本研究之目的在比較住在護理之家、日間照護與居家照護老人的士氣差異。樣本大小共計老人87人。研究對象為1.參與衛生署實驗計劃之護理之家、日開照護中心及醫院附設之居家照護單位，其中年滿65歲以上的老人。2.能聽懂國語或台語。3.可以進行語言溝通。所收集之資料以描述性分析、變異數是分析及共變數分析等統計方法分析。研究結果顯示:接受日間照護的老人其認知、功能狀態和士氣顯著高過護理之家與居家照護的老人(F ( 2, 84) = 3.24, F ( 2, 84) = 21.75, F (2, 84) = 6.57,，p < .05 )。由於三組之間的認知、功能狀態皆有顯著差異，而這兩個變數被認為關係老人士氣，故控制設兩項變數進行共變數分析，結果仍有顯著差異，(F = 5.25, p < .05 )。未來研究建議擴大樣本數以增進外在效度。對臨床服務之建議為:推展社區式日開照護中心及健保給付，結合志工團體提供護理之家老人外來刺激，以及發展鄰、里社區服務網絡提供居家照護之照護者所需之協助。

The purpose of this study was to compare the difference in morale among the elderly in nursing home, day care center and home care environments. The research consisted two stages, a pilot (stage one) and a later major study (stage two). The sampling criteria for subjects were that they are (1) 65 years old or older and reside in a nursing home, attend a day care program or receive home care; (2) able to understand the Mandarin or Taiwanese language; and (3) capable of verbal communication. In the pilot study, 30 elderly were used to test the reliability of instruments used. In stage two, 87 elderly from the nursing home, day care center and home care environments were sampled. Descriptive analysis, ANOVA, and ANCOVA were used for data analysis. One-way ANOVA was used to compare differences of functional status, mental status, and morale among the three types of care environments. The elderly's functional status, mental status and morale in day. care centers were significantly higher than in nursing homes and home care (F(2, 84) = 21.75, F(2, 84) = 3.24, F(2, 84) = 6.57, p < .05 respectively). ANCOVA was used to control the two covariates functional and mental status, which yielded a significant difference for morale among the three groups (F = 5.25, p < .05). To increase external validity, it is recommended that a larger sample size be used in future studies. Results of the study indicate community-based adult day care facilities would provide the most positive morale environment for the elderly. Recommendations derived from this study would also include organizing outside volunteers to work within the nursing home environment, and providing respite care for caregivers in the home care environment.