Chang Su-Hsien, Wung Shu-Fen, Crogan Neva L
Department of Nursing, Chung Hwa University of Medical Technology, Tainan Hsien, Taiwan, ROC.
Nurs Res. 2008 May-Jun;57(3):191-8. doi: 10.1097/01.NNR.0000319492.14005.7f.
Excess disability among nursing home elder persons can be prevented or remediated. Because of self-selected disuse and caregiver support of dependency, nursing home residents are likely to develop excess disability. No study was found to test a theory-based program aimed at improving elder persons' self-care abilities for Taiwanese nursing home elder persons who are at risk for developing excess disability.
The purpose of this study was to test the effectiveness of a theory-based intervention program on self-care, specifically on activities of daily living (ADLs) performance among nursing home elder persons in Taiwan. A secondary aim was to determine the correlation between ADLs performance and three bliss concepts: life satisfaction, self-esteem, and motivation in health behavior.
This study used a quasi-experimental, two-group, pretest-posttest design. Forty-two qualified participants were recruited from two nursing homes located in southern Taiwan and assigned to either the experimental group (n = 21) or the comparison group (n = 21). Participants in the experimental group received the Self-Care Self-Efficacy Enhancement Program (SCSEEP), and those in the comparison group received biweekly social visits for 6 weeks. Levels of ADLs performance were measured by Tappen's Refined ADL Assessment Scale. Life satisfaction was measured by Adams' Life Satisfaction Index A. Self-esteem was measured by Rosenberg's Self-Esteem Scale. Motivation in health behavior was measured by Cox's Health Self-Determinism Index.
Elder persons receiving the SCSEEP had significant improvement in feeding, dressing, grooming, and washing activities. Self-esteem (p = .011) and life satisfaction (p = .033) but not motivation in health behavior (p = .282) were positively correlated with levels of ADLs performance.
The SCSEEP provides a theory-based intervention model for Taiwanese nursing home elder persons aimed at improving ADLs performance. Further research with a larger sample size is needed to determine the long-term maintenance and effectiveness of this theory-driven SCSEEP in specific culture groups.
养老院老年人的过度失能是可以预防或改善的。由于自我选择的废用以及照顾者对依赖的支持,养老院居民很可能会出现过度失能。尚未发现有研究针对台湾养老院中存在发展为过度失能风险的老年人,测试基于理论的旨在提高其自我护理能力的项目。
本研究的目的是测试基于理论的干预项目对自我护理的有效性,特别是对台湾养老院老年人日常生活活动(ADL)表现的有效性。第二个目的是确定ADL表现与三个幸福概念之间的相关性:生活满意度、自尊和健康行为动机。
本研究采用准实验、两组、前后测设计。从台湾南部的两家养老院招募了42名合格参与者,并将其分为实验组(n = 21)或对照组(n = 21)。实验组的参与者接受自我护理自我效能增强项目(SCSEEP),对照组的参与者接受为期6周的每两周一次的社交探访。ADL表现水平通过塔彭改良的ADL评估量表进行测量。生活满意度通过亚当斯生活满意度指数A进行测量。自尊通过罗森伯格自尊量表进行测量。健康行为动机通过考克斯健康自我决定指数进行测量。
接受SCSEEP的老年人在进食、穿衣、修饰和洗漱活动方面有显著改善。自尊(p = 0.011)和生活满意度(p = 0.033)与ADL表现水平呈正相关,但健康行为动机(p = 0.282)与ADL表现水平无正相关。
SCSEEP为台湾养老院老年人提供了一个基于理论的干预模型,旨在提高ADL表现。需要进行更大样本量的进一步研究,以确定这个理论驱动的SCSEEP在特定文化群体中的长期维持效果和有效性。