優質老化內涵建構與動因模式分析

Abstract

由於高齡人口快速增加，使得成功老化成為各界關心的議題，普遍認為當年長者能夠維持身心靈的健康與社會參與，即達到成功老化的境界。然而，成功老化專注年長者自身的狀況而忽略了其與外界的互動情形，故陳啟光、王國明、王熙哲等台灣學者以儒家對老的觀點出發，合力提出「優質老化(Graceful Aging)」的概念，其強調「不僅以年長者為中心，同時也必須考量年長者自身如何與外在環境和諧共處」的思考模式，希望為年長者建立優質的服務、系統或社會。本研究以2007年行政院衛服部中老年身心社會生活狀況長期追蹤調查問卷為基礎，挑選65歲以上自答之年長者為研究對象，以建構優質老化內涵。不僅了解台灣年長者達到優質老化的程度，更探討在不同人口背景變項下，健康生活型態、經濟安全、居住安養、休閒社交四個層面對優質老化的影響。研究發現如下： 1. 針對自身狀況，年長者普遍擁有良好的身心理健康狀態，表示有足夠的能力維持獨立自主的生活。然而，他們對於未來生活的展望多抱持不樂觀的態度且缺乏積極向外發展的社會參與精神。 2. 針對自身與環境的互動，年長者普遍免於外在環境所帶來的壓力(家庭經濟、工作等)，也得到家人充分的關愛與照護，但年長者自覺其意見在家庭內並不受到重視。 3. 從調查結果了解，人口背景變項中性別、年齡、受正式教育年數影響年長者達到優質老化的程度。 4. 考量不同人口背景變項下，健康生活型態、經濟安全、居住安養、休閒社交四個層面下的變數顯著地影響年長者達到優質老化的程度。 根據上述研究結果，本研究針對各機關團體以及未來研究提出相關建議。

This study aims at developing the Graceful Aging construct and studies its determinants among the elders in Taiwan. With an increase on global life expectancy, aging population has become a reality and often causes a new challenge socially and economically. Scholars have examined the issues on how to achieve Successful Aging in elder life as an attempt to mitigate any risks and negative disruption caused by aging in the productivity and economic development. Rowe and Kahn (1987) had proposed the well-known Successful Aging model which emphasizes the balance of three components: absence of disease and disease-related disability, high functional capability and active engagement with life. This model focused on physical, psychological and social participation to access the state of successful aging. With well developed instruments, it has been widely applied to assess the quality of life for elders. However, with the advance of technology and the emerging of service innovation and economy (e.g, co-create, co-share, and experience-based), it has been reported that more and more elders are engaging as well as interacting with environmental stakeholders via various enablers and agencies. Applying this new trend, Wang etc. (2013) proposed a holistic view on assessing elder’s needs, the Graceful Aging, which refers to the fulfillment of elder needs in nine areas. Originated from traditional Chinese culture, it is claimed that Graceful Aging not only emphasizes the aging needs itself, but also includes the benefits and concerns deriving from external stakeholder and environment. In this study, a measurement tool to assess the Graceful Aging is proposed. The determinants on Graceful Aging are examined. In particular, four aspects (economic safety, healthy lifestyle, residential cares and recreational education) are explored by applying the survey data from Taiwan Longitudinal Study in Aging (TLSA). The major findings are shown as followed: 1. Generally, the elders have good physical and psychological health status. However, they aren’t satisfied with current life and lack of social participation. 2. The elders feel free from the pressure of family, work and economic problem. What is more, they are well taken of by their family physically and emotionally. However, the elders feel disregarded by family when making decision. 3. Demographic variables (including gender, age and education years) significantly influence the status of graceful aging. 4. Considering different demographic backgrounds, four aspects (economic safety, healthy lifestle, residential cares and recreational education) are significant related to the status of gracefull aging. According to the results of the study above, this study brings out some suggestions to institutions and future research.