長照機構照顧服務員對老人性的認知量表之發展

Development of the Aging Sexual Knowledge Scale for Nurse Aides in Long Term Care Facilities

研究目的：探究長照機構照顧服務員對老人性的認知，作為未來性教育介入方案的計畫參考，進而提升照顧服務員對老人性的認知，以避免老年住民衍生性問題風波，終能提升老人的生活與照護品質。測量工具的有無與良窳為評估之關鍵，學術領域缺乏長照機構照顧服務員對老人性認知的量表，希冀能發展深具信效度的結構式臺灣本土化量表。研究方法：以作者自編之「老人性的認知量表（The Aging Sexual Knowledge Scale, ASKS）」立意抽樣中臺灣長照機構照顧服務員進行面訪問卷，完成結構式問卷484份，分二組為238份與246份，分別進行探索性因素分析（EFA）與驗證性因素分析（CFA）。研究結果：原始問卷43題；內容效度指數 < .8予刪除6題；項目分析之決斷值及t檢定考驗後刪除3題。接著進行EFA，共同性 < .3逐題行刪除，共刪除13題；再進行三次主成份分析，共刪除3題，結果分析出三個因素為「性表達」6題、「性功能」7題及「親密感」5題，總量表Cronbach’s α值為 .93。最後進行CFA，樣本為常態分配、無違反估計、適配指標值均達模式可接受的標準、也具收斂效度與區別效度。研究結論：長照機構照顧服務員對「老人性的認知量表」涵蓋具信效度的性表達、性功能及親密感三項構面。

Purpose: The purpose of this study is to investigate the knowledge of nurse aides caring for elderly people in long-term care facilities with regard to elder sexuality. Our empirical findings may help to increase the effectiveness of senior sexuality education programs for nurse aides and ultimately improve the quality of life and care for older adults. The substance of the assessment tools were classified as essential, the aging sexual knowledge for nurse aides in long term care facilities wasn’t present in the academic world, and we hoped to develop the indigenous and structured questionnaire in Taiwan, with the reliability and validity. In order to achieve this goal, we developed the Aging Sexual Knowledge Scale (ASKS). Methods: Using purposive sampling and a 37-item structured questionnaire, we interviewed nurse aides working in long-term care facilities in central Taiwan. We collected 484 valid interviews. We used 238 for exploratory factor analysis (EFA), and the rest for confirmatory factor analysis (CFA). Results: The original 43-item ASKS scale was reviewed by experts for validity. We deleted 6 items with a content validity index of less than .8. We also eliminated a further 3 items through item analysis with critical ration and t-test. The EFA revealed 13 items with a communality of less than .3, which we removed. Next, we performed principal components analysis 3 times, and deleted 3 items. In total, the EFA classified 18 items into 3 domain factors, namely sexual expression, sexual function and intimacy. These structures contained 6, 7, and 5 items, respectively. Overall scale reliability was .93. The CFA results indicated that the sample had a normal distribution, non-offending estimated, goodness-of-fit indices were labeled as outstanding fit, with convergent and discriminant validity. Conclusions: The ASKS scale may be applied in long-term care facilities to assess nurse aide’s knowledge of seniors’ sexual expression, sexual function, and intimacy.