臺中縣九二一震災災區重度傷殘者居家照護資源使用效益之研究

The Study of the Effectiveness of Home Care Resources for Severely Disabled People in Taichung County 921 Earthquake's Area

本研究旨在評值台中縣、九二一震災災區重度傷殘者居家照護資源的使用 效益。以台中縣、八大災區曾接受過重大傷殘者居家照護服務的個案為研究對 象，扣除死亡、遷移、與只接受過一次居家照護需求評估的個案，以結構式 問卷共訪談了171位個案。此外亦邀請提供該項服務的居家護理師18 人，填寫 結構式問卷以陳述她們對此項資源使用效益上的意見。同時籍由實地訪查13 所居家護理機構中，客觀評值台中縣、九二一震災災區重度傷殘者居家照護資 源的使用效益。研究結果發現使用台中縣、九二一震災災區重度傷殘者居家照 護資源的個案，約有五分之一個案對此項資源的可利用性其有充分的認知， 近六成的個案則對此項資源的可近性有充分的認知與掌握。在居家護理服務 品質的評值方面， 66.7 % 的個案表示整體而言相當滿意。提供居家護理服務的 護理人員，不論是教育程度、工作資格、臨床經驗與就業動機皆其有良好的 準備度。在其自評中，她們亦表示，所服務的個素有過半數以上獲有適當的 居家照護次數與項目；對所提供的居家護理品質亦自評為非常滿意或滿意。 在實地訪查居家護理機構中，發現結構、過程與結果的品質指標，皆有需待 改善的項目。此外，自覺居家照護資源有幫助者，其對居家護理服務品質的 整體滿意度亦較高。本研究特色為使用多重資料，以增加居家照護資源使用 效益評值的信度與效度。研究結果可提供九二一震災災區重度傷殘者照護計 劃一長期照護計劃品質稽核之參酌。

The purpose of this study was to investigate the effectiveness of home care resources for severely disabled people in Taichung County 921 Earthquake's area. The sample was recruited from eight disastrous districts in Taichung County. A total of 171 subjects were interviewed with structured questionnaires, excluding death, move and just receiving home care service once for assessment. Eighteen home care nurses were invited to express their opinions toward the effectiveness of home care resources. In addition, the site visiting on 13 home care institutions was conducted to evaluate the effectiveness of home care resources for severely disabled people in Taichung County 921 Earthquake's area objectively. The results of data analysis showed that one-fifth subjects were fully aware of the availability of these home care resources. More than sixty subjects completely understood the accessibility of home care resources. With regard to the home care services quality, 66.7% of the subjects were satisfactory. All home care nurses had good preparations in education, qualification, clinical experiences and motivation to perform the home care services. According to the self-assessment, home care nurses expressed that their services quality was in the satisfactory level. In the site visiting on 13 home care institutions' quality evaluation, there were items to improve in the dimensions of structure, process and outcome. Furthermore, the subjects evaluated that the home care resources were useful; they had higher satisfaction toward home care services quality. The feature of this study is using multifarious data to increase the validity and reliability for evaluating the effectiveness of home care resources. The results could serve as a reference for auditing the long-term care quality in caring severely disabled people in Taichung County 921 Earthquake's area.