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系統識別號 U0026-1301201417254400
論文名稱(中文) 居住在社區的老年人自覺環境障礙與其影響因素之研究—以台南市的兩個社區為例
論文名稱(英文) Factors associated with perceived environmental barriers in community-dwelling elderly in two communities in Tainan
校院名稱 成功大學
系所名稱(中) 老年學研究所
系所名稱(英) Institute of Gerontology
學年度 102
學期 1
出版年 103
研究生(中文) 連偉志
研究生(英文) Wei-Chih Lien
學號 TC6004063
學位類別 碩士
語文別 英文
論文頁數 34頁
口試委員 指導教授-官大紳
指導教授-郭乃文
召集委員-張哲豪
中文關鍵字 自覺環境障礙  居住在社區的老年人 
英文關鍵字 perceived environmental barriers  community-dwelling elderly 
學科別分類
中文摘要 背景:本研究的目的是研究居住在社區的老年人自覺環境障礙的影響因素。
設計:本研究是橫斷性研究,由研究者直接面對面施測研究量表及觀察。
受試者:本研究是在台南市的兩個社區的社區服務中心進行收案。在2012年有213位住民規則會來社區服務中心量血壓。所有受試者須符合下列收案條件:年滿65歲;在原社區居住長達12個月以上。排除條件為診斷有失智症或簡易精神狀態檢查量表小於8分。在204位符合收案條件的個案中,202位個案同意參與本研究。2個個案因簡易精神狀態檢查量表小於8分而被排除。最後總收案數為200位。
測量:以多項羅吉斯迴歸的統計模型來量測照護需求等級中日常生活活動及家務活動構面與自覺環境障礙(克雷格醫院環境量表)的相關性,控制可能的干擾因子(年齡、性別、教育程度、居住安排、經濟條件、老年憂鬱量表、自覺健康狀況及起立行走測驗)。95%信賴區間不包括1,或p值小於0.05代表統計上顯著。
結果:結果顯示自覺環境障礙與日常生活活動失能有相關(調整過後的勝算比=.228,95%信賴區間=.052–.994)也與家務活動失能有相關(1-2項家務活動有困難:調整過後的勝算比=.101,95%信賴區間=.033–.310;超過2項家務活動有困難:調整過後的勝算比=.119,95%信賴區間=.026-.546)。物理性的自覺環境障礙與日常生活活動失能有相關(調整過後的勝算比=.204,95%信賴區間=.042-.993)也與家務活動失能有相關(1-2項家務活動有困難:調整過後的勝算比=.217,95%信賴區間=.060-.789;超過2項家務活動有困難:調整過後的勝算比=.059,95%信賴區間=.010-.355)。
結論:居住在社區的老年人的自覺環境障礙與失能有相關性。
英文摘要 Objectives: To identify the factors associated with perceived environmental barriers in community-dwelling elderly.
Design: A cross-sectional design utilized the face-to-face administration of study instruments and direct observation.
Participants: We enrolled cases from 2 community service centers in Tainan, Taiwan. There were 213 inhabitants regularly came to these 2 community service centers for measuring blood pressure in 2012. All participants met the following inclusion criteria: they were aged above 65 years old; and had resided in the same community for at least 12 months. Exclusion criteria included being diagnosed as dementia and 8 points below on the Short Portable Mental State Questionnaire (SPMSQ). Of the 204 subjects, 202 agreed to participate in the study. 2 subjects were excluded due to 8 points below on SPMSQ. The final case number was 200.
Measurements: Activity of daily living (ADL) and instrumental activity of daily living (IADL) subscales of Hierarchy of the Care Required (HCR) associated with perceived environmental barriers (Craig Hospital Inventory of Environmental Factors, CHIEF) were calculated by multinomial logistic regression to control for possible confounding factors (age, gender, education years, living arrangement, financial status, geriatric depression scale, self-rated health, and time get-up and go test). Ninety-five % confidence intervals (CIs) not include 1, or p<.05 was regarded as statistically significant.
Results: Results indicated that the presence of perceived environmental barriers was related to ADL disability (adjusted OR=.228, 95% CI=.052–.994) and IADL disability (IADL with difficulty in 1-2 items: adjusted OR=.101, 95% CI=.033–.310; IADL with difficulty in more than 2 items: adjusted OR=.119, 95% CI=.026-.546). The presence of physical perceived environmental barriers was related to ADL disability (adjusted OR=.204, 95% CI=.042-.993) and IADL disability (IADL with difficulty in 1-2 items: adjusted OR=.217, 95% CI=.060-.789; IADL with difficulty in more than 2 items: adjusted OR=.059, 95% CI=.010-.355).
Conclusion: Perceived environmental barriers are related to disability in community-dwelling elderly.
論文目次 Introduction 1
1.1 Person and the Environment: Lewin’s Person-Environment (PE) Fit Model 2
1.2 The influences of environmental barriers on community-dwelling elderly 3
1.3 The goal of this study 3
Material and Methods 5
2.1 Variables 5
2.1.1 Perceived environmental barriers 5
2.1.2 Activity of daily living (ADL) and Instrumental activity of daily living (IADL) 10
2.1.3 Mobility limitation 11
2.1.4 Personal factors 11
2.2 Statistical analysis 12
Results 13
Discussion 16
4.1 Environmental barriers faced by elderly living in community 16
4.2 The relationships between difficulty in ADL/IADL and the perceived environmental barriers 16
4.3 Limitations 18
Conclusion 20
References 21
Appendix .29
Appendix 1. Authorization Letter .29
Appendix 2. Institutional Review Board (同意人體研究證明書) 30
Appendix 3. CHIEF-CET(克雷格醫院環境量表-台灣老年人版) 31
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