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護理暨健康照護研究 Scopus

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篇名 提升長期照顧機構長者如廁能力之研究
卷期 8:3
並列篇名 Improving Toileting Abilities in Elders Living in Long-Term Care Facilities
作者 郭詩伶余慶仁張素嫺
頁次 169-178
關鍵字 如廁能力長期照顧機構長者toileting abilitylong-term care facilitieselders
出刊日期 201209

中文摘要

背景:如廁是一個複雜的活動,如廁能力會影響個體的身心健康及生活品質。然而,目前機構照顧人員缺乏理論為基礎的照護模式,來促進機構長者的如廁能力。目的:探討以理論為基礎之自我照護及運動自我效能活動,提升如廁能力之成效。方法:採實驗性、雙組、追蹤性研究設計。資料收集時間共有4次:基本資料收集、介入措施執行後2個月、4個月、6個月。實驗組住民接受由機構工作人員提供的活動指導,採用Bandura的社會認知理論為基礎所設計的自我照顧及運動自我效能促進課程活動。結果:本研究共有274位機構長者參與(實驗組120位;對照組154位)。在介入措施執行半年後,實驗組個案在下半身強度、左右髖關節及膝關節屈曲與伸展角度,均有顯著性改變。對照組個案只有左右膝關節伸展角度有顯著性改變。也發現如廁能力之預測因子項目中,功能能力自我效能、下半身強度、疼痛感、及右膝關節伸展度,可解釋的總變異量達52.3%。實驗組個案在如廁能力有進步,但統計上無顯著改變。對照組如廁行為能力也出現無統計上顯著改變,然其變化較呈現不穩定狀態。結論/實務應用:提供長照機構工作人員,運用以理論為基礎的自我照顧及運動自我效能促進課程,來維持老年人之如廁功能。

英文摘要

Background: Self-toileting is a complicated and complex activity. Inability to perform such can impact negatively upon the physical health, psychological health, and quality of life of affected individuals. Staff caregivers in long-term care facilities lack a theory-based intervention to improve toileting abilities in elders who live in long-term care facilities.Purpose: This study tested the effectiveness of a theory-based intervention program on improving the toileting abilities of elders living in long-term care facilities.Methods: This study used a research design that was experimental, two-group, and longitudinal. Data was collected four times, respectively, at baseline and at 2 months, 4 months, and 6 months post-intervention. Care facility staff administered a theory-based intervention designed on Bandura's social cognitive theory to subjects in the experimental group.Results: A total of 274 subjects participated in the study, with 120 assigned to the experimental group and 154 assigned to the comparison group. The experimental group recorded statistically significant changes in lower-body strength and flexion and extension in both hips and knees. The comparison group recorded statistically significant changes in knee extension degrees only. Results showed lower body strength, perception of pain, and degree of right knee extension to be significant predictors of self-toileting abilities (R^2 = .53). Although toileting ability improved in the experimental group, the change was not statistically significant. The comparison group further showed no statistical changes in toileting behavior, and these changes present unstable state.Conclusions / Implications for Practice: This study provides valuable information that staff caregivers can apply in theory-based interventions focused on enhancing elder self-care abilities and self-efficacy in order to sustain the self-toileting abilities of elders living in long-term care facilities in Taiwan.

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