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研究生:林佳慧
研究生(外文):Chia-Hui Lin
論文名稱:靈性照顧對安老所老人生活適應之探討
論文名稱(外文):The Study of Relationship Between Spiritual Care and Life Adaptation in Retirement Home Residents
指導教授:陳雅美陳雅美引用關係
指導教授(外文):Ya-Mei Chen
口試委員:羅美芳釋覺方
口試日期:2015-05-11
學位類別:碩士
校院名稱:國立臺灣大學
系所名稱:公共衛生碩士學位學程
學門:醫藥衛生學門
學類:公共衛生學類
論文種類:學術論文
論文出版年:2015
畢業學年度:103
語文別:中文
論文頁數:126
中文關鍵詞:靈性照顧生活適應質性研究Maslow理論成功老化
外文關鍵詞:spiritual careadaptation lifequalitative studyMaslow’s needs Hierachysuccessful aging
相關次數:
  • 被引用被引用:8
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研究背景與目的
 「靈性照顧」是長期照顧特殊的服務方式,已在國外老人照顧專業領域中受到關注及倡議,目前在國內老人機構的服務模式對此議題探討甚少,且機構式照顧大部分仍著重在生物醫療層面,忽略老年人的心理及靈性需求的滿足。而靈性照顧場域不僅在安寧病房的服務,而是需提早在長輩們身體健康時就開始著手,以因應未來高齡化社會老化人口的需求,因此靈性照顧實有探究之必要。故本研究之探討目的有三:(一)了解住民對靈性照顧在生活適應的感受與看法;(二)照顧服務者如何在生活上運用靈性照顧協助住民生活之適應;(三)從靈性照顧身、心、社會及靈性觀點,探討住民成功老化的關聯性。

研究方法
  本研究為質性研究,研究對象針對佛教安養機構安老所的長者15人,工作人員5人共20人,從研究者事先建立的訪談摘要進行半結構式訪談,以Maslow需求層次理論為理論架構,並以樣板式分析法,建立分析架構進行本文分析。

研究結果
研究結果包括:
(一)老人居住的安養機構有佛教靈性的支持環境,能減少老人從原居住地移居至安養機構時的焦慮情緒,有助於靈性照顧的心理適應,其宗教資源的可近性及可及性,使老人增加參與宗教活動頻率,滿足靈性需求,進而提高社交網絡的機會,維持社會關係。佛教環境具有靈性及健康發展的雙重意義,有助於老人生活的適應。

(二)宗教繞佛活動提供老人健康促進方式,老人從靈性需求層面尋找到能增加運動以及身體保健的方法,也滿足其靈性需求。

(三)宗教師透過宗教義理為工具,傳播信仰的觀念,以教育者角度教育老人正向的思考與負面行為的規範,協助老人察覺靈性需求的成長,具有傳播宗教信仰的弘法者及教育者雙重角色。

(四)靈性照顧提供住民心靈沉殿及適應機構生活的照顧方式,而宗教為工作人員帶來便利性且正當性的工具與方法。

研究討論與建議
  Maslow需求層次理論對安老所的老年人而言,靈性需求滿足不是最高層次的追求,老年人的需求是先透過高層次靈性需求的滿足而達成低層次需求滿足。透過靈性照顧老年人可以滿足其生理、安全、愛與隸屬、自尊、自我實現等層面的需求,朝向達成正向的成功老化目標一致。
依據研究結果,提出下列建議:(一)家屬能多陪伴老年人共同參與靈性休閒活動,協助老人獲得屬於親情的靈性關懷;(二)提供工作人員相關靈性照顧訓練,培養靈性服務的專業能力,給予個別化的靈性照顧;(三)舉辦增加靈性休閒活動,提高個人身體及心理健康,啟發心靈省思、解決靈性困擾。

Background and purpose:
Spiritual care has been an important concern in long-term care, but has received less attention in institutional care in Taiwan. Most of the Seniors’ long-term care institutions for older adults in Taiwan only focus on the basic needs of physiological care, and neglect their mental and spiritual needs.

  The purpose of this study was:(a) to understand the spiritual needs of older adults living in a retirement home ; (b) to discuss the current situation with the staff on how to provide spiritual resources allowing them to turn to for help in times of crisis or concern ; (c) to discuss the relationship between the spiritual care and successful aging in retirement home.

Research method:
  This qualitative study was based on the theory of Maslow''s hierarchy of needs. Semi-structured interviews were conducted by a researcher following a written interview guide. In this study 15 elderly residents and 5 staff members who work in the Buddhist private retirement home were interviewed.

Findings:
Highlights from the study''s findings included:
(a) The Buddhism building and environment of the institution served as a great support for spiritual care and reduced older adults'' anxiety resulted from moving to the retirement home from their homes . A good accessibility to religious resources may increase the participation of religious activities and increase their social networks and social relationships with others among older adults. Through these activities older adults are more likely to meet their spiritual needs. The Buddhism environment also adds significant meaning to spirituality and the health of older adults living in the retirement home. .

(b) Through the ritual of walking around the Buddha, older adults were able to increase their physical activity and to maintain physical health as well as meeting their spiritual needs.

(c) Through Buddhism, the Buddhist nun served as a mentor of the older adults and was able to help older adults to think positively and to fulfill older adults'' needs for spiritual care.

(d) Spiritual care can provide elder residents a source of calm and healthy life. Religion can be a good tool for providing spiritual care.

Discussion and Recommendations:
Spiritual needs are not considered priority in the theory of Maslow’s Hierachy Needs. In long-term care setting, older adults'' spiritual needs should be considered while meeting older adults'' basic needs and more advanced needs. Through spiritual care, older adults living in a retirement home can meet the needs of physiological, safety, love, ''esteem, and self-actualization, and move forward toward successful aging.

According to our study findings, we recommended:
(a) Families'' acknowledgment of spiritual care can have a great influence on elder residents.

(b) Staffs'' training in providing spiritual care should be strengthened.

(c) Spiritual care related activities are strongly recommended for institutionalized elders, which may improve their health both physically and psychologically.

中文摘要 i
ABSTRACT iii
目 錄 v
表目錄 vii
圖目錄 viii
第一章 緒論 1
第一節 研究背景與動機 1
第二節 研究目的 5
第三節 名詞釋義 5
第二章 文獻探討 7
第一節 靈性概念及相關研究 7
第二節 老化現象及相關理論之探討 20
第三節 老人入住機構的生活適應 26
第三章 研究方法 33
第一節 研究設計 33
第二節 研究對象 34
第三節 資料蒐集方式 37
第四節 資料整理與分析方法 38
第五節 訪談大綱 42
第六節 分析架構 44
第七節 研究資料的信度、效度 47
第四章 研究結果 49
第一節 研究參與者的背景資料 49
第二節 住民對靈性照顧在生活適應的感受與看法 51
第三節 工作人員運用靈性照顧協助生活適應的實務現況 77
第五章 研究討論與限制 90
第一節 研究討論 90
第二節 研究限制 102
第六章 研究結論與建議 103
第一節 研究結論 103
第二節 建議 106
參考文獻 109
網路資訊 109
英文文獻 109
中文文獻 116
附錄一 121
附錄二 125

網路資訊
內政部102年第11週,101年底我國老人長期照顧及安養機構概況
http://sowf.moi.gov.tw/stat/week/week10211.doc
內政統計通報103年第30週,103年6月底人口結構分析http://sowf.moi.gov.tw/stat/week/list.htm
2010 年國民長期照護需要調查(第一階段)之失能率及經建會(2010),  
  「2010-2060 年臺灣人口推計」中之人口中推計資料估算各年失能人數.
劉訓蓉、陳艷秋、林姿吟,常住人口長期照護需求與資源配置之研析(103.2)
   http://www.stat.gov.tw/public/Attachment/431817381390V10W9I.pdf
黃奇璋,養護機構內老年人自主性及其相關因素之探討
   www.stat.gov.tw/public/Attachment/431817381390V10W9I.pdf
大正新脩大藏經 第十六冊 No. 700《右繞佛塔功德經》,中華電子佛典學會http://www.cbeta.org/result/normal/T16/0700_001.htm

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1. 杜明勳.(2003). 談靈性.護理雜誌,50(1),81-85.Tu, M. S. (2003).
2. 謝佳容,蕭伃伶,劉淑娟.(2007). 老年住民在長期照護機構中的心理健康促進與情緒調適.長期照護雜誌.11(2)132-140.
3. 曾愉芳,杜明勳,(2007). 老年人的靈性照顧,長期照護雜誌.11(2):09-115
4. 顏敏玲,陳玉敏,葉明珍,(2007). 協助一位老人適應遷住養護機構的護理經驗,弘光學報. 51: 29-36
5. 楊克平,(1998). 護理實務中的靈性照護,護理雜誌,45(3),77-83
6. 劉秋固,(1998). 超越個人心理學與宗教心理學對靈問題之研究,宗教哲學,4(3),(頁173-188) 
7. 林曉君,(2010). 高齡者靈性發展對我國老人教育之啟示,慈濟大學人文社會科學學刊, 9, 193-215.
8. 蕭雅竹,(2002). 靈性概念之認識與應用, 長庚護理;13(4):345-349.
9. 潘貝頎,(2000).「靜觀」在現代社會中的意義與價值.哲學與文化,27(3),220-227.
10. 陳文輝,(1999). 藝術與人文學習領域之統整與研修發展課程.教育研究資訊,7(4),48-78.
11. 徐立忠,(1993). 生涯計劃與成功的老人,社區發展季刊;第五十五期.
12. 吳奇璋,黃惠滿,高家常,高碧凰,(2010). 養護機構內老年人自主性及其相關因素之探討.長期照護雜誌;14(1):27-41.
13. 徐慧娟,張明正,(2004) 臺灣老人成功老化與活躍老化現況:多層次分析,臺灣社會福利學刊;3(2):1-36.
14. 李彩鳳,吳麗芬,蘇惠珍(2013). 以靈性懷舊探討老年人生命意義的經驗.臺灣高齡服務管理學刊;2(1):83-112.
15. 吳秀芳, 蕭雅竹,(2009). 護理人員靈性健康與靈性照護能力之相關性研究.護理暨健康照護研究; 5(1):68-78.
 
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