臺灣博碩士論文加值系統

研究背景與目的：輔具可幫助身心障礙者達到理想的功能並使其在日常生活、職場、教育或休閒活動中達到功能提升與生活自立，若有大量的輔具未被使用，就個人而言可能會造成功能上的缺損並進而導致生活品質的低落；以服務體系的觀點來看，輔具的失用代表的是有限的資源沒有被有效的利用。目前國內針對輔具失用情形與相關因子的研究仍不多。根據文獻，我國身心障礙者之輔具需求最多者為個人行動輔具和矯具，又參考臨床輔具服務數量統計，顯示氣墊床以及氣墊座的比例偏高，值得進一步探討。本研究的目的乃初步探討政府補助之個人行動輔具、床及坐、背墊類輔具與和矯具的失用情形以及相關因子。方法：本研究以曾接受台灣五個縣市政府輔具補助之個案，利用研究者自行研發之問卷工具來調查使用者之個人因子、輔具因子以及環境因子，作為影響輔具失用的自變項。結果：總共收集249名有效問卷，426項輔具，並依輔具特性分為個人行動輔具、床及坐、背墊輔具與矯具三類，結果發現共有11.7%的輔具失用，輔具失用的相關因子在個人行動輔具使用者為戶籍縣市、障礙程度、使用經驗、使用期待、輔具使用時間、政府補助金額、購買地點滿意度、維修保養滿意度、與環境障礙等9項；輔具失用的相關因子在矯具類使用者為使用者之認知程度、使用期待、輔具訓練與指導、環境障礙與同住者支持度等5項。並依二元邏輯式迴歸發現個人行動輔具使用者使用經驗、維修保養滿意與否、障礙程度以及所在戶籍縣市是為重要的相關因子，共解釋個人行動輔具失用與否46.6%的變異量。根據邏輯式迴歸分析模式可知，初次使用者輔具失用的發生比較高，為非初次使用者的15.25倍；障礙程度為輕度與中度者輔具失用的發生比較高，為障礙程度重度與極重度者的6.08倍；維修保養不滿意者輔具失用的發生比較高，為維修保養滿意者的5.49倍；縣市5失用率發生比普遍較其他縣市為高。結論：輔具失用的相關因子會因輔具種類不同而有所差異，針對個人行動輔具使用者，又特別需要注意初次使用者、維修保養不滿意者、障礙程度較輕者以及所在戶籍縣市5，建議輔具臨床工作者優先針對以上因子擬定策略以改善輔具的失用情形。

Background: Numerous individuals with disabilities are not satisfied with their assistive devices and are not used appropriately. Previous report showed an average of about thirty percent of provided assistive devices were not used. If large number of assistive devices is not being used, then resources are not being spent efficiently. On the other hand, the problems of individuals with disabilities were not resolved appropriately. However, there are few studies in Taiwan focusing on this issue about the factors which lead to non-use. Purpose: To investigate the factors related to non-use of government-provided assistive devices which include personal mobility devices, beds and seat, back cushions and orthoses. Study design: An exploratory research design. Methods: A self-administering questionnaire investigates the factors related to non-use and which will be divided into three parts: personal, devices and environment factors. Individuals with disabilities who had received assistive devices which were provided by the government from five counties have been recruited in this study. Results: 249 valid questionnaires, 426 assistive devices were collected and divided into three categories, which are aids for personal mobility, beds and seat, back cushions and orthoses. There are 11.7% of assistive devices which were not used in total. According to univariate analysis, the factors related to non-use of aids for personal mobility are users’ location, level of disability, experience of usage, the expectation to the device, time of usage, government reimbursement, satisfaction with institutions which sell assistive devices, satisfaction with maintenance for the devices and environmental obstacles. As for orthoses category, the factors related to non-use are users’ intelligence and cognitive condition, expectation to the device, training and guidance of the devices, environmental obstacles and support from the people who live with users. Furthermore, based on binary logistic regression analysis, the dominant factors of non-used aids for personal mobility are users’ experience of usage, level of disability, maintenance for the devices and location, which can explain 46.6% of the variance of non-use of aids for personal mobility. Conclusion: Factors related to non-use of assistive devices will differ on the types of devices. As for personal mobility users, the factors which should be concerned are first time users, users with lower level of disability, users who are dissatisfied with maintenance for the devices and users in county 5. Assistive technology practitioners should take into account in order to improve the status of non-use of assistive devices.

目錄…………………………………………………………………………………Ⅰ
表目錄………………………………………………………………………………Ⅲ
中文摘要……………………………………………………………………………Ⅳ
英文摘要……………………………………………………………………………Ⅵ
第一章 緒論…………………………………………………………………..1
第一節 背景………………………………………………………………………1
第二節 研究目的…………………………………………………………………3
第三節 研究的重要性……………………………………………………………3
第二章 文獻回顧……………………………………………………………..4
第一節 輔助科技定義與理論……………………………………………………4
第二節 輔具失用的定義......................................................................................15
第三節 輔具失用的相關因子…………………………………………………..17
第三章 研究方法……………………………………………………………25
第一節 研究對象………………………………………………………………25
第二節 研究工具………………………………………………………………26
第三節 研究步驟………………………………………………………………31
第四節 資料分析………………………………………………………………31


第四章 結果…………………………………………………………………33
第一節 個案基本資料與輔具使用情形……………………………………..33
第二節 輔具失用之影響因子單變項分析…………………………………..41
第三節 個人行動輔具失用相關因子之邏輯式迴歸分析…………………..47
第五章 討論…………………………………………………………………50
第一節 輔具失用情形與受試者基本特性探討……………………………..50
第二節 輔具之失用之相關因子探討………………………………………..52
第三節 實務應用……………………………………………………………..60
第四節 研究限制與未來方向………………………………………………..62
第六章 結論…………………………………………………………………64
參考文獻……………………………………………………………………………66
表……………………………………………………………………………………71
附錄1 內政部補助標準………………………………………………………….97





表目錄

表1 受試者之人口學基本資料分布…………………………………………….71
表2 受試者的輔具使用情形…………………………………………………….74
表3 各類輔具使用者之基本資料……………………………………………….75
表4 各類輔具使用者之輔具因子分佈結果…………………………………….78
表5 各類輔具使用者之環境因子分佈結果…………………………………….82
表6 各類輔具失用原因分佈…………………………………………………….84
表7 各類輔具使用原因分佈…………………………………………………….85
表8 個人行動輔具失用之類別影響因子單變項分析………………………….86
表9 矯具失用之類別影響因子單變項分析………………………………….…90
表10 各類輔具之連續影響因子單變項分析……..…………………………….94
表11 個人行動輔具使用頻率與輔具服務指標相關性………………………….95
表12 個人行動輔具失用之邏輯式迴歸………………………………………….96

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