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研究生(外文):Lee, Huey-Jane
論文名稱(外文):A Study On The Intention Of Home Care Worker Towards Providing Care For Demented Elders
指導教授(外文):Hong Jer Chang ,PhD
外文關鍵詞:DementiaHome Servicethe Theory of Planned Behavior
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Backgroud:Taiwan Alzheimer’s Disease Association estimates the population of people with dementia to be around 170,000 in this country. The number has been growing steadily. People with dementia may experience difficulties in daily living, jobs, and social activities, needing long-term care. Currently, the majority of demented people are cared for by their family members. Family caregivers are nonetheless short in supply due to women’s participation in labor forces and changes in the family structure. Caregiving families need a plethora of supports in order to provide care continuously and to keep their demented members at home to avoid premature entry into institutions. One of the primary supports currently available pertains to home helper services. Unfortunately, home care workers are poorly prepared, avoid providing care, or terminate services prematurely due to difficulties in handling demented people with behavioral problems. These problems have led to a gap between the demands for care and home helper supplies. It is therefore crucial to examine the factors contributing to home helpers’ intention to provide care to the demented people. Few previous studies have tapped the subject.
Materials and Methods: The study was guided by the theory of planned behavior. The theory postulated that behavior intentions was the function of three factors, attitude toward the behavior, subjective norm, and perceived behavioral control. This study was cross-sectional in design. The subjects were drawn from home care agencies in the Taipei County. These agencies were under the commission by the County Social Welfare Department to provide home helper services to the dependent people within the county.
A total of 574 home helpers were recruited. 550 of them agreed to participate in the study. A battery of self-administered questionnaire was used to collect data. 499 of them completed the questionnaires, accounting for 91.6% of completion rate. Path analysis was employed to analyze data to determine whether they fitted the paths by the theory.
Results: The result of path analysis indicated that the three paths from worker attitude toward the behavior, their subjective norm, and perceived behavioral control to behavior intention were all turned out to be significant. Their correlations were all positive in direction. The theoretical model of behavior intention was thus confirmed in this data.
Among the three paths, subjective norm to behavior intention was the strongest with attitude toward the behavior coming on the second, and perceived behavioral control ranking as the last. The result pointed to the needs to boost the all three factors in the home care workers, particularly subjective norms which have been shaped particularly by home care supervisors.
Conclusion: Home care workers or helpers need more encouragement and compliments from supervisors or staffs to inaugurate a willingness to provide care for the demented and to maintain their commitment persistently. They also need more training and preparation to stay committed to providing care. Their intention to provide care may not take place and their commitment may be wearing thin without the good coordination from families. Families with demented members need more awareness to make possible of an early detection, early diagnosis, and timely support for their demented members.
誌 謝 Ⅰ
中 文 摘 要 Ⅱ
Abstract Ⅲ
第一章 緒 論 1
第一節 研究背景 1
第二節 研究重要性 3
第三節 研究目的 5
第二章 文獻探討 6
第一節 失智症照顧之現況 6
一、失智症盛行率 6
二、失智症的診斷及照顧上的問題 6
三、失智症之照顧服務模式 8
第二節 居家服務之現況 9
一、居家服務的變遷 9
二、居家服務員的培訓 10
第三節 計畫行為理論 13
一、計畫行為理論的演繹 13
二、計畫行為理論 14
三、計畫行為理論之應用 18
第四節 影響居家服務員行為意向的相關因子 18
一.行為態度 18
二.主觀規範 19
三.知覺行為控制 20
第三章 研究方法 22
第一節 研究架構 22
第二節 研究假設 23
第三節 研究變項與測量 23
第四節 研究對象與樣本 28
第五節 資料處理與分析 28
第四章結果分析 30
第一節 樣本基本資料的分析 30
第二節 計畫行為模式各變項之分析 34
第三節 人口學資料與各變項間之關係 37
第四節 信效度分析 42
第五節 路徑分析 43
第五章 討論與建議 45
第一節 討 論 45
第二節 研究建議 48
第三節 研究限制 50
附件 58

表 格 目 錄
表2 1 台灣四個不同地區調查所得的失智症社區盛行率 6
表2 2 內政部加強居家服務員教育訓練辦法 12
表3 1 研究變項之操作行定義及測量 26
表4-2 居家服務員人口學變項分析 31
表4-3 居家服務員對提供失智個案服務的行為態度的描述性統計結果 36
表4-4 居家服務員對提供失智個案服務的主觀規範的描述性統計結果 36
表4-5 居家服務員對提供失智個案服務的知覺控制行為的描述性統計結果 36
表4-6 變項之Pearson 積差相關係數矩陣(雙尾) 37
表4-7 人口學資料與各變項間之T值檢定 38
表4-8 人口學資料與各變項間T檢定組別統計量 39
表4-9 居家服務員教育、職業、薪資、證照及機構別與各變項間的變異數分析 40
表4-10 居家服務員薪資與變項之事後比較(Scheffe法)分析表 40
表4-11 證照種類與知覺行為控制之事後比較(Scheffe法)分析表 41
表4-12 居家服務員年齡及服務年資與各變項間的皮爾森積差相關分析 42
表4-13 問卷信度分析 42
表4-14 迴歸分析模式摘要 43
表4-15 行為態度、主觀規範、知覺行為控制對行為意向之變異數分析 43
表4-16 行為態度、主觀規範、知覺行為控制對行為意向之迴歸分析 44
表4-17 研究假設的應證 44

圖2 1 理性行為理論 14
圖2 2 計畫行為理論 15
圖3 1 研究架構 22

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