研究背景： 世界衛生組織提出健康老化的十年計畫(Decade of Health Ageing)，其中提及參與多樣性活動有助於老年人身心健康，提高生活品質，使老年人在社區中保持獨立性。本研究目的在探討日照中心老年人的活動多樣性與生活品質關係。先前有關老年人社會參與相關政策未特別關注多樣性的概念，本研究關注日照中心老年人之活動多樣性，日照中心是失智或失能老年人平日唯一較能參與社交聚會的地點，以支持老年人的功能並長時間生活在社區裡，參與日照中心活動以社會參與為主要目標，本研究藉著社會融合到健康的理論框架，探討日照中心老年人的活動多樣性與生活品質與健康狀態之關係。
研究方法：本研究使用橫斷性研究，以結構式問卷進行一對一訪談。研究地點為台灣南部地區(屏東、高雄及台南)之日照中心。本研究使用日本學者發展之Activity Diversity Questionnaire(簡稱ADQ)為活動多樣性測量工具。納入條件為(1)參與日照中心三個月以上；(2)年齡60歲以上，最終參與研究的日照中心有13家，回收有效問卷192份。資料分析使用SPSS 22版進行描述性與推論性的統計。使用Pearson相關性及迴歸分析來了解活動多樣性與生活品質及健康狀態之關係，以及影響活動多樣性與生活品質之因素。
研究結果：Pearson相關性分析結果發現(1)活動多樣性與生活品質呈現正相關；(2)活動多樣性與幸福感、自覺健康狀態、認知程度與日常生活功能呈現正相關；(3)活動多樣性與憂鬱呈現負相關。迴歸分析結果則發現(1)影響活動多樣性之因素為居住狀態(獨居)和參與日照中心的頻率；(2)影響生活品質之因素為與不同住子女見面頻率和活動多樣性。代表活動多樣性受到個人社會網絡之影響，其中社會網絡涵蓋朋友、家人與社區(日照中心)，且參與多種活動可提升個人生活品質。
結論：本研究結果發現活動多樣性與生活品質和健康狀態有關，而主要影響活動多樣性因素為個人社會網路，而日照中心對失智或失能老年人來說，是一個可以間接獲得社會參與的場所，以提升個人生活品質及健康狀態。期望未來政府可制定一套多元的課程準則與內容可以供日照中心參考，並使日照中心活動課表公開透明化，以便社區民眾選擇符合自己需求及喜好的日照中心。

This study aims to explore the relationship between activity diversity and quality of life among older adults in day care centers. Day care centers serve as crucial venues for social participation and engagement for those with dementia or disabilities, supporting their functions and living in the community for long-term. Social participation is a primary goal of these centers. A cross-sectional study was conducted using structured questionnaires in one-on-one interviews in day care centers located in southern Taiwan (Pingtung, Kaohsiung, and Tainan). The measurement of Activity Diversity Questionnaire (ADQ) were used. The inclusion criteria: (1) participation in day care centers for more than three months; (2) aged 60 years or older. There were 13 day care centers participated in this research and a total of 192 valid samples were collected. Pearson correlation and regression analyses were used to examine the relationship between activity diversity, quality of life, and health status, as well as the factors influencing activity diversity and quality of life. Pearson correlation analysis revealed positive correlations between activity diversity and quality of life, well-being, self-perceived health status, cognition, and daily living functions. Hierarchical regression analysis found that the factors influencing activity diversity included residence status(living alone) and frequency of attending day care centers; influencing quality of life included frequency of meeting with children who do not live together and activity diversity. Activity diversity was significantly related to quality of life, indicating that personal social networks, comprising friends, family, and community (day care centers), influence activity diversity. Engaging in diverse activities enhances personal quality of life. The study concludes that day care centers provide opportunities for social participation, and further enhancing the quality of life and health status of older adults.

王增勇(1988)。西方日間照顧的歷史與重要議題。社區發展季刊，83，168-190。
王靜怡、李雪楨、楊越安、陳佑昇、蔡一如、曹昭懿（2017）。團體運動對行動不穩老人下肢活動功能之療效。物理治療，42(2)，134-135。https://doi.org/10.6215/FJPT.2017.73.O05
石泱、羅惠慈、陳重吟（2018）。老人日間照顧中心服務品質與滿意度之研究： 以台灣南部某地區醫院為例。福祉科技與服務管理學刊，6(2)，121-136https://doi.org/10.6283/JOCSG.201807_6(2).121
石婷飴（2023）。日間照顧機構活動對失智症長者之身心健康促進成效與影響因子。﹝碩士論文。臺北醫學大學﹞臺灣博碩士論文知識加值系統。https://hdl.handle.net/11296/vp7uut
呂寶靜（2001）。《老人照顧：老人、家庭、正式服務》。台北：五南。
呂寶靜、李佳儒、趙曉芳（2014）。臺灣老人日間照顧服務之初探：兩種服務模式之比較分析。東吳社會工作學報，(27)，87-109。
周麗華(2003)。從臺北市老人長期照顧機構的消長-看台灣老人照顧政策。社區發展季刊，141，214-222。
周月青、張恆豪、李慶真、詹穆彥(2015)。聯合國國際衛生組織ICF緣起與精神：文獻檢視。社區發展季刊，150，17-39。
周瑛琪、吳芷芸、盧慶樺、張育瑄（2023）。探討日照中心活動課程設計與降低失智者躁動之關聯性。當代商管論叢，8(1)，35-53。https://doi.org/10.6852/JCBM.202312_8(1).03
李月萍、黃惠子（2014）。〈老年生活品質概念與測量應用〉，《台灣老年醫學暨老年學雜誌》， 9，57-67。
林明禛（2011）。社會服務品質的建構與提昇－以老人日間照顧為例。台灣健康照顧研究學刊，(11)，23-44。https://doi.org/10.29750/TJTHCA.201109.0002
林儷蓉、陳亞琦、饒淑梅、余雪如（2014）。園藝生命回顧課程對日照中心失智症長者心理與認知功能效果之初探。長期照護雜誌，18(1)，81-94。 https://doi.org/10.6317/LTC.18.81
林莉玲、施淑芳（2020）。探討獨居長者社會參與之相關因素研究：以臺北市南港區為例。健康促進與衛生教育學報，(51)，67-91。https://doi.org/10.3966/2070106320200600510003
林芷妘、陳宛妮、許雅婷、許建隆、游曉微（2021）。【論文摘要】智能運動介入對老年人身體功能及生活品質之探討：以日間照顧中心長輩為例。物理治療，46(4)，313-314。https://doi.org/10.6215/FJPT.202112.P24
邱懿瑩（2020）。老年人社會參與、社會支持及生活品質之關係研究。屏東大學體育，(6)，1-23。https://www.airitilibrary.com/Article/Detail?DocID=P20161017005-202006-202011090009-202011090009-1-23
金韋志、劉嘉逸、李晉邦、朱俊霖(2014)。於台灣老年族群使用五種簡短型老年憂鬱量表之可行性。台灣精神醫學，28(3)，156-163。
長期照顧司(2023年，8月31日)，各縣市日照中心資源盤點情形一覽表。https://1966.gov.tw/LTC/lp-6485-207.html
姚開屏（2002）。台灣版世界衛生組織生活品質問卷之發展與應用。台灣醫學，6(2)，193-200。https://doi.org/10.6320/FJM.2002.6(2).09
姚開屏、錢承君、張育誠、林韋伶、王榮德、謝清麟、林茂榮（2017）。台灣版WHOQOL-OLD問卷之發展與驗證。台灣公共衛生雜誌，36(3)，239-258。https://doi.org/10.6288/TJPH201736106018
柯宏勳、黃妍華、李美慧、吳菁宜、李冠逸、謝妤葳（2013）。職能治療計畫介入對日間照顧中心失智症患者日常與社交功能以及照顧者負荷之成效探討。臺灣職能治療研究與實務雜誌，9(2)，113-125。https://doi.org/10.6534/jtotrp.2013.9(2).113
洪宏、姚卿騰（2017）。運用代間學習提升日間照顧中心老人人際互動之研究。福祉科技與服務管理學刊，5(2)，121-132。https://doi.org/10.6283/JOCSG.2017.5.2.121
胡倍瑜、游曉微、邱慈穎、林莉玲、陳端容、陳雅美。(2019)。衰弱量表的效度驗證-一般社區長者以及獨居長者的應用。台灣公共衛生雜誌，38(6)，648-659。
孫智辰（2018）。老人進入日間照顧中心之基本心理需求滿足之研究－以自我決定理論分析。臺灣社會福利學刊，14(2)，115-161。https://doi.org/10.6265/TJSW.201812_14(2).0
國家發展委員會(2022年，8月)，中華民國人口推估(2022年至2070年)。https://pop-proj.ndc.gov.tw/cp.aspx?n=1
連火顧（2022）。日間照顧中心課程規劃之研究〔碩士論文，國立臺灣師範大學〕。華藝線上圖書館。https://doi.org/10.6345/NTNU202201460
郭乃文、劉秀枝、王珮芳、廖光淦、甄瑞興、林恭平、陳祖裕、徐道昌(1988)。「簡式智能評量」之中文施測與常模建立。中華民國復健醫學會雜誌，16，52-29。
陳柏宗(2014)。日間照顧中心在台灣推展之初探。台灣老年學論壇，22。
陳佳雯、林舜穀、賴淑貞、呂文娟、余錦美、吳孟嬪（2020）。多元化課程對高齡失智長者在延緩認知退化之探討。北市醫學雜誌，1-22。https://doi.org/10.6200/TCMJ.202304/PP.0015
傅從喜(2019)。長期照顧2.0初期的資源佈建與服務發展。國土及公共治理季刊，3(7)，60-71。
曾思瑜（2010）。日間照顧中心中高齡者行爲特徵與活動規模之研究－「混合收托型」日照中心空間規劃與設計之探討。建築學報，(72)，45-64。https://doi.org/10.6377/JA.201006.0002
詹譽賢（2006）。老年人參與日間照顧各類休閒活動之研究─以台中市老人日間照顧中心為例。﹝碩士論文。東海大學﹞臺灣博碩士論文知識加值系統。https://hdl.handle.net/11296/57up4a
劉立凡、林姮君、陳佳楨(2022)。中老年人健康狀況與主觀幸福感之相關性研究：以臺灣南部某都市社區調查為例。社區發展季刊，177，311-330。
劉苑蓉、謝佳容、黃冠評（2022）。以方塊踏步團體活動介入於日照中心長者衰弱改善的效果：一項前驅研究。台灣健康照顧研究學刊，(26)，42-71。https://www.airitilibrary.com/Article/Detail?DocID=19946236-202207-202209300009-202209300009-42-71
蔡惠雅、張玉龍（2018）。老人日間照顧服務的選擇動機與決定態度之研究。社會發展研究學刊，(22)，130-161。https://doi.org/10.6687/JSDS.201809_(22).0005
衛生福利部(2002年)，我國長期照顧十年計畫~101年至104年中程計畫。
衛生福利部(2016年，12月)，長期照顧十年計畫2.0(106~115年)(核定本)。https://1966.gov.tw/LTC/cp-6572-69919-207.html
衛生福利部(2018年，11月)，中華民國107年版衛生福利年報。
衛生福利部(2023年，10月)，中華民國112年版衛生福利年報。https://www.mohw.gov.tw/cp-3196-76172-1.html
衛生福利部(2024年，1月)，111年老人狀況調查報告。https://dep.mohw.gov.tw/DOS/cp-5095-77509-113.html
盧瑞芬、曾旭民、蔡益堅（2003）。國人生活品質評量(Ⅰ)：SF-36台灣版的發展及心理計量特質分析。台灣公共衛生雜誌，22(6)，501-511。https://doi.org/10.6288/TJPH2003-22-06-09
蕭文高（2013）。南投縣日間照顧中心老人生活品質影響因素之研究。社會政策與社會工作學刊，17(1)，89-130。https://doi.org/10.6785/SPSW.201306_17(1).0003
蕭婉鎔（2022）。老年要快樂，老友很重要？從互動觀點探討網絡對中高齡者情緒之影響。福祉科技與服務管理學刊，10(4)，288-301。https://doi.org/10.6283/JOCSG.202212_10(4).288
謝佩儒（2013）。日間照護中心之觀察研究〔碩士論文，中原大學〕。華藝線上圖書館。https://doi.org/10.6840/cycu201300699
蘇姵伊、廖泰翔、范袺雯、鄭宇傑、游曉微、林佩欣（2021）。【論文摘要】紅繩懸吊系統運動對日間照顧中心長者體適能之影響。物理治療，46(4)，298-299。https://doi.org/10.6215/FJPT.202112.P01
Aday, R. H., Wallace, B., & Krabill, J. J. (2018). Linkages Between the Senior Center as a Public Place and Successful Aging. Activities, Adaptation & Aging, 43(3), 211-231. https://doi.org/10.1080/01924788.2018.1507584
Berkman, L. F., Glass, T., Brissette, I., & Seeman, T. E. (2000). From social integration to health: Durkheim in the new millennium. Social science & medicine, 51(6), 843-857.
Brown, C. J., Jeon, S., Ng, Y. T., Lee, S., Fingerman, K. L., & Charles, S. T. (2023). Switching it up: Activity diversity and cognitive functioning in later life. Psychol Aging, 38(6), 483-493. https://doi.org/10.1037/pag0000770
Caballero, F. F., Miret, M., Power, M., Chatterji, S., Tobiasz-Adamczyk, B., Koskinen, S., Leonardi, M., Olaya, B., Haro, J. M., & Ayuso-Mateos, J. L.(2013). Validation of an instrument to evaluate quality of life in the aging population: WHOQOL-AGE. Health and quality of life outcomes, 11, 1-12.
Chin, W. C., Liu, C. Y., Lee, C. P., & Chu, C. L. (2014). Validation of Five Short Versions of the Geriatric Depression Scale in the Elder Population in Taiwan. 台灣精神醫學, 28(3), 156-163+ii. https://www.airitilibrary.com/Article/Detail?DocID=10283684-201409-201410200065-201410200065-156-163+ii
Czaja, S. J., Moxley, J. H., & Rogers, W. A. (2021). Social Support, Isolation, Loneliness, and Health Among Older Adults in the PRISM Randomized Controlled Trial. Front Psychol, 12, 728658. https://doi.org/10.3389/fpsyg.2021.728658
Diggs, J. (2008). Activity Theory of Aging. In: Loue, S.J., Sajatovic, M. (eds) Encyclopedia of Aging and Public Health. Springer, Boston, MA.https://doi.org/10.1007/978-0-387-33754-8_9
Ellen, M. E., Demaio, P., Lange, A., & Wilson, M. G. (2017). Adult Day Center Programs and Their Associated Outcomes on Clients, Caregivers, and the Health System: A Scoping Review. Gerontologist, 57(6), e85-e94. https://doi.org/10.1093/geront/gnw165
Fukuzawa, A., & Sugawara, I. (2022). Social Support and Participation as Factors Relating to Ikigai and Life Satisfaction in Lonely Older Japanese. Ageing International, 48(2), 465-481. https://doi.org/10.1007/s12126-022-09486-6
Havighurst, R. J. (1961). Successful aging. The gerontologist.
Hoyl, M. T., Alessi, C. A., Harker, J. O., Josephson, K. R., Pietruszka, F. M., Koelfgen, M., ... & Rubenstein, L. Z. (1999). Development and testing of a five‐item version of the Geriatric Depression Scale. Journal of the American Geriatrics Society, 47(7), 873-878.
Iecovich, E., & Biderman, A. (2013). Attendance in adult day care centers of cognitively intact older persons: reasons for use and nonuse. Journal of Applied Gerontology, 32(5), 561-581.
Lee, S., Koffer, R. E., Sprague, B. N., Charles, S. T., Ram, N., & Almeida, D. M. (2018). Activity Diversity and Its Associations With Psychological Well-Being Across Adulthood. J Gerontol B Psychol Sci Soc Sci, 73(6), 985-995. https://doi.org/10.1093/geronb/gbw118
Lee, H. Y., Yu, C. P., Wu, C. D., & Pan, W. C. (2018). The Effect of Leisure Activity Diversity and Exercise Time on the Prevention of Depression in the Middle-Aged and Elderly Residents of Taiwan. Int J Environ Res Public Health, 15(4). https://doi.org/10.3390/ijerph15040654
Lin, C.-Y., Wang, J.-D., & Liu, L.-F. (2020). Can We Apply WHOQOL-AGE to Asian Population? Verifying Its Factor Structure and Psychometric Properties in a Convenience Sample From Taiwan. Frontiers in Public Health, 8, 575374.
Lunt, C., Dowrick, C., & Lloyd-Williams, M. (2021). What is the impact of day care on older people with long-term conditions: A systematic review. Health Soc Care Community, 29(5), 1201-1221. https://doi.org/10.1111/hsc.13245
Larsson Ranada, Å., & Österholm, J. (2022). Promoting Active and Healthy Ageing at Day Centers for Older People. Activities, Adaptation & Aging, 46(3), 236-250. https://doi.org/10.1080/01924788.2022.2028050
Mahoney, F. I., & Barthel, D. W. (1965). Functional evaluation: the Barthel Index: a simple index of independence useful in scoring improvement in the rehabilitation of the chronically ill. Maryland state medical journal.
Menec, V. H. (2003). The relation between everyday activities and successful aging: A 6-year longitudinal study. The Journals of Gerontology Series B: PsychologicalSciences and Social Sciences, 58(2), S74-S82.
Mazurek, J., Szczesniak, D., Trypka, E., Lion, K. M., Wallner, R., & Rymaszewska, J. (2020). Needs of Older People Attending Day Care Centres in Poland. Healthcare (Basel), 8(3). https://doi.org/10.3390/healthcare8030310
Netten, A., Burge, P., Malley, J., Potoglou, D., Towers, A. M., Brazier, J., ... & Forder, J. (2012). Outcomes of social care for adults: developing a preference-weighted measure. Health technology assessment, 16(16), 1-166.
Naruse, T., & Yamamoto-Mitani, N. (2021). Service Use Objectives among Older Adult Day Care Clients with Disability in Japan. Nurs Rep, 11(3), 608-614. https://doi.org/10.3390/nursrep11030058
Naruse, T., Hatsushi, M., Tsuchiya-Ito, R., Kobayashi, M., & Kato, J. (2023). Experiences of Disabled Older Adults in Urban Area Adult Day Care Centers: A Multisite Case Study. Gerontol Geriatr Med, 9, 23337214231156304.https://doi.org/10.1177/23337214231156304
Khalaila, R., & Vitman-Schorr, A. (2021). Social support and loneliness among frail older adults attending daycare centers: A multicultural study in Israel. Arch Gerontol Geriatr, 97, 104486. https://doi.org/10.1016/j.archger.2021.104486
Orellana, K., Manthorpe, J., & Tinker, A. (2020). Day centres for older people: a systematically conducted scoping review of literature about their benefits, purposes and how they are perceived. Ageing Soc, 40(1), 73-104. https://doi.org/10.1017/s0144686x18000843
Orellana, K., Manthorpe, J., & Tinker, A. (2020). Day centres for older people –attender characteristics, access routes and outcomes of regular attendance: findings of exploratory mixed methods case study research. BMC Geriatr, 20(1), 158. https://doi.org/10.1186/s12877-020-01529-4
Oye, C. (2022). Fresh news as meaningful? A multi-site ethnographic analysis of meaningful activities at four day centres in Denmark and Norway. Health Soc Care Community, 30(6), e4705-e4712. https://doi.org/10.1111/hsc.13877
Osterholm, J., Andreassen, M., Gustavsson, M., & Larsson Ranada, A. (2023). Older people's experiences of visiting social day centres: The importance of doing and being for health and well-being. Scand J Occup Ther, 30(1), 76-85. https://doi.org/10.1080/11038128.2022.2130423
Santos, D., Abad, F. J., Miret, M., Chatterji, S., Olaya, B., Zawisza, K., Koskinen, S., Leonardi, M., Haro, J. M., & Ayuso-Mateos, J. L. (2018). Measurement invariance of the WHOQOL-AGE questionnaire across three European countries. Quality of Life Research, 27, 1015-1025.
Siette, J., Knaggs, G. T., Zurynski, Y., Ratcliffe, J., Dodds, L., & Westbrook, J. (2021). Systematic review of 29 self-report instruments for assessing quality of life in older adults receiving aged care services. BMJ Open, 11(11), e050892. https://doi.org/10.1136/bmjopen-2021-050892
Siette, J., Knaggs, G., & Haddock, R. (2022). Quality of life tools to support measurement of aged care quality. https://ahha.asn.au/publication/health-policy-evidence-briefs/evidence-brief-no-23-quality-life-tools-support
Topp, C. W., Ostergaard, S. D., Sondergaard, S., & Bech, P. (2015). The WHO-5 Well-Being Index: a systematic review of the literature. Psychother Psychosom, 84(3), 167-176. https://doi.org/10.1159/000376585
Tsai, P. H., Liu, J. L., Lin, K. N., Chang, C. C., Pai, M. C., Wang, W. F., Huang, J. P., Hwang, T. J., & Wang, P. N. (2018). Development and validation of a dementia screening tool for primary care in Taiwan: Brain Health Test. PLoS One, 13(4), e0196214. https://doi.org/10.1371/journal.pone.0196214
Takahashi, J., Kawai, H., Suzuki, H., Fujiwara, Y., Watanabe, Y., Hirano, H., Kim, H., Ihara, K., Ishii, K., Oka, K., & Obuchi, S. (2020). Reliability and Validity of the Activity Diversity Questionnaire for Older Adults in Japan. Int J Environ Res Public Health, 17(7). https://doi.org/10.3390/ijerph17072384
Takahashi, J., Kawai, H., Fujiwara, Y., Watanabe, Y., Hirano, H., Kim, H., Ihara, K., Ejiri, M., Ishii, K., Oka, K., & Obuchi, S. (2021). Association between activity diversity and frailty among community-dwelling older Japanese: A cross-sectional study. Arch Gerontol Geriatr, 95, 104377. https://doi.org/10.1016/j.archger.2021.104377
Takahashi, J., Kawai, H., Ejiri, M., Fujiwara, Y., Hirano, H., Sasai, H., Ihara, K., Ishii, K., Oka, K., & Obuchi, S. (2023). Activity diversity is associated with the prevention of frailty in community-dwelling older adults: The Otassha Study. Front Public Health, 11, 1113255. https://doi.org/10.3389/fpubh.2023.1113255
Vitman-Schorr, A., & Khalaila, R. (2022). Utilization of ADCCs and quality of life among older adults: ethno-regional disparities in Israel. BMC Geriatr, 22(1), 18. https://doi.org/10.1186/s12877-021-02674-0
World Health Organization. (2000). Home-based long-term care.
World Health Organization. (2001). International classification of functioning disability and health.
World Health Organization. (2002). Active ageing a policy framework. https://extranet.who.int/agefriendlyworld/active-ageing-a-policy-framework/
World Health Organization . (2015). Decade of health ageing. https://www.who.int/initiatives/decade-of-healthy-ageing
Wu, C. L., Lee, K. T., & Hung, C. F. (2022). The differences in the care model between ＂ Unit Care＂ and ＂Yume-No-Mizuumi-Mura＂. 輔仁醫學期刊, 20(3), 1-11.https://doi.org/10.53106/181020932022092003001
Yao G, Chung CW, Yu CF, Wang JD. Development and verification of validity and reliability of the WHOQOL-BREF Taiwan version. J Formos Med Assoc. 2002May;101(5):342-51. PMID: 12101852.