失智症預防社區整備程度集群分析和影響因子：台北市調查研究

Abstract

研究背景：隨著台灣人口老化快速，罹患失智症人數也不斷節節攀升，中央政府結合地方政府推動失智症社區介入方案，提供社區中失智症患者非藥物治療。然而社區介入方案受到社區中對失智症的知識、資源、社區領導者態度、介入方案的認知及社區氛圍等因素影響，這些因素被歸納成社區整備模型，而台灣鮮少有這方面的研究，無法對社區介入方案提供適當的建議，繼而改善社會風氣和介入效果。 研究目的及方法：本研究對台北市456個里進行社區整備程度郵寄結構式問卷調查，調查對象為里長、鄰長和社區發展協會理事長，並進行集群分析，找出集群和群聚的特性，並驗證不同的整備程度是否與各里的社會凝聚、非正式社會控制及相關人口學變項有關。 研究結果：總體問卷回收比率為16%，集群分析結果顯示，可以依照社區整備程度各領域分數分為4組，每組間各領域皆有顯著差異(p<0.001)。根據迴歸分析結果，截距項、社會凝聚、非正式社會控制、65歲至84歲人口比例、85歲以上人口比例和是否曾經有過失智症社區據點可顯著預測CRM總分(p<0.05, R2=0.288)。 結論：本研究發現可將台北市各里在失智症議題使用CRM各領域分數明確的分組，且可使用社會人口學變項和相關變項對CRM總分建立具有顯著性的迴歸模型，在高分和低分里別的分布上有群聚的現象。

Background: With the rapid aging of Taiwan's population, the number of people suffering from dementia is also increasing. The central government, in conjunction with local governments, promotes a dementia community intervention program to provide non-drug treatments for dementia patients in the community. However, community intervention programs are affected by factors such as knowledge, resources, leadership, knowledge about intervention, community climate, and these factors are summarized into a community readiness model (CRM). There is little research in Taiwan to provide appropriate recommendations on improving society engagement and intervention outcomes for dementia community intervention programs. Methods: This study mailed a structured questionnaire survey to community leaders such as village president and vice president and chief of community development associations on the degree of community readiness in 456 villages in Taipei City, and conducted a cluster analysis to find out the characteristics of clusters and display spatial distribution, and to verify whether different levels of CRM were associated with social cohesion and informal social control in each villages and related demographic variables. Results: The overall questionnaire recovery rate was 16%. The results of cluster analysis showed that they could be divided into 4 groups according to the scores of each dimension of CRM, and there were significant differences in each dimension between each group (p<0.001). According to the regression analysis, the intercept term, social cohesion, informal social control, the proportion of the population aged 65 to 84, the proportion of the population over the age of 85, and whether they had ever had dementia community intervention site in village significantly predicted the total CRM score (p<0.05, R2=0.288). Conclusion: This study found that there are distinct clusters of villages in Taipei city according to each dimension score of dementia community readiness. A significant regression model can be established on the total CRM score using sociodemographic variables and related variables. There are dense areas of villages in both high and low score group.