暨老年學會雜誌,14(3),138-155。 曾清文 (2013)。入住長期照顧中心之公費安置老人生活適應經驗之研究 [碩士論文,中正大學成人及繼續教育系高齡者教育研究所]。2013。 楊文廣,賴明德,彭于珊,李素箱(2010)。台灣中高齡者對老人住宅設施需求 影響因素之探討。旅遊健康、休閒學術研討會,13-22。 楊靜芸(2001)。老人安養機構服務品質影響因素之探討。未出版碩士論文,中正大學社福研究所,嘉義縣。 葉淑娟、施智婷、莊智薰、蔡淑鳳(2004)。社會支持系統與老人生活滿意度之關係—以高雄市老人為例。中山管理評論 2004年六月號 第十二卷第二期 p.399-427 劉正、齊力(2018)。臺灣高齡者的居住狀況與機構照顧的需求趨勢。國土及公共治理季刊 劉淑娟(1999)。長期照護的社會心理層面。長期照護( p.311- 326)·台北:藝軒。 劉淑娟(1999)。罹患慢性病老人生命態度及生活滿意度之探討。護理研究,7卷4期,p.294-306。 蔡英儀、許雅娟、楊燦(2013)。護理之家老人身體功能、社會活動與孤寂感之相關因素研究。長期照護雜誌,17(3),267-282。 衛生福利部統計處(2023年數據)。老人長期照顧、安養機構概況。 蕭淑貞 (Shu-Chen Hsiao) 、金繼春 (Chi-Chun Chin) 、劉芹芳 (Chi-Fang Liu) (2007)。腦中風病患之日常活動自我效能及其相關因素。實證護理, 3(1), 45-53。 薛承泰(1995)。「變遷中的台灣家庭結構—從人口與婚姻談起」,社會建設,89期,p.81-94。 謝美娥(2002)。失能老人與成年子女照顧者對失能老人遷居的歷程與解釋:從家庭到機構。社會政策與社會工作學刊,6(2),7-63。 簡春安、鄒平儀(2005)。社會工作研究法。台北:巨流。 Alan Boyle , Sarah Maguire , Adrian Martin , Clare Milsom , Rhu Nash , Steve Rawlinson , Andrew Turner , Sheena Wurthmann & Stacey Conchie (2007) Fieldwork is Good: the Student Perception and the Affective Domain, Journal of Geography in Higher Education, 31:2, 299-317. Allen, N. B., & Badcock, P. B. (2003). The social risk hypothesis of depressed mood: evolutionary, psychosocial, and neurobiological perspectives. Psychological Bulletin, 129(6), 887–913. Alpass, F. M., & Neville, S. (2003). Loneliness, health and depression in older males. Aging & mental health, 7(3), 212–216. Beerens, H. C., Zwakhalen, S. M., Verbeek, H., Ruwaard, D., Ambergen, A. W., Leino-Kilpi, H., Stephan, A., Zabalegui, A., Soto, M., Saks, K., Bökberg, C., Sutcliffe, C. L., Hamers, J. P., & RightTimePlaceCare Consortium (2015). Change in quality of life of people with dementia recently admitted to long-term care facilities. Journal of Advanced Nursing, 71(6), 1435–1447. Bowers, B. J., Esmond, S., & Jacobson, N. (2000). The relationship between staffing and quality in long-term care facilities: Exploring the views of nurse aides. Journal of Nursing Care Quality, 14(4), 55-64. Brook, V.(1989). How elders adjust. Geriatric Nursing,10 p.66-68 Buchman, A. S., Boyle, P. A., Wilson, R. S., James, B. D., Leurgans, S. E., Arnold, S. E., & Bennett, D. A. (2010). Loneliness and the rate of motor decline in old age: the Rush Memory and Aging Project, a community-based cohort study. BMC Geriatrics,10, 77. Cacioppo, J. T., Hawkley, L. C., & Thisted, R. A. (2010). Perceived social isolation makes me sad: 5-year cross-lagged analyses of loneliness and depressive symptomatology in the Chicago Health, Aging, and Social Relations Study. Psychology and aging, 25(2), 453–463. Chen, C. N. (2000). Change of Living Arrangements among the Elderly in Taiwan. Proceedings of the National Science Council, Republic of China (Part C), 9(2), 364-375. Chen, X., & Silverstein, M. (2000). Intergenerational social support and the psychological well-being of older parents in China. Research on Aging, 22(1), 43–65. Chenitz W. C. (1983). Entry into a nursing home as status passage: a theory to guide nursing practice. Geriatric nursing (New York, N.Y.), 4(2), 92–97. Dalgard, O. S., Dowrick, C., Lehtinen, V., Vazquez-Barquero, J. L., Casey, P., Wilkinson, G., Ayuso-Mateos, J. L., Page, H., Dunn, G., & ODIN Group (2006). Negative life events, social support and gender difference in depression: a multinational community survey with data from the ODIN study. Social psychiatry and psychiatric epidemiology, 41(6), 444–451. DE JONG GIERVELD, J., & DYKSTRA, P. (2008). Virtue is its own reward? Support-giving in the family and loneliness in middle and old age. Ageing & Society, 28(2), 271-287. Diwan, S., Lee, S. E., & Sen, S. (2011). Expectations of filial obligation and their impact on preferences for future living arrangements of middle-aged and older Asian Indian immigrants. Journal of cross-cultural gerontology, 26(1), 55–69. Good, H., Riley-Doucet, C. K., & Dunn, K. S. (2014). The prevalence of uncontrolled pain in long-term care: a pilot study examining outcomes of pain management processes. Journal of gerontological nursing, 41(2), 33-41. Hansen, N. B., Harrison, B., Fambro, S., Bodnar, S., Heckman, T. G., & Sikkema, K. J. (2013). The structure of coping among older adults living with HIV/AIDS and depressive symptoms. Journal of health psychology, 18(2), 198–211. Harris, R.,(2001).Archival fieldwork, Geographical Review, 91(1-2): 328-335. Hawkley, L. C., & Cacioppo, J. T. (2010). Loneliness matters: a theoretical and empirical review of consequences and mechanisms. Annals of behavioral medicine : a publication of the Society of Behavioral Medicine, 40(2), 218–227. Hui-Chi,Li & Yu-Hua,Lin(2016).The impact of traditional filial piety between older people and their children in Taiwan.Journal of Comprehensive Nursing Research and Care. Jongenelis, K., Pot, A. M., Eisses, A. M., Beekman, A. T., Kluiter, H., & Ribbe, M. W. (2004). Prevalence and risk indicators of depression in elderly nursing home patients: the AGED study. Journal of affective disorders, 83(2-3), 135–142. Kool, M. B., van Middendorp, H., Lumley, M. A., Bijlsma, J. W., & Geenen, R. (2013). Social support and invalidation by others contribute uniquely to the understanding of physical and mental health of patients with rheumatic diseases. Journal of health psychology, 18(1), 86–95. Lee, J. E., Kahana, B., & Kahana, E. (2016). Social support and cognitive functioning as resources for elderly persons with chronic arthritis pain. Aging & mental health, 20(4), 370–379. Lapane, K. L., Lim, E., McPhillips, E., Barooah, A., Yuan, Y., & Dube, C. E. (2022). Health effects of loneliness and social isolation in older adults living in congregate long term care settings: A systematic review of quantitative and qualitative evidence. Archives of gerontology and geriatrics, 102, 104728. Liu, L., Gou, Z., & Zuo, J. (2016). Social support mediates loneliness and depression in elderly people. Journal of health psychology, 21(5), 750–758. Michael, Y. L., Berkman, L. F., Colditz, G. A., & Kawachi, I. (2001). Living arrangements, social integration, and change in functional health status. American journal of epidemiology, 153(2), 123–131. Nguyen, A. W., Chatters, L. M., Taylor, R. J., & Mouzon, D. M. (2016). Social Support from Family and Friends and Subjective Well-Being of Older African Americans. Journal of Happiness Studies,17(3), 959–979. Ong, A. D., Bergeman, C. S., Bisconti, T. L., & Wallace, K. A. (2006). Psychological resilience, positive emotions, and successful adaptation to stress in later life. Journal of personality and social psychology, 91(4), 730–749. Ong, A. D., Bergeman, C. S., Bisconti, T. L., & Wallace, K. A. (2006). Psychological resilience, positive emotions, and successful adaptation to stress in later life. Journal of personality and social psychology, 91(4), 730–749. Olsen, C. F., Telenius, E. W., Engedal, K., & Bergland, A. (2015). Increased self-efficacy: the experience of high-intensity exercise of nursing home residents with dementia - a qualitative study. BMC health services research, 15, 379. Pearson, M. and D. Smith(1985).Debriefing in experience-based learning. In Reflection: Turning experience into learning, ed. Boud, D., R. Keogh and D. Walker, 69-84, London: Routledge. Rose, G. (1993). Feminism and geography: The limits of geographical knowledge. Cambridge: Polity. Ryff, C. D., Singer, B., Love, G. D., & Essex, M. J. (1998). Resilience in adulthood and later life: Defining features and dynamic processes. In J. Lomranz (Ed.), Handbook of aging and mental health: An integrative approach (pp. 69–96). Sarason, B. R., Sarason, I. G., & Pierce, G. R. (Eds.). (1990). Social support: An interactional view. John Wiley & Sons. Schuster, T. L., Kessler, R. C., & Aseltine, R. H., Jr (1990). Supportive interactions, negative interactions, and depressed mood. American journal of community psychology, 18(3), 423–438. Sonnenberg, C. M., Deeg, D. J., van Tilburg, T. G., Vink, D., Stek, M. L., & Beekman, A. T. (2013). Gender differences in the relation between depression and social support in later life. International psychogeriatrics, 25(1), 61–70. Shrestha, S., Alharbi, R. J. M., While, C., Ellis, J., Rahman, M. A., & Wells, Y. (2021). Self-efficacy of direct care workers providing care to older people in residential aged care settings: a scoping review protocol. Systematic reviews, 10(1), 105. Thoits P. A. (2011). Mechanisms linking social ties and support to physical and mental health. Journal of health and social behavior, 52(2), 145–161. Walker, C. A., Curry, L. C., & Hogstel, M. O. (2007). Relocation stress syndrome in older adults transitioning from home to a long-term care facility: myth or reality? Journal of psychosocial nursing and mental health services, 45(1), 38–45. Wang, L., Yang, L., Di, X., & Dai, X. (2020). Family Support, Multidimensional Health, and Living Satisfaction among the Elderly: A Case from Shaanxi Province, China. International Journal of Environmental research and Public Health,17(22), 8434. Weiner, A. S., & Ronch, J. L. (Eds.). (2003). Culture change in long-term care. New York: Haworth Press, Inc. West, D. A., Kellner, R., & Moore-West, M. (1986). The effects of loneliness: a review of the literature. Comprehensive psychiatry, 27(4), 351–363. Yasuda, T., Iwai, N., Yi, C., & Xie, G. (2011). Intergenerational Co-residence in China, Japan, South Korea and Taiwan: Comparative Analyses Based on the East Asian Social Survey 2006. Journal of Comparative Family Studies, 42(5), 703–722. |
Description: | 碩士 國立政治大學 社會工作研究所 111264013 |
Source URI: | http://thesis.lib.nccu.edu.tw/record/#G0111264013 |
Data Type: | thesis |
Appears in Collections: | [社會工作研究所] 學位論文
|
Files in This Item:
File |
Description |
Size | Format | |
401301.pdf | | 9396Kb | Adobe PDF | 0 | View/Open |
|
All items in 政大典藏 are protected by copyright, with all rights reserved.
|