臺灣博碩士論文加值系統

人口老化伴隨而來的最大問題包括生活照顧、健康照護及經濟安全等。在許多老人長期照護問題中，失智症的特殊照護需求對家屬所造成的壓力與困擾，為積極建構專業性失智症照護環境需考量的重要因素,而對失智症患者行為問題發生之影響則為失智症照護居住安排的重要考量。綜觀國內失智症相關研究皆著重家庭主要照護者的負荷，並無環境的議題相關性的探討。本研究針對四所長期照機構的77位失智症患者，就其不同居住型態對記憶和行為問題之影響進行探討，所得結果以卡方檢定、t檢定、複相關迴歸分析等方法進行分析。研究結果顯示在本研究對象中，阿滋海默氏症患者居多，失智嚴重度則以中期者居多。（一）混合收容型態之失智症患者，其記憶和行為問題發生頻率高於單獨收容型態之失智症患者，（二）房間共居程度複雜的失智症患者，其與記憶和行為問題正面相關，（三）在失智嚴重程度上，中期失智症患者在混合收容型態之記憶和行為問題高於單獨收容型態，（四）不同居住型態失智症患者之記憶和行為問題對照護者所產生的困擾及自我效能並無顯著的不同。本研究結果可供未來機構內失智症患者居住型態安排之參考。

The problems come along with population aging exactly should be lifecare, healthcare and social security. Problems & needs lots of elders in long-term care, especial to dementia, and the remarkable stress accompanied for patient families both should be the major factors of actively professional caring environment for dementia itself. Furthermore the effects of behavior problems for dementia victims, should be usually the major consideration of environment design for dementia care mandatory.
There is no peculiar information or study regarding to environment issues among thousands of related researches in Taiwan so far, which should be focused on the loading of family caregiver. This study as below has been carried out onto 77 dementia patients in 4 long-term facilities in different arrangement of living status for memory and behavior problem, and the results had been after analyzed by Chi-square, t-test, multiple regression mixed-living arrangment to show in these most Alzheimer type patients, and the situated in middle stage of dementias. (1) The frequency of memory and behavior problem for should be higher than of independent; (2) The frequency of memory and behavior problem for the complexily of room-sharing should be in in direct proportion; (3) As for the dementia senerity, the frequency of memory and behavior problem for mixed type patients in middle stage should be higher than of independent type; (4) No significant differences in stress and self-efficiency of caregiver caused by memory and behavior problem for dementia patients in different living status. The result of this study may be regarded as reference for living arrangement for dementia patients of care units in coming future.

誌 謝 I
中文摘要 II
英文摘要 III
目 錄 IV
圖表目錄 VI
第一章 緒論 1
第一節 研究動機 1
第二節 研究目的 12
第二章 文獻探討 13
第一節 失智症之相關性研究 13
第二節 失智症之記憶和行為問題之相關性研究 17
第三節 失智症機構居住環境之相關性研究 25
第三章 研究設計 29
第一節 研究架構 29
第二節 研究內容 31
第三節 名詞界定 32
第四章 研究方法 35
第一節 研究對象 35
第二節 研究工具 36
第三節 研究步驟 42
第四節 資料分析方法 43
第五章 研究結果 45
第一節 長期照護機構失智症患者屬性分析 45
第二節 居住型態對失智症患者記憶和行為問題之影響 54
第三節 不同居住型態失智症患者其失智嚴重度在記憶和行為問題之差異 61
第四節 不同居住型態照護者對失智症患者記憶和行為問題之困擾及自我效能之評量 65
第六章 討論 69
第一節 長期照護機構中失智症患者之屬性與居住特徵 69
第二節 不同居住型態對失智症患者記憶和行為問題之影響 72
第三節 不同居住型態失智嚴重度對失智症患者記憶和行為問題之影響 74
第四節 不同居住型態主要照護者對失智症患者記憶和行為問題 76
之困擾及其自我效能 76
第五節 結語 78
第六節 研究限制 79
第七章 結論與建議 81
第一節 結論 81
第二節 建議 84
參考資料 86
中文部分 86
英文部分 90
附錄 101
附錄一 記憶和行為問題量表同意書 101
附錄二 研究問卷同意書 102
附錄三 基本資料表 103
附錄四 臨床失智評估表 104
附錄五 記憶和行為問題量表 105
附錄六 巴氏量表 106

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