台中某日間照護中心自立支援訓練之成效探討

The Effectiveness of Independent Living Support Training in a Day Care Center in Taichung

隨著台灣逐步邁入高齡化社會，提升老年人生活品質並延緩身體功能退化已成為長期照顧的重要議題。然而，自立支援訓練在長期照顧中的尚未普及。本研究為探討台中市某日間照顧中心執行「自立支援」照顧模式後之成效研究。採回溯性研究設計，針對2023年7月17日至2023年10月10日期間29位服務對象參與為期12週、每週五天的自立支援活動進行成效分析。活動內容涵蓋肌力訓練、步行與反應能力訓練、平衡測試、上肢功能訓練及心肺耐力訓練等，並透過簡易身體功能評估（SPPB）進行前後測分析，以檢視對長者日常生活功能的影響。成對樣本t檢定結果顯示，參與者的日常生活活動能力（ADL）、步行/反應速度、上肢肌力及心肺耐力皆有顯著提升（P < .05）。儘管站立/下肢肌力與平衡測試－並排站立、直線站立等項目未達顯著差異，但進步率分別為10.13%、7.57%、10.87%。並發現這些都是與ADL相關的主要身體能力，而且意識清楚者程度，相關影響其自主性與日常生活能力、下肢肌力與步行能力等。證實自立支援活動可有效提升高齡者生活品質，建議長照機構將自立支援融入日常活動設計中，並倡導政府將延緩與預防失能計畫可推展至長照機構，以促進高齡者的自我照顧能力，達到延緩失能與促進健康老化的目標。

As Taiwan gradually enters an aging society, improving the quality of life for the elderly and slowing the decline of physical functions have become important issues in long-term care. This study focuses on the ''self-reliance support'' care model, which aims to enhance the elderly's ability for self-care, increase autonomy in daily life, and mitigate functional decline. However, the application of self-reliance support training in long-term care is not yet widespread. Using a day care center in Taichung as a case study, this research adopts a retrospective design to analyze the effectiveness of a 12-week self-reliance support program, held five days a week, between July 17, 2023, and October 10, 2023, involving 29 elderly participants. The activities included strength training, walking and reaction ability training, balance testing, upper limb function training, and cardiorespiratory endurance training. Pre- and post-tests using the Short Physical Performance Battery (SPPB) were conducted to assess the impact on participants’daily functional abilities.
Paired sample t-test results showed significant improvements (P < .05) in participants' activities of daily living (ADL), walking/reaction speed, upper limb strength, and cardiorespiratory endurance. Although no significant differences were found in standing/lower limb strength or balance testing, functional improvements were still deemed meaningful. Further analysis revealed that elderly participants with clear consciousness exhibited significant improvements in upper limb strength, walking speed, and cardiorespiratory endurance, indicating that the training effectively enhanced their autonomy and daily life capabilities. In contrast, participants with cognitive impairments showed limited training effects, though improvements in lower limb strength and walking ability were observed.
This study confirms that self-reliance support activities have a positive impact on the quality of life of the elderly. It is recommended that long-term care institutions integrate self-reliance support into daily activity designs, and that government agencies promote disability delay and prevention programs to enhance the elderly's self-care abilities, achieving the goals of delaying disability and promoting healthy aging.