公共圖書館失智症照護者健康資訊服務模式之探討

Abstract

本研究旨在透過消費者健康資訊服務的行動研究模式，針對公共圖書館如何協助提升照護老年失智症者之照護品質並降低其照護壓力提出相關建議，同時期望研究成果能提供未來相關實務工作者與照護者之參考。 本研究問題包括：（一）老年失智症的照護者之資訊需求為何？（二）藉由消費者健康資訊服務，公共圖書館可提供的老年失智症相關資源的特徵為何？（三）老年失智症照護者對消費者健康資訊服務的使用經驗為何？（四）公共圖書館應如何與社區機構合作，為老年失智症照護者有效提供消費者健康資訊服務？本研究是以問卷調查及半結構式訪談法進行資料的蒐集，分為兩方面進行：一方面藉由與臺北市松山區健康中心的合作，為失智症照護者辦理「健康資訊服務課程」的方式進行調查與訪談；另一方面則是邀請失智症相關專家成立「資源評選小組」，協助檢視失智症資源清單及進行訪談。 根據研究結果發現，可從失智症照護者所需的健康資訊、「資源評選小組」針對資源提出的建議、照護者對資源使用的經驗與回饋等三個不同發現進行說明。首先在失智症照護者所需的健康資訊方面，主要表現在三個面向：失智症相關的照護資源主題、失智症照護相關的資源類型，以及非失智症照護直接相關的資源用途。第二，研究過程中成立的「資源評選小組」針對在公共圖書館可提供的失智症資源特徵提出以下幾點建議：（一）失智症健康資訊資源的作者或出版者具失智醫療相關背景或經過專家考證；（二）應注意健康資訊資源出版年份之時效性；（三）資源特徵應為字體較大、內容易懂、圖示為佳；（四）資源內容主題清楚、分類明確；（五）失智症健康資訊資源的選擇有其優先順序。第三，照護者對於健康資訊資源的使用經驗與回應分析結果則顯示：（一）整體資源運用幫助照護者了解更多失智症相關健康資訊；（二）資源真實反映照護者心聲與傳遞社會支持；（三）可獲取相關案例及照顧技巧 ii 的新知；（四）透過失智症相關圖書了解多面向的照護資訊；（五）運用資訊資源減輕壓力、爭取喘息時間；（六）接觸介面容易、內容有趣的App軟體，有助於訓練記憶及減少無聊時間；（七）懷舊影音連結過去記憶，成為家人情感互動的橋樑；（八）圖書館館藏利用課程實用有幫助；（九）圖書館員本身也為照護者提供了關懷和支持；（十）健康資訊資源成為家人互動的良好媒介。 從研究訪談結果得知公共圖書館與社區機構合作模式有以下四種方式：（一）辦理健康資訊服務課程的合作模式；（二）提供資源清單的合作模式；（三）設置失智健康資訊資源專區的方式；（四）合作推廣或建立合作制度、平台的合作模式。 最後依據本研究成果針對下列兩個方向提出建議：首先建立公共圖書館員蒐集、整理、產生失智症資源清單，進而由資源評選小組協助審視資源清單的完整流程；第二則是對於未來公共圖書館與社區機構合辦健康資訊服務課程的規劃事項，提出相關建議。

This study aims to enhance the care quality of elderly persons with dementia, and to help reducing caregiver’s stress by means of consumer health information service action research model outreached from public library. Adopting the action research model, the researcher expects to provide useful suggestions based on the research findings to the practitioners, such as librarians and caregivers. This study conducted semi-structured interview and questionnaire to collect data in two parts: first part is through cooperation with Taipei City Songshan District Health Center to hold ‘Health Information Service Program’ for dementia caregivers; second part is to set up a ‘Committee for Evaluating Dementia Health Information Resources’ by inviting five experts specialized in dementia. Four research questions raised in this study are as follows: 1) What information needs do dementia caregivers propose? 2) What are characteristics of dementia health information resources public library could provide? 3) What are the dementia caregivers experience in consumer health information services? 4) How could a public library cooperate with social agencies efficiently on providing consumer health information services for dementia caregivers? According to the research results, the health information which dementia caregivers need represented in three aspects: caring resources of dementia-related subjects, caring resources of dementia-related types, and caring resources of indirectto dementia-related functions. Moreover, group members of Committee for- ‘Evaluating Dementia Health Information Resources’ - proposed five principles for public library to choose resources on dementia: 1) Choosing dementia resources when the author or publisher has medical background, or at iv least to choose resources which had been verified by experts. 2) The year of publication and timeliness of health information resources should be noted. 3) Characteristics of book resources should be easy to read, easy to understand, and have more pictures. 4) The subject of resource content should be classified clearly. 5) There are some priorities in selecting dementia health information resources. The analysis of the experience and feedback results of caregivers using health information resources during the program are as follows: 1) The experience of using the resource provided by the librarian indeed helped caregivers to understand more dementia-related health information; 2) The video resources truly reflected the feelings of caregivers and provided social support; 3) The provision of the resources helped caregivers to access advanced information on new cases and caring skills; 4) The book resources on dementia led caregivers to understand multiple aspects of caregiving; 5) The experience of using the resources helped caregivers to reduce stress and earn a respite which is important to them; 6) The resources, such as APPs were useful for the memory training and reduce boredom; 7) Reminiscent audio discs aroused the memory and helped the interaction between family members; 8) The program unit on library instructions and collections was functional to caregivers; 9) The librarian was perceived as delivery of caring and support to caregivers; 10) Health information resources are also useful as a good intermediary for the whole family. According to the interview results, there are four suggested models for the future cooperations of public library and social agencies: 1) Model of conducting a health information service program / curriculum; 2) Model of providing resources reference list; 3) Model of setting up dementia health information area; v 4) Model of promoting health information services together or of building a collaborative system or platform.. Finally, two suggestions are important to practice for such collaboration: firstly, librarians are to build a procedure from collecting and organizing resources, then to set up an expert group for evaluation of selected resources; secondly, health professionals are to provide some advices of conducting health information service program for public library.