台灣與澳洲老人長照設施之失智友善設計EAT環境評量比較研究

A Comparative Study using Environmental Audit Tool (EAT) on Environmental Designs of Residential Aged Care Facilities in Taiwan and Australia

本研究實地查訪台灣十九家老人長照設施評估EAT失智友善環境十個設計準則分項（保全安全、規模大小、視覺輔助、環境刺激、導引標示、徘徊空間、熟悉感覺、隱私/社交、社區連結、融入在地）及總分數並與澳洲老人長照設施EAT評分作比較，結果顯示台灣長照政策因應高齡失智人口遞增所興辦的失智照護型老人長照設施（老人福利機構失智專區、護理之家失智專區及失智團體家屋）顯著（p= .002）優於台灣一般型老人長照設施，而並無明顯的（p= .530）城鄉差距，但相較於澳洲失智照護型老人長照設施，整體上並無明顯的（p= .312）差異，惟台灣失智照護型老人長照設施在規模大小、環境刺激、導引標示、徘徊空間等四項失智友善環境設計依然有提升改善的空間。相較於澳洲一般型老人長照設施，整體上也無明顯的（p= .217）差異，台灣一般型老人長照設施在保全安全、環境刺激、導引標示及熟悉感覺等四項失智友善環境設計較優，在規模大小及融入在地兩項失智友善環境設計可以加強及改善。

This study used the Environmental Audit Tool (EAT) to assess environmental designs of 19 residential aged care facilities where 14 located at the Taipei-Keelung metropolitan area and 5 located at Yilan-Hualien rural area. The aim of this study is to compare data on the mean and standard deviation scores of both non-purpose-built and purpose-built facilities in Taiwan and Australia based upon design principals by ten EAT subscales (safety, size, visual access, unwanted stimuli, helpful stimuli, planned wandering, familiarity, privacy and community, community links, and domestic activities). The validated EAT is an observational tool requiring a rater to move through the environment and look for specific design features defined by the 72 questions. The results show non-purpose-built facilities in Taiwan got higher scores in 4 subscales (safety, unwanted stimuli, helpful stimuli and familiarity) while those ones in Australia received better scores in 2 subscales (size and planned wandering). However, there is no significant difference (p= .312) in total score between non-purpose-built facilities in Taiwan and Australia. The purpose-built facilities in Australia got higher scores in 3 subscales (size, unwanted stimuli, helpful stimuli and planned wandering) while there is still no significant difference (p= .217) in total score. The purpose-built facilities in Taiwan had higher scores in 3 subscales (size, helpful stimuli and planned wandering) than the non-purpose-built facilities in Taiwan and there is a significant difference (p= .002) in total score. Facilities located at the Taipei-Keelung metropolitan area got higher scores in only one subscale (unwanted stimuli) in comparison with those at Yilan-Hualien rural area and there is not a significant difference (p= .530) in total score.