肝硬化病人主要照顧者之生活品質及其相關因素

Quality of Life of Primary Caregivers of Liver Cirrhosis Patients and Related Factors

10.6224/JN.201902_66(1).08

徐雯娟(Wen-Chuan HSU)；林瑞香(Jui-Hsiang LIN)；林梅香(Mei-Hsiang LIN)；徐秀琹(Hsiu-Chin HSU)；石惠美(Whie-Mei SHIH)

肝硬化 ； 主要照顧者 ； 生活品質 ； liver cirrhosis ； primary caregivers ； quality of life

護理雜誌

66卷1期（2019 / 02 / 01）

60 - 69

繁體中文

背景：肝硬化病人主要照顧者常面對病人疾病的合併症及反覆入院，可能出現負荷，進而影響生活品質。目的：探討肝硬化病人主要照顧者生活品質及其相關因素。方法：採相關性研究設計，問卷包括：負荷量表、因應行為量表、生活品質量表、照顧者基本屬性。以描述性及推論性統計（獨立樣本t檢定、單因子變異數分析、皮爾森積差相關分析以及逐步複迴歸分析）進行資料分析。結果：以北部某醫學中心肝硬化病人主要照顧者共113位為研究對象。結果發現：(1)負荷以財務負荷最高，身體負荷最低；生活品質以環境層面得分最高，以生理健康層面最低，(2)大多採取問題取向因應策略，(3)整體負荷與整體生活品質呈顯著負相關（r = -.223, p ＜ .05）。自覺健康狀況好、每日照顧時數少，其生活品質較好。照顧者「自覺健康狀況」、「財務負荷」及「每日照顧時數」三者為整體生活品質之重要預測因子（F = 52.78, p ＜ .05），可解釋總變異量的58%。結論：本研究有助於護理人員瞭解肝硬化病人主要照顧者生活品質狀況，尤其是當照顧者有較差的經濟狀況及健康狀況時，應評估其需求，以便能適時提供必要的支持與協助。

Background: The prognosis of patients with liver cirrhosis often involves multiple complications and repeated admissions, which may significantly burden and reduce the quality of life of the primary caregivers of these patients. Purpose: The purpose of this correlational study was to explore the relationship between the burden of caregivers of liver cirrhosis patients and their quality of life. Methods: A structured questionnaire, which included the Primary Caregiver Burden Scale, Coping Behaviors Scale, the WHOQOL-BREF, and a caregiver demographic datasheet, was used to collect data. Descriptive and inferential statistics (independent t-test, one-way ANOVA, Pearson's product-moment correlation, and stepwise regression analysis) were used to analyze data. Results: A total of 113 participants were recruited from a medical center in northern Taiwan. The results revealed: (1) The highest average scores for caregiver burden were in the financial domain, while the lowest average scores were in the physical domain. The highest average scores for quality of life were observed in the environment domain, while the lowest average scores were in the physical health domain. (2) Most of the caregivers adopted a problem-solving oriented strategy to care for their patient. (3) Overall care burden correlated negatively with overall quality of life (r = -.223, p ＜ .05). The caregivers' ＂self-assessed health＂, ＂financial load＂, and ＂daily care hours＂ were significant factors affecting overall quality of life (F = 52.78, p ＜ .05), accounting for 58% of the total variance in the results. Conclusions: The results of this study may help nurses better understand and work to reduce the burden of caregivers in order to enhance their quality of life. Nurses should assess caregiver burden, especially in cases where caregivers themselves are in a poor financial situation or have poor self-assessed health, in order to provide necessary support and assistance.

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