[[alternative]]Apply the Theory of Planned Behavior to Study the Home-Based Reabement Services

[[abstract]] 台灣的出生率逐年下降，人口結構老化，為了因應高齡社會所衍生的失能者長期照顧需求及實現在地老化的政策目標，行政院於民國96年及民國106年分別通過並實施「長期照顧十年計畫」 (民國96-105年)及「長照十年計畫2.0」(民國106-115年)。居家復能服務能提升失能者的生活品質及實現在地老化的目標，是長照十年計畫2.0非常重要的部分。本研究以計畫行為理論為基礎，來探討醫事人員參與居家復能服務的意圖與失能者接受居家復能服務的意圖。在探討醫事人員參與居家復能服務的意圖部分，是以立意抽樣方式將問卷發放給雲林縣、嘉義市和嘉義縣參與居家復能服務的醫事人員。本研究共收集101個有效樣本。實證結果顯示，醫事人員的社會責任、態度、主觀規範及知覺行為控制會正向影響其意圖，而知覺行為控制最能影響其參與服務的意圖，其次依序為態度、社會責任及主觀規範。態度在社會責任對意圖之間和主觀規範對意圖之間具有部分中介作用。知覺行為控制在主觀規範對意圖之間具有部分中介效果。在探討失能者接受居家復能服務的意圖部分，是以「社團法人嘉義市職能治療師公會」居家復能服務資料庫中的次級樣本資料來進行研究，本研究共獲得198份有效樣本。資料分析的結果顯示：失能者接受居家復能服務的意圖會受其態度、主觀規範和知覺行為控制正向影響。而態度對意圖影響最大，其次依序為知覺行為控制及主觀規範。失能者的態度和知覺行為控制在其主觀規範對意圖之間具有部分中介效果。 研究結果顯示，公部門可以透過公開表揚、網路或大眾媒體報導居家復能服務的介入成功的案例、建立可成為醫事人員堅強後盾的長照專業發展輔導團、強化職前訓練及透過政策的制定鼓勵醫事人員全職投入服務，都有助於提昇醫事人員參與居家復能服務的意圖。此外，建置以村或里為長照互助單位、改善社區無障礙環境及結合社福團體，主動協助因某些因素無法獲得社會福利補助身分的經濟弱勢族群失能者能獲得的合理補貼，都有助於提升失能者接受居家復能服務的意圖，讓更多失能者能因居家復能服務的介入，重新獲得參與活動的能力，不因環境、生理和心理原因而將自己限制在家中，重回失能前的生活模式。[[abstract]] The birth rate in Taiwan is declining year by year, and the overall population structure is rapidly aging. In order to meet the long-term caring demands of the physical challenged who are easily influenced by the aged society and to realize the policy goal of aging in place, the Executive Yuan has approved and promote the “long-term care ten-year plan” (2007-2016) in 2006 and the “Long-term Ten-Year Plan 2.0” (2017-2026) in 2017 respectively. The home-based reablement service can improve the quality of life of the disabled and achieve the goal of aging in place, which is a very important part of the Long-term Ten Year Plan 2.0. The purpose of this study is based on the theory of planned behavior to explore the intention of medical personnel to participate in home-based reablement service and the intention of the people with disability to accept home-based reablement service. In this study, purposive sampling was employed and the questionnaires were distributed to collect opinions of medical personnel who participated home-based reablement services in Yunlin County, Chiayi City and Chiayi County. A total of 101 valid samples were collected. Empirical results reveal that the social responsibility, attitude, subjective norm and perceived behavioral control of medical personnel are respectively positive effect on their intention. Among these four variables, perceived behavioral control has the greatest impact on intention. The following rankings are for attitude, social responsibility and subjective norm. Attitude has a partial mediation effect on social responsibility to intention and subjective norm to intention. Perceived behavioral control has a partial mediation effect on subjective norm to intention. In the discussion about the intent of the residents with disability to accept home-based reablement services, the study was conducted with secondary sample data. The sample data was obtained from the home-based reablement service database provided by the Chiayi Occupational Therapist Association. 198 valid data were collected. The results of the data analysis show that the intent of the people with disability to accept the home-based reablement service will be positively influenced by their attitude, subjective norm and perceived behavioral control. In particular, the attitude of the people has the greatest impact on their intention. The following rankings are for perceived behavioral control and subjective norm. Attitude and perceived behavioral control of the people have a partial mediating effect on subjective norm to intention. The results of the study show that through giving public recognition of the medical personnel by the public sector and positive reports by media or mass media, the public sector can establish a long-term professional development counseling team that can be a strong backing for medical personnel, both strengthening pre-employment training and encouraging the full-time service of medical personnel through policy formulation can help to enhance the intent of medical personnel to participate in home-based reablement service. In addition, in order to enable more people with disabilities to regain their ability to participate in activities, not to limit themselves to the home due to environmental, physiological and psychological reasons anymore, return to the life mode before disability, because of the intervention of the home-based reablement service. The public sector can report many successful stories by mass media, build the long-term care mutual aid units in the village, improve accessibility facilities of the community and integrate the social welfare groups and actively assist the people with disabilities in economically disadvantaged status who are unable to obtain social welfare benefits due to certain factors to obtain the reasonable subsidies. All policy above can improve the intention of the people with disabilities to accept the home-based reablement service