台灣使用長照的人口數正快速的攀升，因此，第一線照護人力的需求已成為亟需被重視的議題。就目前而言，在台灣不論長期照護的人力或是照護品質仍呈現許多不足的地方。在職的居家照顧人員，其投入照顧工作的意願或留任率皆普遍呈現低落的情形，但是擁有足夠的照護人力及一定的照護品質卻應該是每位長者所應擁有的基本人權。根據相關文獻證據顯示，當社會中存在著對老年人歧視的文化或觀點，將對老人的身、心健康產生負向的影響。更進一步而言，在職的居服員對老年人的負面態度或歧視行為往往亦影響著其為老年人工作的意願以及照護的品質。如何改善居服員對老年人的歧視態度及行為並進而增加其留任的意願已成為長照人力的重要議題。
本研究以雙因子理論為基礎，探究居服員內、外在因子的工作滿意度是否對留任意願產生影響，並使用中介及調節模式檢驗對老年人的歧視態度與歧視行為是否在居服員的工作滿意度與留任意願扮演相關的影響角色，並檢視其他相關影響留任意願的因素。
本問卷調查針對台灣南部某都市的居家照顧服務人員發放問卷共400人，完整填答者380份，回覆比率95%。資料收集後，運用SPSS統計軟體進行敘述性統計、皮爾森相關性檢定、T檢定、ANOVA、線性迴歸、階層線性迴歸。抽樣方式採取分層隨機抽樣。量表乃針對居服員探究其對老年人的歧視態度與歧視行為；以及其工作滿意度與留任意願。研究結果顯示，內、外在因子的工作滿意度皆對居服員的留任意願有正向顯著影響，而對老年人的歧視態度在居服員的內在工作滿意度與留任意願具有中介的效果、對老年人的正、負向歧視行為在居服員的工作滿意度與留任意願具有調節的效果。要改善居服員的留任意願，除了要適當地提升他們的內、外在工作滿意度，在訓練的過程中傳遞正確的高齡相關知識並改善其對老年人的歧視態度與行為，亦是不可或缺。藉由對老年人的歧視態度與行為的探究，將可凸顯高齡社會老年歧視議題對老年人權益的重要性，進而提供政策建議並期盼提升長照人力的質與量。

As the population ages in Taiwan, the demand for long-term care (LTC) is rising rapidly. Consequently, providing high-quality care and abundant manpower has emerged as a major issue. In order to improve human resources for recruitment and retention in LTC, it is important to examine what factors could attract the workforce to care for the aging population. Ageist attitudes and ageist behaviors are influenced by societal values and are linked to the retention of workers to provide care for older adults. The study examined whether intrinsic and extrinsic job satisfaction affected home care workers’ intentions to stay, and determined whether ageist attitudes and ageist behaviors played a moderating or mediating role in job satisfaction and intention to stay. The stratified random cluster sampling method was applied in this study. The survey was conducted on 400 home care workers from home service organizations in one city in southern Taiwan. Overall, 380 participants completed the questionnaires. The monthly wages of NT$30,000 to NT$39,999 were associated with home care workers’ retention. Intrinsic and extrinsic job satisfaction had significant effects on their retention. Furthermore, ageist attitudes played a mediating role in intrinsic job satisfaction and retention, and ageist behaviors played a moderating role in job satisfaction and retention. Thus, we suggest that home care workers’ retention can be raised by giving appropriate extrinsic rewards and by enhancing the intrinsic factors of the job itself. In addition, providing accurate aging-related knowledge to raise awareness of ageism may enhance the correlation between job satisfaction and retention. This study will provide the government with different aspects of recruiting the future workforce and retaining the existing workforce.

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