研究背景:
隨著全球人口高齡化的趨勢，高齡者及失智者遭遇財務濫用的問題日益嚴重。財務濫用是指他人不當地利用高齡者或失智者的財產或資金，而這種行為對被害人造成嚴重的影響。根據研究，每年全球有數百萬的高齡者遭受財務濫用。財務濫用不僅對個體的自尊心和生活品質造成傷害，也對社會造成了重大的損失，因此解決這個問題的重要性不可忽視。
然而過去文獻多數針對高齡者發生財務濫用的盛行率、各種濫用類型及風險因子進行討論，較少文獻提及教育介入對於第一線金融領域的專業人士防止長者遭遇財務濫用發生的有效性，因此本研究目的為探討失智友善培訓是否能提高銀行行員對疑似失智症客戶面臨財務風險的警覺心，以及行員是否會拒絕辦理有財務風險的業務。
研究方法:
本研究以前、後測的設計來評估失智友善課程的成效，以匿名自我填答問卷的方式進行資料蒐集，針對行員對於疑似失智客戶當時的風險程度以及其行動決策，使用6題情境題之結構式問卷，包括本人濫用財務、家人侵占財產、他人詐騙三種情境，行員依據不同情境給予0-10的風險分數，分數越高代表該行員認為當前客戶越可能有財務被濫用的風險；每題情境最後也詢問該行員是否會接受辦理業務，來判斷教育介入後行員的行為決策是否有變化。除了填答基本資料外，其他變項包括是否曾經照顧過失智者、有認識的失智親友，並以失智症知識評估量表來評估行員在接受教育介入前對失智症認識的程度。
統計分析使用McNemar檢定及廣義估計方程式比較行員的風險分數及行動決策在介入前後的改變，及探討與失智者接觸經驗對於行員的風險評估結果的影響。
研究結果:
樣本來自6家金融機構，共309位行員納入研究中，樣本多為女性(54.05%)、年齡以50歲以上居多(42.4%)、教育程度多為大專院校以上(71.17%)、沒有接觸過失智者為多數(63.43%)，且失智症知識分數平均為16分。
在失智友善培訓前，行員對於6題情境題給予的風險分數平均在7.34分至9.18之間，而加總後的風險總分平均為49.55分。經過教育介入後，各題的風險分數提升至7.52~9.28間，而總分平均為51.11分。以廣義估計方程式分析，控制社會人口學變項及前測的知識分數後，第四題及第五題在課程介入的β值及SE分別為0.59、0.47，皆有統計學上的顯著，表示行員在課後對於評估疑似失智者的家人可能濫用財務的風險有所提升，另外以風險總分來看也有顯著(β=1.42)。
在6題行動決策題的部分，行員在培訓前有65.4%~97.7%的比例選擇拒絕辦理業務，課後選擇拒絕辦理的比例提升至82.2%~97.9%。使用廣義估計方程式分析，控制社會人口學變項及前測知識分數後，除了第二題外每一題皆有統計學上的顯著，教育介入後確實提升行員對疑似失智客戶面臨財務風險的敏感度，更傾向拒絕辦理以保護客戶的財產。
研究結論:
研究主要結果顯示友善培訓能提升行員對失智症的認識，以及提升行員對疑似失智者正面臨財務風險的警覺心，不過有接觸失智者經驗的行員沒有更傾向拒絕辦理業務。然而本前導研究仍有些研究限制，包括未能納入對照組，建議未來的研究採取準實驗或隨機對照實驗設計並收錄對照組的樣本，以及行員作答可能受到社會偏好的影響，在後測時有學習效應。本研究的6題情境題無法涵蓋所有在臨櫃實際出現的情形，建議擴大研究問卷的臨櫃情境的代表性，以增加介入效果的可信度

SUMMARY:
Financial abuse is a common form of abuse for people with dementia (PWD). This study aimed to evaluate whether bank staff changed their risk assessment of financial abuse after receiving dementia-friendly training. We conducted a pre- and post-test study to evaluate the effectiveness of dementia-friendly training designed by our team. Data were collected from dementia-friendly training participants by anonymous questionnaires by self-reports, including whether they had dementia-related experience. There were 6 vignette scenarios representing financial abuse cases involving patients, families, and strangers to assess the risk of financial abuse, and whether bank staff would decline to provide service. Generalized estimation equations (GEE) models were used to compare the changes in risk assessment scores, changes in decision-making after intervention, and whether bank staff’s risk scores differ by having dementia-related experience. In conclusion, the study demonstrated that the dementia-friendly training was effective in raising staff awareness and sensitivity towards financial abuse among the PWD. However, this study found no impact of dementia-related experience on the likelihood to decline service by bank staff. Acknowledging study limitations, recommendations for future research include improve research designs to include a control group and expanding the scope of vignette scenarios in questionnaires.

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