探討社區高齡者參與「樂智課程」之主觀需求：應用深度訪談形成Q 陳述句的歷程研究

Investigating the subjective needs of community-dwelling older adults for a “cognitive enhancement program”: A study on the formation of Q-statements using in-depth interviews

失智人口增加所衍生的社會照顧的需求是刻不容緩之要務，失智所造成的問題除了個人身心社會的改變，也會造成生活品質改變與家庭結構的影響。早期提供失智症預防活動的介入，或可延緩失能、憂鬱症以及行為改變的速度，幫助維持獨立自主，減少合併症；若能在早期接受認知復健活動，能保有較佳的功能性，確保失智症個案擁有較好的生活品質。研究目的為分析高齡者參與意願影響因素，做為未來規劃相關活動設計依據，增加高齡者參與活動意願。本研究以立意取樣方式進行取樣，取樣標準為75 歲以上居住於北部地區且出現輕微認知功能障礙之社區高齡者，經簽署同意書後進行個別深度訪談，將資料進行歸納整理。分析高齡者對於「樂智課程」的主觀需求，從深度訪談資料到Q 陳述句的歸納，依照6C 行銷架構進行分類，將詞句進行多次分類彙整，以高齡者的閱讀習慣將關鍵詞擬定成為Q-statement 初稿。包括擔憂影響（concerned），消費者的需要（consumer），成本（cost），方便性（convenience），雙向溝通（communication），以及社群影響（community）等。Q 方法的特點是利用陳述句，藉由較少的樣本數，來深入了解對於這些概念的評析，並歸納出其對特定主題的想法，以因素分析的方式，找出高齡者與陳述句之間的關連性，瞭解其主觀的想法。研究者可依據各種因素的分布情形並加以解釋，並分辨出高齡者之不同特質，而歸納出高齡者在「樂智課程」的主觀態度，而運用在預防失智症的「樂智課程」設計中。

The aim of this study was to analyze the factors influencing the willingness of older adults to participate in activities, which can serve as a design basis for the future planning of relevant activities in order to increase their willingness. Purposive sampling was conducted to recruit community-dwelling older adults aged 75 years and over, residing in the northern regions of Taiwan, who had mild cognitive impairment (MCI). After obtaining written consent, in-depth interviews were conducted with the patients, and the data were then sorted and summarized. We analyzed the subjective needs of older adults for a “cognitive enhancement course.” Q-statements were summarized from the in-depth interviews and categorized according to the 6C marketing model. The phrases were subjected to multiple sorting and categorization. The key phrases used by older adults regarding their reading capacity were used to formulate the draft of Q-statements. These included concerned impact, consumer needs, cost, convenience, mutual communication, and community impact. A feature of the Q methodology is using such statements to gain an in-depth understanding of patients’ assessment of these concepts using a small sample size and summarizing their views on specific topics. A factor analysis will be performed to identify the relationship between older adults and these statements in order to understand their subjective views. By examining and explaining the distribution of various factors, the researchers were able to differentiate the characteristics of older adults and summarize the main subjective attitudes of older adults towards a “cognitive enhancement course.” The results were used to design a “cognitive enhancement course” for the prevention of dementia.