臺灣博碩士論文加值系統

背景及重要性：全球人口快速高齡化，失智症雖非正常老化過程，但年齡是最重要的不可改變因素。多數失智者由家庭照顧者提供照護，然而失智症照護問題複雜且廣泛，需要整體性、全面性、跨領域的評估與服務支援，才能滿足家庭照顧者的照護需求。
研究目的：本研究為發展一簡便且符合臨床需要的「失智症照護需求評估表」，從跨專業領域的角度，來建構評估表之題項內容並檢驗其信效度，用以檢視我國失智症家庭照護者的照護問題及需求。
研究方法：本工具發展性研究包含量表建立、專家內容效度測試、問卷調查與資料分析。依據文獻查證及臨床經驗擬定初步題項並於失智照護諮詢門診進行10 名個案測試，經跨領域研究團隊人員討論修正後邀請五位跨領域專家檢定評估表的內容效度。
問卷調查以全國失智嚴重程度的比例配額取樣在台灣南部某醫學中心神經科門診進行，收集200 對失智者及照顧者進行資料信效度分析，並探討基本資料與照護需求評估之間的關係。
研究結果：失智症照護需求評估表包含21 個題項的失智者及其家庭照顧者基本資料及31個題項的八大照護需求評估。工具之專家內容效度為.99，日常生活功能次類目與巴氏日常生活活動量表（Barthel Index, BI）、行為精神症狀次類目與簡短版神經精神行為評估表（Neuropsychiatric Inventory Questionnaire, NPI-Q）之同時效度分別為r= -.889、.750（p〈 .001）。各次類目之內在一致性信度α 值介於.625 至.905 間。本研究另分析照護需求與失智嚴重程度的差異性，發現多數的照顧需求在失智嚴重程度輕度組較中度或重度組低。
結論：本研究發展的失智症照護需求評估表有良好的信效度，且評估表內容清晰、簡潔易懂又照顧者能快速填答，另還可用於跨專業失智照護人員的評估與溝通，提供失智者及其照顧者適切的服務。

Care problems of people with dementia are complicated and require diverse service support for family caregivers. This study developed Assessment Tool for Care Needs of People with Dementia to assess the family care needs for clinical and family caregivers to provide people with dementia and their caregivers with more suitable services. The instrumental development process included the establishment of scales, expert content validity tests, questionnaire surveys, and data analysis. 200 dyads of people with dementia and their family caregivers participated in the survey for data analysis. The tool had satisfactory content validity index, internal consistency (Cronbach's α) and concurrent validities with 21 items of demographic data of people with dementia and their family caregivers and 31 items of 8 categories of care needs assessment. The tool was clear, concise and can complete quickly for caregivers. Therefore, the result of the study helps the assessment and communication for dementia transdisciplinary professionals in the clinical practice and researches.

第一章 緒論………………………………………………………………………………………1
第一節 研究動機與重要性…………………………………………………………1
第二節 研究目的……………………………………………………………………………4
第三節 研究問題……………………………………………………………………………4
第四節 名詞界定……………………………………………………………………………5
第二章 文獻查證………………………………………………………………………………7
第一節 失智症…………………………………………………………………………………7
第二節 失智症之照護問題…………………………………………………………11
第三節 評估工具的發展……………………………………………………………16
第四節 失智症照護需求評估工具…………………………………………18
第三章 研究方法……………………………………………………………………………20
第一節 研究設計…………………………………………………………………………20
第二節 研究對象與地點……………………………………………………………23
第三節 研究工具…………………………………………………………………………24
第四節 資料收集過程…………………………………………………………………29
第五節 倫理考量…………………………………………………………………………30
第六節 資料分析方法………………………………………………………………31
第四章 研究結果……………………………………………………………………………33
第一節 基本資料與照護需求評估………………………………………33
第二節 效度分析…………………………………………………………………………42
第三節 信度分析…………………………………………………………………………43
第四節 基本資料與照護需求評估之相關…………………………45
第五章 討論………………………………………………………………………………………49
第一節 基本資料與照護需求評估…………………………………………50
第二節 效度分析……………………………………………………………………………53
第三節 信度分析……………………………………………………………………………54
第四節 基本資料與照護需求評估之相關……………………………55
第五節 研究限制與應用建議……………………………………………………59
第六章 結論………………………………………………………………………………………60
參考資料………………………………………………………………………………………………61
附錄…………………………………………………………………………………………………………86

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