榮家照顧服務員失智症照護能力及影響因素之探討

Exploration of Dementia Caregiving Competence and Influencing Factors among Care Workers in Veterans Home

我國即將邁入超高齡社會，尤其榮譽國民之家的住民平均年齡高，是失智症的高風險族群。照顧服務員是榮家及其他長照機構中主要照顧人力，且為第一線負責住民日常生活照顧服務之照顧者，但其中僅有部分人員完成失智症照顧服務20小時訓練課程，在職訓練策略並未強制規範需包括失智症照護課程，因此榮家照顧服務員之失智症照護能力極需進一步探討。本研究的目的是要探討榮家照顧服務員之失智症照護能力及相關影響因素。採橫斷式研究，以方便取樣方式招募北台灣四所榮家共66位照顧服務員，並採用問卷調查方式收集資料，包括照顧服務員基本資料、失智症照護知識量表、失智症照護態度量表及失智症照護專業能力評估量表。以描述性統計、獨立樣本t檢定、單因子變異數分析、皮爾森積差相關及逐步迴歸等進行資料分析。結果顯示，榮家照顧服務員以台灣籍已婚女性居多、平均年齡53.4歲，教育程度以國中（小）及高中（職）佔多數。照顧服務員具備中等程度之失智症照護能力，在九大核心能力中，能力較低為「失智症的辨識與認識失智症相關診斷」、「失智症緩和照顧」、「倫理與法律」三項；照顧服務員之年齡、教育程度、國籍、失智症照顧經驗、對失智症照顧工作的喜歡程度、及失智症照護態度等變項，與照顧能力有相關且能顯著預測失智症照顧能力，整體解釋變異量為23.8%。本研究可提供臨床照顧實務，對失智症照顧能力評估及規劃照顧訓練課程之參考。

Taiwan is rapidly becoming a super-aged society, with the average age of residents in veterans homes being high, making them at high risk of dementia. Care workers are the main workforce in veterans homes and other long-term care institutions, and are the first-line personnel responsible for daily care services for residents. However, few care workers have completed the 20 hours of training in the dementia care service. The in-service training strategy does not mandate the inclusion of dementia-related courses. Therefore, the dementia care competencies of veterans home care workers require further exploration. The purpose of this study is to explore the factors that affect the dementia care competencies of veterans home care workers. A cross-sectional study was conducted using convenient sampling to recruit 166 care workers from four veterans homes in northern Taiwan. Data were collected through a questionnaire survey, which included basic information on care workers, the dementia care knowledge scale, the dementia care attitude scale, and the dementia care professional competency assessment scale. Descriptive statistics, independent sample t-test, one-way analysis of variance (ANOVA), Pearson’s correlation coefficient, and stepwise regression were used for data analysis. The results showed that the majority of care workers were married Taiwanese females with an average age of 53.4 years, and had an education level mainly from primary to senior high school. Further, it was shown that care workers have moderate dementia care competency. Among the nine core competencies,“understanding thw symptoms, diagnosis and treatment of dementia”“palliative care for dementia,”and“ethics and law”were the lowest scoring competencies. Age, education, nationality, dementia care experience, preferences for dementia care, and attitudes toward dementia care were associated with and significantly predicted dementia care competencies, with an overall explained variance of 23.8%. This study can be used as a reference for clinical care practice to assess dementia care competencies and to plan dementia care training programs.