Mao, H.-F., Tsai, A. Y.-J., Yeh, H.-C., & Chang, L.-H. (2024).The Gerontologist, 65(2).Read this article

As evidence-based interventions (EBIs) for older adults expand, successful community delivery depends on both protocol adherence and responsiveness to context. This study explored the real-world implementation of a complex cognitive EBI—Multiple-component Cognitive Intervention using Simulated Everyday Tasks (MCI-SET)—from the perspective of occupational therapists in Taiwan. A convergent mixed-methods design was used. Quantitative data from 47 therapists were collected using the Perceived Fidelity Questionnaire (PFQ), while qualitative data were gathered through two World Café discussions. Results showed therapists rated community-oriented skills as more important and demonstrated greater proficiency and adherence in these areas. Qualitative analysis emphasized the need for rapport-building, strategic program introduction, and tailoring interventions to local needs. Integrated findings highlight the importance of community engagement skills and the adaptability of interventions to support fidelity and sustainability. These findings underscore the need for dynamic fidelity frameworks and tailored training that includes adaptation strategies responsive to community contexts.

隨著政府擴大高齡者相關的實證介入（evidence-based interventions）推廣，成功在社區中執行相關介入需同時注重治療師是否能夠遵循方案的原則及同時回應社區的需求。本研究探討了一項複合式認知介入「模擬日常任務的多元複合認知介入（Multiple-component Cognitive Intervention using Simulated Everyday Task）」在台灣的實施情況，聚焦於職能治療師對於方案保真度、執行挑戰與策略的看法。我們採用收斂式混合方法設計，透過主觀保真度問卷（perceived fidelity questionnaire）調查47位職能治療師，並透過兩場「世界咖啡館」座談收集質性資料。結果顯示，治療師認為與社區互動相關的能力比認知方案介入技巧更重要，且在社區相關之技巧的熟練度與執行率也較高。質性資料進一步指出，治療師需透過策略性介紹、調整活動以貼近在地需求、並與社區建立關係來提升長輩的參與與執行效果。結果強調，治療師的社區參與能力與介入彈性是實施與永續推動的重要關鍵，並呼籲未來在治療師訓練中納入動態忠實性的概念與調整策略，以因應不同社區脈絡需求。