苗栗老人使用伯公站服務、復原力與生活品質研究

Abstract

人口老化帶來老人照顧的文化議題。文化照顧理論由Leininger（1995）提出，強調文化一致的照顧能提升老年人的生活福祉。我國在客家地區推動的「客家伯公照護站」，正是文化照顧在社區照顧據點的實踐，但相關研究仍付之闕如。本研究以生活品質作為文化照顧成效的指標，並結合象徵客家「硬頸」精神的復原力觀點，探討老人接受伯公照護站服務對生活品質的影響，以及復原力在其中的作用。 研究對象為苗栗縣20間伯公站的使用者，採配額抽樣取得353份65歲以上有效樣本，並運用SPSS與R進行統計分析。結果顯示：經常使用客語、參與據點頻率較高、與子女或配偶同住者，以及客家老人，其復原力與生活品質表現均較佳；其次，伯公站服務的效果分為據點服務與文化照顧，其中據點照顧能夠預測復原力與生活品質，而文化照顧也能直接預測生活品質；最後，據點服務的效果會透過復原力的逆境適應、自信與掌控感、正向信念三個部分影響生活品質，為完全中介，文化照顧中復原力的整體中介效果不顯著，僅透過自信與掌控感、正向信念兩部分影響生活品質。 伯公照護站服務對老人生活品質有重要助益。伯公照護站對老人生活品質具有顯著助益。建議政策與實務推展時，一方面應強化據點軟硬體能量，並確保文化融入服務的多元性與持續性；另一方面，可設計以提升復原力為目標的活動方案，協助老人透過社會參與、家庭支持與正向心態因應逆境，維持良好生活品質。同時，鼓勵據點工作人員深入理解客家文化照顧內涵，推展結合在地文化的活動，以進一步提升伯公照護站文化照顧的效能。

Population aging underscores the importance of culturally sensitive elder care. Leininger’s (1995) theory of cultural care emphasizes that culturally congruent services enhance the well-being of older adults. In Taiwan, the “Hakka Bogong Care Stations (HBCS)” exemplify this approach within community-based elder care; however, empirical evidence remains limited. This study adopts quality of life (QOL) as an indicator of cultural care outcomes and integrates the concept of resilience, reflecting the Hakka spirit of persistence, to examine how HBCS services influence older adults’ QOL and the mediating role of resilience. Data were collected from 353 respondents aged 65 and above across 20 HBCS in Miaoli County using quota sampling. Results indicate that demographic factors such as Hakka language use, active participation, co-residence with family, and Hakka identity were associated with higher resilience and QOL. HBCS exert two effects: station services and cultural care. Station services, effect on QOL was fully mediated by resilience dimensions of adversity adaptation, confidence and control, and positive beliefs. In contrast, the effect on cultural care was only mediated through confidence and control and positive beliefs. These findings highlight the role of HBCS in promoting the well-being of older adults and provide empirical support for cultural care theory in a Hakka community context. Policy and practice should focus on strengthening both the physical and program capacities of HBCS, ensuring the continuity of cultural integration, and designing activities that foster resilience. Additionally, staff are encouraged to deepen their understanding of Hakka cultural care and develop culturally grounded activities to further enhance the effectiveness of HBCS.