题名

老人安養之道德決策

并列篇名

Ethical Decision for Gerontological Healthcare

DOI

10.6160/2011.12.02

作者

盧龍泉(Long-Chuan Lu)；林凌華(Ling-Hua Lin)；林泰安(Tai-An Lin)

关键词

道德強度 ； 孝道責任 ； 道德決策 ； 老人安養 ； moral intensity ； filial obligation ； ethical decision ； elderly care

期刊名称

中山管理評論

卷期/出版年月

19卷4期（2011 / 12 / 01）

页次

833 - 874

内容语文

繁體中文
中文摘要

由於平均壽命的延長，必然面對身體機能的老化與慢性疾病的呈現，這不僅帶來龐大長期照護的需求，更凸顯老人安養問題的重要性。因此民眾面對此問題，是否選擇自家安養或送至長期照護機構安養，可能在經濟、情感與社會道德（孝道）上產生猶疑或掙扎，造就了面臨孝道困境與道德的兩難。本研究之問卷設計採用三種情境劇本問卷作為衡量工具。研究對象為以1963～1973年開始以後出生的人為主軸，父母親至少一方仍健在之已婚成年子女。本研究共發放450份問卷，有效樣本為312份，有效回收率為89.4%。假設驗證則以複迴歸和階層迴歸分析來檢定，結果發現人口統計變數在道德決策程序的差異，道德強度對道德決策程序的直接效果，以及孝道責任對道德決策程序有調節效果。x
英文摘要

As the average life expectancy is lengthened, people will inevitably face the body's aging and chronic diseases, which not only bring substantial long-term nursing needs, but also highlight the importance of gerontological healthcare problems. Thus, the people face the question on whether to send their home or long-term care institute. Economic, emotion and social morality (filial piety) generate hesitation or struggle and create a dilemma between filial piety and ethics. This study uses three kinds of vignette and questionnaire as an assessment tool. The study subjects were people who were born between 1963 and 1973. At least one of their parents is living and they are married. A total of 450 questionnaires were issued with 312 valid responders (response rate of 89.4%). The multiple regression and hierarchical regression analysis were used to analyze the hypotheses. The results show that demographic variables bring difference in ethical decision making process and that moral intensity has a significant direct effect on ethical decision making process. Additionally, the filial obligations have a moderating effect on the ethical decision making process.
主题分类 社會科學 > 管理學
参考文献
  1. 王正、曾薔霓(1999)。倫理與價值：長期照護財務機制之理念與原則。社會政策與社會工作學刊，3(2)，101-142。
    連結：
  2. 莊耀嘉(1999)。家庭中人際互動結構與運作模式。本土心理學研究，12，3-46。
    連結：
  3. 葉光輝(1998)。孝道概念的心理學探討：雙層次孝道認知特徵的發展歷程。本土心理學研究，9，53-117。
    連結：
  4. 劉雅文、莊秀美(2006)。探討失能老人家庭選擇長期照護福利服務之決策過程─老人自主權之分析研究。東吳社會工作學報，14，91-123。
    連結：
  5. 謝美娥(2001)。成年子女與照顧失能父母之影響─一個量化的探討並以台北市為例。社會政策與社會工作學刊，5(2)，57-111。
    連結：
  6. 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。
    連結：
  7. 謝美娥(2004)。失能老人的資源、居住安排、居住決定的掌控力與生活品質：一個量化的初探。社會政策與社會工作學刊，8(1)，1-49。
    連結：
  8. 內政部統計處，2008，「97年底老人長期照顧及安養機構概況」，http://www.moi.gov.tw/stat/news_content.aspx?sn=2197 , accessed on March 28, 2009
  9. 內政部統計處，2005，「民國94年老人狀況調查結果摘要分析」，http://www.moi,gov.tw/stat/survey.aspx , accessed on March 31, 2009
  10. 行政院衛生署，1998，老人長期照護三年計畫，台北：行政院。
  11. 行政院經建會，2008a，「2008年至2156年人口推計」，http://search.cepd.gov.tw/search-cgi/query_run.exe , accessed on March 28, 2009
  12. 行政院，2007，「我國長期照顧十年計畫─大溫暖社會福利套案之旗艦計畫」，http://sowf.moi.gov.tw/newpage/tenyearsplan/我國長期照顧十年計畫.doc , accessed on October 19,2010
  13. 內政部社會司老人福利，2007，「老人福利機構設立標準」，http://sowf.moi.gov.tw/04/02/02_3.htm , accessed on October 19, 2010
  14. 行政院經建會，2008b，「97年好管家專案成果報告」，http://www.cepd.gov.tw/m1.aspx?sNo=0007899&key=&ex=%20%ic= , accessed on March 28, 2009
  15. Janet, A. C. and Katherine, A., 1996, “Challenges and Choices: Elderly Caregiving”Working paper, University of Missouri-Columbia
  16. Alexander, C. S.,Becker, H. J.(1978).The Use of Vignettes in Survey Research.Public Opinion Quarterly,42(1),93-104.
  17. Barnett, T.(2001).Dimensions of Moral Intensity and Ethical Decision Making: An Empirical Study.Journal of Applied Social Psychology,31(5),1038-1057.
  18. Boldero, J.(1995).The Prediction of Household Recycling of Newspapers: The Roles of Attitudes, Intentions, and Situational Factors.Journal of Applied Social Psychology,25(5),440-462.
  19. Burstin, K.,Doughtie, E. B.,Raphaeli, A.(1980).Contrastive Vignette Technique: An Indirect Methodology Designed to Address Reactive Social Attitude Measurement.Journal of Applied Social Psychology,10(2),147-165.
  20. Butterfield, K. D.,Trevino, L. K.,Weaver, G. R.(2000).Moral Awareness in Business Organizations: Influences of Issue-Related and Social Context Factors.Human Relations,53(7),981-1018.
  21. Carlson, D. S.,Kacmar, K. M.,Wadsworth, L. L.(2002).The Impact of Moral Intensity Dimensions on Ethical Decision-making: Assessing the Relevance of Orientation.Journal of Managerial Issues,14(1),15-30.
  22. Casper, W. J.,Fox, K. E.,Sitzmann, T. M.,Landy, A. L.(2004).Supervisor Referrals to Work-Family Programs.Journal of Occupational Health Psychology,9(2),136-151.
  23. Crimmins, E. M.,Ingegneri, D. G.(1990).Interaction and Living Arrangements of Older Parents and their Children.Research on Aging,12(1),3-35.
  24. Dukerich, J. M.,Waller, M. J.,George, E.,Huber, G. P.(1993).Moral Intensity in Group Problem Solving.National Academy of Management Meetings,Atlanta, Georgia:
  25. Ellemers, N.,Spears, R.,Doosje, B.(2002).Self and Social Identity.Annual Review of Psychology,53(1),161-186.
  26. Ferrell, O. C.,Gresham, L. G.(1985).A Contingency Framework for Understanding Ethical Decision Making in Marketing.Journal of Marketing,49(3),87-96.
  27. Ferrell, O. C.,Gresham, L. G.,Fraedrich, J.(1989).A Synthesis of Ethical Decision Models for Marketing.Journal of Macromarketing,9(2),55-64.
  28. Fishbein, M.,Ajzen, I.(1975).Belief, Attitude, Intention, and Behavior: An Introduction to Theory and Research.Readings, MA:Addison-Wesley.
  29. Flannery, B. L.,May, D. R.(2000).Environmental Ethical Decision Making in the U.S. Metal-Finishing Industry.Academy of Management Journal,43(4),642-662.
  30. Flynn, B. S.,Dana, G. S.,Goldstein, A. O.,Bauman, K. E.,Cohen, J. E.,Gottlieb, N. H.,Solomon, L. J.,Munger, M. C.(1997).State Legislators' Intentions to Vote and Subsequent Votes on Tobacco Control Legislation.Health Psychology,16(4),401-404.
  31. Fraedrich, J. P.,Ferrell, O. C.(1992).The Impact of Perceived Risk and Moral Philosophy Type on Ethical Decision Making in Business Organizations.Journal of Business Research,24(4),283-295.
  32. Fritzsche, D. J.,Becker, H.(1984).Linking Management Behavior to Ethical Philosophy: An Empirical Investigation.Academy of Management Journal,27(2),166-175.
  33. Hunt, S. D.,Laverie, D. A.(2004).Experiential Learning and the Hunt-Vitell Theory of Ethics Teaching Marketing Ethics by Integrating Theory and Practice.Marketing Education Review,14(3),1-14.
  34. Hunt, S. D.,Vasquez-Pazrraga, A. Z.(1993).Organizational consequences, marketing ethics, and salesforce supervision.Journal of Marketing Research,30(1),78-90.
  35. Hunt, S.,Vitell, S.(1986).A General Theory of Marketing Ethics.Journal of Macromarketing,6(1),5-16.
  36. Johnson, M. A.(1990).Nursing Home Placement: The Daughter's Perspective.Journal of Gerontological Nursing,16(11),6-11.
  37. Jones, T. M.(1991).Ethical Decision Making by Individuals in Organizations: An Issue-Contingent Model.Academy of Management Review,16(2),366-395.
  38. Kamo, Y.,Zhou, M.(1994).Living Arrangements of Elderly Chinese and Japanese immigrants in the United States.Journal of Marriage and Family,56(3),544-558.
  39. Kellett, U. M.(1999).Transition in Care: Family Carers' Experience of Nursing Home Placement.Journal of Advanced Nursing,29(6),1474-1481.
  40. Kohlberg, L.(1984).Essays in Moral Development: The Psychology of Moral Development.New York:Harper and Row.
  41. Krause, A. M.,Grant, L. D.,Long, B. C.(1999).Sources of Stress Reported by Daughters of Nursing Home Placement.Journal of Ageing Studies,13(3),349-364.
  42. Laczniak, G. R.,Inderrieden, E. J.(1987).The influence of stated organisational concern upon ethical decision making.Journal of Business Ethics,6(4),297-307.
  43. Luescher, K.,Pillemer, K.(1998).Intergenerational Ambivalence: A New Approach to the Study of Parent-Child Relations in Later Life.Journal of Marriage and the Family,60(2),413-425.
  44. May, D. R.,Pauli, K. P.(2002).The Role of Moral Intensity in Ethical Decision Making. A Review and Investigation of Moral Recognition, Evaluation, and Intention.Business and Society,41(1),85-118.
  45. Mayo, M. A.,Marks, L. J.(1990).An Empirical Investigation of a General Theory of Marketing Ethics.Journal of the Academy of Marketing Science,18(2),163-171.
  46. McMahon, J. M.,Harvey, R. J.(2006).An Analysis of the Factor Structure of Jones' Moral Intensity Construct.Journal of Business Ethics,64(4),381-404.
  47. Mencl, J.,May, D. R.(2009).The Effects of Proximity and Empathy on Ethical Decision-Making: An Exploratory Investigation.Journal of Business Ethics,85(2),201-226.
  48. Morris, S. A.,McDonald, R. A.(1995).The Role of Moral Intensity in Moral Judgments: An Empirical Investigation.Journal of Business Ethics,14(9),715-726.
  49. Nay, R.(1996).Nursing Home Entry: Meaning Making by Relatives.Australian Journal on Ageing,15(3),123-127.
  50. Ng, A. C. Y.,Phillips, D. R.,Lee, W. K. M.(2002).Persistence and Challenges to Filial Piety and Informal Support of Older Persons in a Modern Chinese Society: A Case Study in Tuen Mun, Hong Kong.Journal of Aging Studies,16(1),1-20.
  51. O''Fallon, M. J.,Butterfield, K. D.(2005).A Review of the Empirical Ethical Decision-Making Literature: 1996-2003.Journal of Business Ethics,59(4),375-413.
  52. Pauli, K. P.,May, D. R.(2002).Ethics and the Digital Dragnet: Magnitude of Consequences, Accountability, and the Ethical Decision Making of Information Systems Professionals.Best Paper Electronic Proceedings of the Academy of Management,Denver, Colorado:
  53. Rest, J. R.(1986).Moral Development: Advances in Research and Theory.New York:Praeger Publisher.
  54. Ross, M. M.,Rosenthal, C. J.,Dawson, P. G.(1993).Spousal Caregiving Following Institutionalization: The Experience of Elderly Wives.Journal of Advanced Nursing,18(2),1531-1539.
  55. Ryan, A. A.,Scullion, H. F.(2000).Nursing Home Placement: An Exploratory of the Experiences of Family Carers.Journal of Advanced Nursing,32(5),1187-1195.
  56. Singhapakdi, A.,Vitell, S. J.,Franke, G. R.(1999).Antecedents, Consequences, and Mediating Effects of Perceived Moral Intensity and Personal Moral Philosophies.Journal of Academy of Marketing Science,27(1),19-35.
  57. Tan, B.(2002).Understanding Consumer Ethical Decision Making with Respect to Purchase of Pirated Software.Journal of Consumer Marketing,19(2),96-111.
  58. Taylor, S.,Todd, P.(1997).Understanding the Determinants of Consumer Composting Behavior.Journal of Applied Social Psychology,27(7),602-628.
  59. Trevino, L. K.(1986).Ethical Decision Making in Organizations: A Person-Situation Interactionist Model.Academy of Management Review,11(3),601-617.
  60. Trevino, L. K.,Weaver, G. R.,Reynolds, S. J.(2006).Behavioral Ethics in Organizations: A Review.Journal of Management,32(6),951-990.
  61. Vitell, S. J.,Hunt, S. D.(1990).The General Theory of Marketing Ethics: A Partial Test of the Model.Research in Marketing,Vol. 10,237-265.
  62. Weber, J.(1996).Influences upon Managerial Moral Decision Making: Nature of the Harm and Magnitude of Consequences.Human Relations,49(1),1-22.
  63. 吳淑瓊(2005)。人口老化與長期照護政策。國家政策季刊，4(4)，5-24。
  64. 吳齊殷(2006)。親子關係與心理健康的關聯性機制：從雙元性孝道談起。教師教學研討會
  65. 呂寶靜(2005)。支持家庭照顧者的長期照護政策之構思。國家政策季刊，4(4)，25-40。
  66. 卓蕙蓮(2002)。碩士論文(碩士論文)。國立台北護理學院護理研究所。
  67. 卓馨怡(2006)。碩士論文(碩士論文)。輔仁大學兒童與家庭學系。
  68. 林如萍(1998)。博士論文(博士論文)。國立台灣大學農業推廣學系研究所。
  69. 邱惠慈(1993)。碩士論文(碩士論文)。國立臺灣大學公共衛生研究所。
  70. 胡幼慧、郭淑珍、王孝仙(1996)。老人長期病患照顧著對取代方案之考量：潛在需求與困境之分析。中華衛誌，15(4)，275-288。
  71. 徐亞瑛、葉炳強、陳榮基(1996)。北臺灣老年期癡呆症患者的居家照顧者照顧經驗。高雄醫學科學雜誌，12(1)，250-261。
  72. 張宏哲(2002)。社區老人使用福利服務的情形及其相關因素之探討：以台北縣為例。東吳社會工作學報，8，183-232。
  73. 張國賢(2007)。碩士論文(碩士論文)。國立嘉義大學管理研究所。
  74. 張琬琴(2004)。碩士論文(碩士論文)。屏東師範學院教育行政所。
  75. 許敏桃(2001)。臺灣老人家庭照顧研究之評析：護理人類學的觀點。國家科學委員會研究彙刊：人文及社會科學，11(2)，167-177。
  76. 陳正芬、吳淑瓊(2006)。家庭照顧者對長期照護服務使用意願之探討。人口學刊，32(6)，83-121。
  77. 陳明海(2004)。碩士論文(碩士論文)。國立東華大學企業管理研究所。
  78. 陸洛、陳欣宏(2000)。台灣變遷遂中老人的家庭角色調適及代間關係之初探。應用心理研究，14，221-249。
  79. 楊國樞編(2005)。華人本土心理學。台北:遠流。
  80. 萬育維譯、Nolan, M.、Davies, S.、Grant, G.(2004)。老人照護工作─護理與社工的專業合作。台北:洪葉文化。
  81. 鄒永霞(2007)。碩士論文(碩士論文)。國立東華大學企業管理研究所。
  82. 劉弘煌(2002)。老人家庭照顧期待之代間落差。實踐學報，33，287-303。
  83. 劉淑娟、蘇秀娟、謝美娥(1998)。北市失能老人其主要照顧者資源需求之初探。長期照護，2(2)，31-47。
  84. 盧羿廷(2004)。碩士論文(碩士論文)。靜宜大學青少年兒童福利學系。
  85. 蕭燕榮(2007)。碩士論文(碩士論文)。玄奘大學中國語文學系。
  86. 賴豐美(1998)。居家失能病患之女性照顧者的經驗。護理研究，6(5)，372-382。
  87. 謝寶耿(2000)。中國孝道精華。上海:社會科學院出版社。
  88. 簡雅芬、吳淑瓊(1999)。影響子女照顧失能父母之因子。中華衛誌，18(3)，189-198。
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