高雄市居家服務滿足老年照顧需求了嗎？

10.6690/JSWPR.2014.1.5

張江清；黃仲平；楊馥宣

居家服務 ； 滿意度 ； 需求 ； home care services ； satisfaction ； needs

社會工作實務與研究學刊

1期（2014 / 12 / 01）

89+91+93 - 116

繁體中文

本研究目的是為了提昇高雄市老年居家服務輸送的成效，乃進行使用者基本特質、對服務滿意度與需求的調查，期待持續檢視服務使用情形，以重新定義我們已知的需求相關概念，作為未來修訂相關實務政策的參考。本研究採橫斷式設計，以結構式問卷進行調查。問卷參考相關文獻，以及社會工作、社會福利與護理學三位專家之審查意見編製而成。依據2012年12月高雄市居家服務使用個案數4941人為母群體，亂數隨機抽取樣本進行電訪，成功樣本數有479人，運用社會科學統計套裝軟體(SPSS)來進行資料分析。本次樣本平均年齡79.27歲，以女性、已婚、有親人同住、有照顧者、一般戶、中度失能者、國小以下教育程度者居多；整體來說，高達98.5％的受訪者認同服務對生活品質的改善；85.6％表示服務能夠符合本身的需要。資料顯示，失能程度越高，照顧負擔減輕越多；負擔減輕越多，對人力品質滿意度也越高，也越感符合需求，越有意願繼續使用服務。現鳳岡旗美區(原高縣)相較於高雄南北區(原高市)，對人力品質的滿意度較高、照顧者感到減輕較多照顧負擔；教育程度高者，對服務滿意度較低、服務也較不能符合需要、繼續使用意願較低，未來可以進一步瞭解其照顧需求，以協助降低照顧負荷。從98.9％的照顧者照顧負荷減輕可知，這項結合公、私部門所提供的居家服務，確實符合「支持家庭照顧能力，分擔家庭照顧責任」的政策目標。然需多關注14.4％需求尚未滿足的受訪者，協助排除服務障礙。

In order to increase effectiveness on elderly service delivery, the study aimed to investigate the basic characteristics of home care users, and the satisfaction and needs for services in Kaohsiung City. The research looked forward to surveying continuously on the services used, redefining the need concepts, and providing references for future policy modification. The study had adopted a cross-sectional design with structured questionnaires. The content of the questionnaires were constructed by literature review, and reviews from social work, social welfare and nursing experts. Based on the number of home service users on December 2012, the study population in Kaohsiung was 4941. By conducting telephone interviews on random samples, there are 479 successful cases. The data was analyzed by SPSS, a software package for scientific statistical analysis. The average age of the study population is 79.27. Most of the respondents are females, married, living with family members, with caregivers, moderate disabilities, below elementary educational background, and their families were not poor. Generally viewed, 98.5 % of the respondents agreed services could improve quality of life, and 85.6% met the needs of services. According to the data, the higher the degree of disability is, the more alleviating burdens they experience. The more alleviating burdens they experience, the better satisfaction on labor quality shows. The needs were met and with higher willingness to continue services. Compared to the northern and southern districts of Kaohsiung (original Kaohsiung city); Fengshan, Kangshan, Qishan, and Mino (the original Kaohsiung County) are areas with higher satisfaction on labor quality, and caregivers feel less pressure for home cares. For those with higher educational background, the satisfaction of services is lower, which did not meet the needs, and are less willing to continue the services; the future study should be carried on to investigate the needs so that it could support to alleviate caring burdens. 98.9% on the alleviating burden shows that combination of public and private sector on home care services did meet the policy target on ＂the ability to support family care, and share family responsibilities＂. However, more attention should be addressed to the other 14.4%, whose needs had not been satisfied; thus, to assist barrier removals in services.

1. 呂寶靜、陳正芬(2009)。我國居家照顧服務員職業證照與培訓制度之探究：從英國和日本的作法反思台灣。社會政策與社會工作學刊，13(1)，185-233。
   連結：
2. 紀玫如、莊坤洋、吳振龍、吳淑瓊(2006)。居家服務使用之相關因素研究。台灣公共衛生雜誌，25(1)，37-48。
   連結：
3. 張江清、林秋菊、蔡和蓁、陳武宗(2011)。困境向前行～高雄縣市居家照顧服務員服務經驗探究。弘光學報，64，70-89。
   連結：
4. 曾淑芬、莊坤洋、陳正芬、葉乃禎、吳淑瓊(2004)。給付標準的設定會引導民眾對社區式服務的利用嗎？－以居家服務為例。臺灣公共衛生雜誌，23(3)，221-234。
   連結：
5. Netten, A., Darton, R., Davey, V., Kendall, J., Knapp, M., Williams, J., Fernandez, J-L., & Forder, J. (2005). Understanding public services and markets: report commissioned by the King's Fund for the care services inquiry. Discussion Paper 2111/4, Personal Social Services Research Unit, University of Kent, Canterbury, UK. Http://www.pssru.ac.uk
6. Bronfenbrenner, U.(1979).The ecology of human development.Cambridge, MA:Harvard University Press.
7. Doyal, L.,Gough, I.(1991).A theory of human need.New York:Guilford Press.
8. Dyck, I.,Kontos, P.,Angus, J.,McKeever, P.(2005).The home as a site for long-term care: meanings and management of bodies and spaces.Health & Place,11,173-185.
9. Gabor, P.,Unrau, Y.,Grinnell, R.(1998).Evaluation for social workers.Bosten:Allyn and Bacon.
10. Kadushin, G.(2004).Home health care utilization: a review of the research for social work.Health and Social Work,29(3),219-244.
11. Kemper, P.(1992).The use of formal and informal home care by the disabled elderly.Health Service Research,27(1),421-51.
12. McKillip, J.(1987).Needs analysis: Tools for the human services and education.Newbuny park:Sage Publications.
13. O'Brien, M.(2010).The conceptualization and measurement of need: A key to guiding policy and practice in children's services.Child & Family Social Work,15,432-440.
14. OECD(1996).Caring for frail elderly people: policies in evolution.Paris:Organization for Economic Cooperation and Development.
15. Stainton, T.,Besser, H.(1998).The Positive impact of children with an intellectual disability on the family.Journal of Intellectual & Developmental Disability,23(1),56-70.
16. 吳玉琴(2004)。臺灣居家服務的現況與檢討。社區發展季刊，106，132-141。
17. 吳振龍、紀櫻珍、黃國哲、莊坤洋、吳淑瓊(2004)。社區失能老人居家支持服務需求之初探～以台北市大安區失能老人為例。新台北護理期刊，6(1)，47-56。
18. 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。
19. 吳淑瓊、莊坤洋(2001)。在地老化：台灣二十一世紀長期照護的政策方向。台灣衛誌，20(3)，192-201。
20. 呂寶靜(2003)。行政院國家科學委員會專題研究計畫行政院國家科學委員會專題研究計畫,行政院國家科學委員會。
21. 林富琴、邱啟潤(2004)。接受居家服務老人生活品質急相關因素探討。長期照護雜誌，8(1)，56-78。
22. 徐慧娟、吳淑瓊(1998)。提供社區式家庭支持方案能否減少機構式長期照護服務之使用意願？。中華衛誌，17(4)，326-336。
23. 莊秀美(2008)。長期照顧機構服務變遷發展之研究。台北:松慧。
24. 陳正芬(2013)。我國長期照顧體系欠缺的一角：照顧者支持服務。社區發展季刊，141，203-213。
25. 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，32，83-121。
26. 陳武宗、張江清(2008)。高雄市老人研究發展中心96年度專題研究期末報告高雄市老人研究發展中心96年度專題研究期末報告,未出版
27. 陳晶瑩(2003)。老年人之長期照顧。台灣醫學，7(3)，404-413。
28. 趙安娜、高美鈴、林壽惠(2004)。鄉村社區老年人健康狀況與生活品質相關性之探討。長期照護雜誌，8(1)，41-54。