在地老化實踐、外在連續性與都市老人生活品質研究：以臺北市為例

Aging in Place Factors, External Continuity and Quality of Life among Older Adults in Cities: Taipei City Taken as an Example

在地老化是1980年代以來各國普世的老人照護目標，被視為提升老年生活品質的關鍵。然而，目前國內缺少探討在地老化實踐如何影響都市老人生活品質的研究。本研究以居家安全性、生活自主性、社區環境高齡友善性三項指標作為在地老化實踐的測量。同時融合連續理論中的外在連續性，探索上述變項對都市長者生活品質的影響效果。
本研究以調查研究法取得台北市253位60歲以上長者的問卷回覆，經確認量表信效度後，藉統計軟體SPSS與AMOS進行多元迴歸及中介效果路徑分析。研究發現居家安全、生活自主、社區環境友善性皆能提升生活品質，又以後兩項實踐的影響力更大。其次，都市長者的人際穩定性與活動連續性亦能提升生活品質，且在生活自主、社區環境友善對生活品質的影響之間具有中介效果。
本研究認為，若欲展現在地老化積極意涵，則勿僅止避免長者入住機構，應關注其居家安全、生活自主、社區高齡友善環境的落實。重要的是，都市長者的外在連續性應被看見。社會工作專業應協助長者與熟悉的人事物和社區環境保有長期且持續的連結，同時，培力長者說出自己在都市空間的需求，以落實真正有生活品質的在地老化。

Aging in place' has long been a popular and desirable term in regard to improving quality of life (QOL) among older adults. However, most extant studies only focus on certain aspects instead of viewing aging in place inclusively from its three elemental definitions: being safe at home, maintaining autonomy, and enjoying an aging-friendly community. Furthermore, less is known about how continuity of daily lives potentially affects older adults' QOL. Integrating the Environmental Press Theory and the Continuity Theory, this study evaluates how aging in place elements and external continuity of city-dwelling older adults combine in affacting their quality of life.
253 adults aged 60 and above were recruited. The sample was not representative of community-dwelling older adults in Taipei city. A structed questionnaire was carried out either by paper-and-pencil or an online survey. The results showed that, firstly, home safety, autonomy and aging-friendly community all positively affect QOL, with the latter two elements having stronger effects. Secondly, the stability of personal relationships and activity continuity not only showed strong effects related to QOL, but also served as mediators between autonomy, aging-friendly community and QOL.
This study urges that in putting aging in place into a more active practice, policy makers and social workers should not only evaluate the situation of home safety, autonomy and aging-friendly community of older adults, but also pay attention to their external continuity, which entails maintaining their long-term relationship with the local community and preserving their own daily routines. To achieve higher QOL among older adults, related organizations could be more proactive to empower older people to become agents of their own communities and city spaces.