自立支援照顧模式於長照機構個案日常生活功能之成效探討

The Effect of Self-Supporting Care Model on Activities of Daily Living in Long-Term Care Facilities

近年來國內長期照顧機構積極推動自立支援照顧模式（Self-supporting Care Model），以提升失能者的自主生活能力及減緩失能快速惡化程度。本研究旨在探討中部某長照機構實施自立支援介入方式之成效，依據日本竹內孝仁博士提出的自立支援照顧行為模式及觀念，透過“進食、飲水、排泄、運動”四項基本照顧原則，提升住民的日常生活自理能力。本研究為準實驗性研究設計，採前後測法，收案對象為中部某住宿式長照機構住民，共收實驗組18人、對照組18人。介入期間對照組維持傳統照顧模式，實驗組個案執行自立支援照顧模式持續追蹤6個月，成果測量工具包括自立支援成效的評估表及巴氏量表，用以檢視自立支援照顧模式對長照機構住民日常生活功能改善的成效，研究期間因病情進展或結案返家而流失3名（8.33%）。研究結果顯示，自立支援介入後個案的日常生活活動能力顯著改善，進食、移位能力及活動力均有提升，同時成功實現了“零尿布、零約束、零臥床”的核心照護目標。本研究結果期作為未來長期照顧機構未來推動自立支援照顧模式時，跨專業團隊合作、機構經營管理及相關政策制定時之重要參考。

In recent years, long-term care facilities in Taiwan have been actively promoting the self-supporting care model to enhance the independence of disabled individuals and slow the progression of deterioration. This study investigates the implementation and effectiveness of the self-supporting care intervention in a long-term care institution in central Taiwan. Based on the self-supporting care behavior model and concept proposed by Dr. Takeshi Takeuchi of Japan, the study focuses on four basic care principles - eating, drinking, defecating, and exercising- to improve individuals’daily self-care abilities. A quasi-experimental design was employed, with residents of a central Taiwan residential long-term care facility as the subjects. The experimental group (n = 18) received the self-supporting care model and was continuously monitored for six months, while the control group (n = 18) received traditional care. The objective was to assess improvements in daily life function among long-term care institution residents following the implementation of the self-supporting care model. During the study period, three cases (8.33%) were lost due to disease progression or residents returning home. The results showed that the experimental group demonstrated significant improvements in daily activity ability, particularly in eating, shifting ability, and mobility. Additionally, the experimental group achieved the goal of“zero diapers, zero restraints, and zero bedridden.”These findings have important implications for the future development of long-term care institutions. The self-supporting care model can serve as a guide for cross-professional team collaboration in promoting independence among individuals while also providing valuable insights for institutional management and policy formulation.