機構安置決策過程研究之剖析及應用－－以家庭為中心的視角

Analysis and Implementation of Research Findings on the Decision Making in Institutionalization of the Elderly: A Family-Centered Perspective

隨著老年人口加速成長，慢性疾病及失能的發生率也隨之增加，加上核心家庭及婦女就業人口增加，使得家庭照顧人力萎縮，老人被安置到機構的機會變大，但是要做機構安置的決定對家屬及老人都是莫大的壓力和痛苦，本文藉由文獻中機構安置決策過程的相關研究，從決策類型、促成因素、決策過程及壓力感受、選擇機構的過程及老人和專業人員在決策過程扮演之角色等角度加以剖析，且從護理研究、護理實務及照護政策三方面提出建議，期能從以家庭為中心的護理切入，關懷家庭照顧者及老人在決策過程所面臨的壓力，並提供支持。

As the size of the population of the elderly increases, so does the incidence of chronic illness and disability. In addition, the rising prevalence of the nuclear family and rising unemployment among women, greatly reduce the resources available to families for caring. The institution placement rate among the elderly is increasing. The decision making process in relation to institutional placement, however, causes the utmost stress and suffering for the elderly and their families. The purpose of this paper is to review research articles concerning decision making in institutionalization, from the perspectives of type of decision, facilitating factors, the nature of the experience and the stress involved therein, the choice of institution, and the roles performed in the process by both the elderly person in question and by professionals, and then to propose recommendations for nursing research, nursing practice and health care policy. The researchers hope, by providing a family-centered perspective to nursing, to enable nurses to extend their concern and support to caregivers and the elderly facing decisions about institution placement.