2012-08-012024-05-18https://scholars.lib.ntu.edu.tw/handle/123456789/701771摘要：失能為老年期常見的壓力事件，對老人而言，為了因應照顧需求而入住長期照護機構，是伴隨著失能而來的另一個失落經驗。機構失能老人受限於身體功能，不僅較少從事工具性活動，與他人互動或參與公共事務的機會也較少，社會互動與活動參與機會的限制與剝奪，成為威脅其心理福祉的主要原因。然而，欲探討活動參與和心理福祉之關係，需將個人活動參與狀況置於機構情境脈絡下進行檢視。本研究嘗試連結身心障礙理論與老人學研究，以 ICF模式的「環境」與「活動參與」觀點，探討機構中的物理、社會與態度環境，如何影響失能老人不同性質的活動參與，並透過活動參與對個人心理福祉產生作用。本研究第一階段以深度訪談與焦點團體收集資料，以瞭解生理功能、活動參與和環境因素間如何交互作用，形塑個別機構失能老人獨特的「障礙」狀態；第二階段預計以分層抽樣方式選取長期照護機構，針對640位機構失能老人進行問卷調查，並使用多層次迴歸分析進行模型驗證與資料分析，以探討機構環境對失能老人活動參與和心理福祉的影響，本研究結果提供正向檢視機構環境助力與個人功能表現的機會，以尋求支持機構失能老人克服功能限制、創造極大化心理福祉的可能性。<br> Abstract: Being dependent has been regarded as one of the most stressful life events in later life. The impact of being disabled can become more severe as older people move into long-term care in order to fulfill their caring needs. Older individuals living in long-term care settings are less likely to participate in self-care activities. In addition, social interaction and civil life participation can be difficult and is not always supported by the environment or the staff, thus leading to a threat to the emotional well-being of disabled older adults. The aim of this study is to explore the effects of environmental factors on activity participation and emotional well-being of disabled older adults living in long-term care by adopting the ICF model. More specifically, different environmental factors can be facilitators and barriers to full participation of different activities such as self-care, social, productivity and leisure for older people with disabilities. They also affect one’s emotional well-being indirectly through the link between activity participation and emotional well-being. In first phase of data collection of this study, sixteen focus group will be convened to discuss the concepts of activity participation, environmental facilitators and barriers as well as how the interaction between environmental factors and activity participation influences one’s experience of disability. In second phase of data collection, a total of 640 older residents in long-term care settings selected through a stratified random sampling method will be interviewed. Multilevel linear modeling will be applied to capture the sequential relationships among various components as well as to take into account of the nesting effects at institution level. The findings from this research provide an opportunity to investigate the positive aspects of environmental factors on individual health status, suggesting that social policy and interventions should be designed in consideration of creating a barrier-free environment to facilitate participating and emotional well-being of this vulnerable population.機構失能老人環境活動參與心理福祉ICFlong-term caredisabledolderenvironmentactivity participationemotional well-beingICF