家訪介入措施對改善居家老人精神受虐狀況之前趨成效探討

The Effect ofthe Home-Visit Intervention onAlleviating Psychological Elder Abuse in a Domestic Context : A pilot study

本研究的目的旨在探討一項同時具教育與關懷之家庭訪視措施對改善居家老人精神受虐狀況之成效，為一單組前後測類實驗研究設計之前驅性試驗研究。以立意取樣方式針對南部二縣市共八對居家老人及其主要照顧者進行資料收集。研究措施針對老人及主要照顧者進行每週乙次，連續八週之教育關懷家庭訪視，此措施包含照護者之衛生教育及諮詢、心理支持、壓力處理技巧等，並提供衛教手冊以及諮詢電話。以老人及照護者基本屬性調查表、老人精神受虐指標調查表、巴氏日常生活功能量表、簡短智能量表進行資料收集，運用Wilcoxon Signed Ranks Test 進行前後測比較。研究結果顯示老人精神受虐指標調查表的前測中介值為11（ IQR=3.75-17.25 ）、後測中介值為8.5 （IQR=5-16.5） ，雖未達統計上的顯著改變（ Z=-.677， p=.498 ）但呈現進步幅度，顯示措施介入後這些原處於受虐危險的老人可能從中得到緩解。本研究成果除了可做為未來研究的基礎外，亦可作為提升居家老人照護品質安全之依據、建立國家老人保護體系之參考、教育計劃之持續宣導及推行、及提供多元化社會資源的應用，深信不論是受虐者或施虐者，他們所需要的不僅是物資上的供給，更需要情感上的支持。Taiwan to participate in this study. The care and education home visit, comprised of health education and counseling, mental support, stress management skills for the caregivers, served as the research intervention. A consulting phone number was also provided. The Elder’s Psychological Abuse Scale ( EPAS ), BartheFs Activity of Daily Living( ADL ), and Short Portable Mental State Questionnaire (SPMSQ) were used for data collection. The Wilcoxon Signed Ranks Test was used for data analysis. Findings indicated that the median score of the PEAS was 11( IQR=3.75-17.25 )and the post-test median score decreased to 8.5( IQR=5-16.5 ), indicating improvement. Although a statistical significance was not achieved( Z=-.677, p=.498 ) , the findings indicate that the intervention may prevent the elderly from being psychologically abused. The findings of this study are not only of benefit to proposed future research, but are crucial to promoting domestic elderly care quality as well as to developing a national system for protecting the elderly. Moreover, a continuing educational plan is required for enforcing communication between caregivers and elders. In conclusion, the researchers believe that emotional as well as material support is needed for both the abused victim and the abuser.