背景：長照2.0以就地養老為長期照顧努力的目標，並提出居家復能專業服務新政策，居家復能服務是一個創新也是典範移轉，翻轉許多以往的舊觀念與做法，促使本研究想探討偏鄉離島的澎湖縣在居家復能服務的現況，從瞭解復能服務供給面的管理者及服務提供者之特性著手；瞭解管理者及服務提供者基本屬性在復能服務認知、態度與行為上之差異與關係。

方法：本研究根據研究目的及問題，採用橫斷面的自答式問卷調查研究法，問卷普查澎湖縣居家復能服務供給面的管理者及居家復能專業服務的提供者，以認知行為學派的計畫行為理論為依據，蒐集有效問卷共34份，以無母數統計檢定、相關性分析呈現復能服務人員的調查結果。

結果：復能服務提供者在認知與行為得分上顯著優於管理者；曾接受復能教育訓練對認知與行為得分也顯著優於没有接受復能教育訓練課程者；21-30歲年齡層的認知得分優於31-40歲年齡層的認知得分；職能治療師的認知得分優於護理師及社工師；物理治療師及老人/長期照護職類的認知得分皆優於護理師；物理治療師及職能治療師的行為得分皆優於社工師及老人/長期照護職類；職能治療所、居家謢理所及復健科診所的行為得分皆優於A單位；且接受復能教育訓練課程時數與認知相關。

結論：解釋澎湖縣居家復能服務管理者與服務提供者的認知、態度與行為表現在身分、職類、機構類型及年齡的差異；且增加教育訓練，包括參與個案討論、研討會可提升復能服務管理者與服務提供者在認知、態度與行為上的表現。

建議：為改善澎湖縣居家復能服務管理者與服務提供者在認知、態度與行為上的差異，有幾點建議，包括同時提升澎湖縣復能教育訓練課程的質與量、復能服務人員應在任職前完成復能服務教育訓練課程、參與的相關會議與教育訓練，納入機構的督考與評鑑、鼓勵A單位調整管理者的工作量以提升服務品質為先，以增進A個管在工作環境的穩定性、聘請有復能實地服務經驗者授課等。

Background: Long-term care 2.0 is targeting home-based care for the aged and formulates a new policy for home-based reablement services. The new home-based reablement service help discarding old beliefs. This study discusses the current situation of home-based reablement services in Penghu County. To compare the differences and relationships between service provider and service manager in terms of knowledge, attitude and practice performance of reablement services.

Methods: This cross-sectional, self-administered questionnaire study was conducted in Penghu County. 34 valid questionnaires were collected by a questionnaire containing items on theory of planned behavior between home-based reablement service provider and service manager. Data analyses were performed using nonparametric statistics and correlation analysis.

Result: Cognitive and behavioral scores of reablement service providers were significantly better than service managers. Cognitive and behavioral scores were also significantly better for those who had received reablement education training than who had not received reablement education training programs. Cognitive scores were better in one’s twenties that in one’s thirties. Occupational therapists have better cognitive scores than nurse practitioners and social workers. Physical therapists and geriatric/long-term care occupations had better cognitive scores than nursing assistants. Physical therapists and occupational therapists have better behavioral scores than social workers and the geriatric/long-term care category. Occupational therapy, home care, and reablement clinics had better behavioral scored than Unit A. The number of hours of implementing training reablement programs had positive correlation with cognition.

Conclusion: The study demonstrates the differences between knowledge, attitude and practice performance, between home-based reablement service managers and service providers in Penghu County in terms of status, job category, agency type, and age. The outcome is revealed with additional educational training, such as participation in case discussions and seminars, can enhance the knowledge, attitude and practice performance of reablement service managers and service providers.

Suggestions: In order to minimize the gap, in knowledge, attitude and practice performance, between home-based reablement service managers and service providers in Penghu, some suggestions were provided: improving the quality and quantity of reablement education and training courses in Penghu, introducing and implementing training reablement programs before start working, evaluating the long-term care facilities base on participating in relevant meetings and courses, easing the workload of A case management to upturn service quality and customer satisfaction, providing stable working environment, and inviting experts to share a lot of experience.

目 錄

中文摘要 . . . .ⅰ
英文摘要 . . . .ⅱ
第一章 緒 論 1
第一節 研究背景 1
第二節 研究動機 4
第二章 文獻探討 6
第一節 澎湖簡介 6
第二節 復能定義 8
第三節 復能相關研究 11
第四節 計畫行為理論相關文獻 20
第三章 研究方法 26
第一節 研究架構 26
第二節 資料收集 27
一、研究對象及調查方法 27
二、樣本來源及普查數 27
三、研究過程 27
四、研究工具 28
五、資料處理與分析方法 28
六、研究倫理 29
第四章 研究結果 31
第一節 受訪者基本特質 31
第二節 受試者認知、態度與行為之比較 36
一、管理者與提供者復能服務認知、態度與行為得分 36
二、管理者、提供者特性與認知得分之差異性分析 41
三、管理者、提供者特性與態度得分之差異性分析 42
四、管理者、提供者特性與行為得分之差異性分析 42
第三節 受試者認知、態度與行為相關檢定 46
第五章 結 論 48
第一節 分析結果 48
一、影響認知與行為 48
二、影響認知 48
三、影響行為 49
第二節 建 議 49
一、對提升認知的建議 49
二、對提升態度的建議 49
三、對提升行為的建議 50
四、改善教育訓練的建議 50
五、穩定A個管工作的建議 51
六、其他相關建議 52
第三節 給後續研究者的建議 53
參考文獻 54
附 錄 58

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