智能障礙者活躍老化健康構面重要性、實施成效及潛在服務需求之研究

Importance, Effectiveness, and Opportunity of Health Domain in Active Ageing Initiatives for People with Intellectual Disabilities

智能障礙者老化現象隨著平均餘命的延長，其身體功能的衰退與老化歷程較一般老人更為明顯，隱含著較高的健康需求，本研究運用「活躍老化」的架構於邁入老年智能障礙者的需求評估，主要以架構中之「健康」構面為研究主軸，針對智能障礙者老化後健康相關服務之重要性、實施成效及潛在服務需求進行調查。以立意取樣選取我國16家身心障礙福利機構為研究場域，利用結構式問卷進行調查，共招募920位機構工作人員為研究對象，隨後將回覆問卷資料以SPSS統計套裝軟體進行統計分析。此外，本研究利用商機演算法（Opportunity algorithm）利用重度性與滿意度界定潛在的服務需求（發展商機），找出最優先應該處理的議題。研究結果發現以照護服務重要性平均分數為9.1分（評分1－10分），其次為心理健康重要性分數為8.7分。就整體實施成效部分，以照護服務實施成效分數為7.8分為最高，其次為身體健康實施成效分數為7.0分。而整體潛在服務需求部分，心理健康潛在服務需求分數為10.9分，其次為照護服務潛在服務需求分數為10.5分。在活躍老化健康服務的重要性之相關因素多變項迴歸分析，控制其他變項顯示老化認知之態度分數達顯著相關（R2＝29.5％）。在健康層面實施成效的多變項分析中，發現身體健康、照護服務、行為和健康層面的實施成效分數達顯著相關（R2＝31.1％）。研究建議應針對健康構面認知與實施成效相關因素檢視，以提升機構照顧者有關智能障礙者老化的健康識能，具備提供適時適當的老化智能障礙者照護能力。

As the life expectancy of people with mental disabilities is prolonged, the decline and aging process of their body functions are more obvious than those of the average elderly, which implies higher health needs. This study uses the framework of ''Active Aging'' in the needs assessment of the elderly with intellectual disabilities. The main research axis is the ''health'' aspect of the framework, and the importance, implementation effectiveness and potential service needs of the elderly with intellectual disabilities are investigated. Sixteen disability welfare institutions were selected as the research setting based on intentional sampling, and a structured questionnaire was used to conduct a survey. A total of 920 institutional staff were recruited as research subjects. This research uses the opportunity algorithm to define potential service needs (development opportunities) which using importance and satisfaction evaluation, and finally find the top priority issues that should be dealt with. The results of the study found that the average score of the importance of care services was 9.1 points (scoring 1-10 points), followed by the importance of mental health scores of 8.7 points. Regarding the overall implementation effectiveness, the care service score is 7.8 points, followed by the physical health score is 7.0 points. As for the overall potential service demand, the mental health score is 10.9 points, followed by the care service score of 10.5 points. In the multiple regression analysis related to the importance of health services, results showed the attitude score of aging awareness is significantly correlated (R2= 29.5%) after controlling for other variables. In the implementation effectiveness of the active health level, it was found that the scores of physical health, care services, behavior and health were significantly correlated with the effectiveness (R2=31.1%). The research suggests that factors related to health perception and implementation effectiveness should be reviewed, so as to enhance institutional caregivers' health literacy of the aging of persons with intellectual disabilities, and have the ability to provide timely and appropriate care for persons with aging and intellectual disabilities.