隨著社會邁入超高齡階段，日間照顧機構之環境品質在高齡者心理福祉中日益重要。然而，現行長照設計多著重於安全與無障礙，對環境氛圍與使用者主觀感知之探討相對不足。本研究旨在整理日照環境品質之構面並建立相應量表，以分析環境構面與高齡者療癒感及主觀幸福感之統計關聯樣態，作為長照空間與服務設計之實證參考。
本研究以注意力恢復理論（Attention Restoration Theory, ART）與自我決定理論（Self-Determination Theory, SDT）作為結果討論之理論參照。其中，療癒感係指高齡者對特定日照場域恢復性特質之知覺；主觀幸福感則反映其近兩週較廣泛之正向心理狀態。心理測量工具採用恢復性環境量表（Perceived Restorativeness Scale, PRS）及世界衛生組織五項幸福指數量表（World Health Organization-Five Well-Being Index, WHO-5）。
本研究以南臺灣31家日間照顧機構之670位高齡使用者為研究樣本，採橫斷式問卷調查。經探索性因素分析（Exploratory Factor Analysis, EFA），將日間照顧環境品質歸納為三大構面及10個次構面，包括實質環境（建築尺度與單元大小、空間配置、社交與開放空間、安全與舒適）、服務機能（照顧服務、自立促進、個別化照顧）及氛圍（自然感、美學與文化、永續生活）。量表經篩選後共保留48個題項，各構面內部一致性良好（Cronbach’s α = 0.948–0.971），三構面之累積解釋變異量介於63.2%至67.3%，初步建構一套可同時評估日間照顧場域實質環境、服務機能及氛圍之環境品質量表，可作為後續量表驗證、場域比較及實務改善之基礎。
研究結果顯示，療癒感與主觀幸福感呈中度正相關（r = 0.59, p < 0.001），且療癒感模型之解釋力（調整後R² = 0.64）高於主觀幸福感模型（調整後R² = 0.27），顯示不同心理結果與環境條件之統計關聯樣態有所差異。在療癒感方面，美學與文化、永續生活及自立促進呈正向關聯；在主觀幸福感方面，自立促進、空間配置、美學與文化及永續生活呈正向關聯，顯示其關聯分布較為分散。此外，安全與舒適及照顧服務於各自最終整合模型中呈現負向關聯，此一結果反映多變項模型中控制其他已納入變項後之條件式統計關聯，不代表相關環境或服務條件具有負面實務價值。
整體而言，本研究之主要貢獻在於初步建構一套整合實質環境、服務機能及氛圍三大構面之日間照顧環境品質量表，將過去較分散於空間設計、照顧服務及環境感知之相關概念納入同一分析架構。研究結果進一步顯示，氛圍構面在療癒感模型中呈現較集中的關聯分布，而主觀幸福感則呈現跨構面之分散關聯樣態；自立促進為服務機能構面中唯一同時與療癒感及主觀幸福感呈現顯著正向關聯之次構面。在ART與SDT之理論參照下，本研究所建構之量表及研究結果，可作為理解日間照顧場域環境品質與不同心理福祉統計關聯樣態之分析基礎，並為後續量表驗證、環境評估、空間規劃及服務設計提供實證參考。

As societies enter a super-aged era, the environmental quality of adult day care centers has become increasingly important to older adults’ psychological well-being. However, existing long-term care design has primarily emphasized safety and accessibility, while environmental atmosphere and users’ subjective perceptions remain relatively underexplored. This study aimed to identify the dimensions of environmental quality in adult day care, develop an environmental quality assessment scale, and examine patterns of statistical associations between environmental quality and older adults’ healing and subjective well-being, thereby providing empirical evidence for environmental planning and service design in long-term care.
Attention Restoration Theory (ART) and Self-Determination Theory (SDT) were adopted as theoretical references for interpreting the findings. Healing was defined as older adults’ perception of the restorative qualities of a specific adult day care setting, whereas subjective well-being reflected a broader positive psychological state during the previous two weeks. Healing and subjective well-being were measured using the Perceived Restorativeness Scale (PRS) and the World Health Organization-Five Well-Being Index (WHO-5), respectively.
A cross-sectional survey was conducted with 670 older adults from 31 adult day care centers in southern Taiwan. Exploratory factor analysis (EFA) identified three environmental quality dimensions comprising ten sub-dimensions: physical environment (building scale and unit size, spatial configuration, social and open spaces, and safety and comfort), service functions (care services, autonomy support, and individualized care), and atmosphere (naturalness, aesthetics and culture, and sustainable living). The final scale consisted of 48 items with good internal consistency (Cronbach’s α = 0.948–0.971). The cumulative variance explained for the three dimensions ranged from 63.2% to 67.3%. These findings provide an initial measurement framework for assessing physical environment, service functions, and atmosphere in adult day care settings and a basis for future scale validation, comparisons across care settings, and practical improvement.
The results showed a moderate positive correlation between healing and subjective well-being (r = 0.59, p < 0.001). The healing model demonstrated greater explanatory power (adjusted R² = 0.64) than the subjective well-being model (adjusted R² = 0.27), indicating different patterns of statistical associations between environmental quality and the two psychological outcomes. For healing, aesthetics and culture, sustainable living, and autonomy support showed positive associations. For subjective well-being, autonomy support, spatial configuration, aesthetics and culture, and sustainable living showed positive associations, indicating a more distributed pattern across environmental dimensions. In contrast, safety and comfort and care services showed negative associations in their respective integrated regression models. These findings reflect conditional statistical associations after controlling for other variables included in the models and should not be interpreted as indicating negative practical value of safety, comfort, or care services.
Overall, this study developed an initial environmental quality measurement framework for adult day care that integrates physical environment, service functions, and atmosphere within a unified analytical framework. The findings further showed that associations with healing were more concentrated in the atmosphere dimension, whereas associations with subjective well-being were distributed across environmental dimensions. Autonomy support was the only service-function sub-dimension that showed significant positive associations with both healing and subjective well-being. Interpreted with reference to ART and SDT, the proposed framework and findings provide a basis for understanding different patterns of statistical associations between environmental quality in adult day care and psychological well-being, while offering an empirical reference for future scale validation, environmental assessment, spatial planning, and service design.

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