背 景：失智飲食改變行為隨病程進展惡化呈現不同樣貌，了解其關聯因素與背後需求是照顧者提升失智照顧品質之重要前提。 目 的：旨在從照顧者角度來探究居家失智老人飲食改變行為與過去至今生活脈絡之關聯因素與潛藏需求。 方 法：採探索性研究設計，以立意取樣方式選取大高雄地區居家失智老人之主要照顧者為一對一深入訪談對象，研究期間自2011年3月至9月，13名符合收案條件之訪談資料達飽和。研究工具包括失智者基本人口學資料、照顧者基本人口學資料、簡易心智狀態問卷調查表及失智老人飲食改變行為訪談指引，運用內容分析法進行資料分析。 結 果：共得三個失智飲食改變行為關聯因素主題及三個需求意涵主題。飲食改變行為關聯因素主題為：(一)大腦功能的退化、(二)過去飲食習慣的延續及(三)先前角色功能的存有。潛藏需求主題為：(一)重回獨立的生活功能、(二)不滿情緒的宣洩及(三)尋求心理安適的感覺。 結論/實務應用：本研究結果提供照顧者能充分了解並掌握失智老人飲食改變行為關聯因素與需求脈絡，期有助於他們採取更有效及友善的照顧方法與態度來因應，以提升居家失智老人之飲食照顧品質。

Background: The eating behavior characteristics of elders with dementia vary with disease progress. Under-standing the key factors and underlying needs that influence eating behaviors in community-dwelling elders with dementia is critical to enhancing the quality of care available to this patient group. Purpose: This study explored the key factors and the underlying needs that influence altered eating behaviors in domestic elders with dementia from the perspective of their primary caregivers. Methods: An exploratory research design with purposive sampling was conducted. Participants were the primary caregivers of community-dwelling elders with dementia living in southern Taiwan. Data were collected from March 2011 to September 2011. New participant recruitment stopped when data saturation was achieved at 13 participants. The instruments used included demographics datasheets for both dementia elders and caregivers; a Short Portable Mental Status Questionnaire; and an interview guide. Content analysis was used to analyze data. Results: Three key factor themes and three underlying-needs themes emerged from the data. The key factor themes were: (1) progression of brain decline, (2) continuation of past eating habits, and (3) preexisting role functions. The underlying-needs themes were: (1) desire for independence, (2) venting of discontent, and (3) eagerness for a sense of psychological wellbeing. Conclusions / Implications for Practice: Findings of this study provide caregivers with additional information on the key factors and underlying needs that influence altered eating behaviors in dementia elders. Caregiver understanding of these factors and needs may facilitate their provision of more efficient and effective care services to provide better quality of care to this vulnerable patient population.