题名

照顧自殺企圖者之照顧負荷與經驗

并列篇名

Care Burden and Care Experiences of Caregivers of Suicide Attempters

DOI

10.6142/VGHN.33.1.77

作者

蔣秀容(Shiou-Rong Jeang);王珮珩(Pei-Hern Wang);齊美婷(Mei-Ting Chi);顧艷秋(Yan-Chiou Ku)

关键词

自殺企圖 ; 主要照顧者 ; 照顧負荷 ; suicide attempter ; caregiver ; care overburden

期刊名称

榮總護理

卷期/出版年月

33卷1期(2016 / 03 / 01)

页次

77 - 86

内容语文

繁體中文

中文摘要

本研究主在探討照顧自殺企圖者之照顧負荷與經驗,採質性研究法,以南台灣某醫學中心急性精神科病房自殺企圖主要照顧者為研究對象,以半結構式訪談大綱進行深度訪談,以質性方法分析資料,共收案8位,照顧者之負荷經驗分為情緒反應、生活狀況改變、接受現實三大主題;情緒反應涵蓋「緊張不安」、「擔心害怕」、「無奈」及「心痛難過」四個次主題,當個案出現自殺企圖行為時,照顧者出現緊張不安,進而擔心害怕,歷經幾次自殺行為後,照顧者深感無奈、心痛難過,甚至也出現負面想法;生活狀況轉變涵蓋「無形壓力」、「工作與家庭無法兼顧」及「睡眠紊亂」三個次主題,長期照顧自殺企圖者,身心俱疲造成無形壓力,處理自殺企圖者突發狀況,工作受到影響,陷入工作與家庭無法兼顧之窘境,但為了現實生活必須堅持下去,出現睡眠紊亂而求醫;接受事實涵蓋「面對現實」、「轉換想法」及「宗教力量支持」三個次主題,照顧自殺企圖者多年下來,照顧者告訴自己接受事實,一切終究要面對現實,轉換自己的想法,藉宗教力量支持,讓自己繼續走下去。建議臨床護理人員可依照顧者之負荷經驗貼切他們的心境,提供鼓勵與支持,不可忽略對照顧者的關心。

英文摘要

This qualitative study investigated the overburden experiences of the caregivers of suicide attempters. Purposive sampling was used to select participants from the acute psychiatric ward of a medical center in Southern Taiwan. Eight caregivers of patients who had attempted suicide were evaluated using semistructured in-depth interviews. A qualitative approach was used to induce and analyze the text data. Three major dimensions of the overburden experiences of caregivers were detected: "emotional response," "changes in living condition," and "acceptance of reality." Emotional response comprised four subthemes: "nervousness," "worry and fear," "helplessness," and "heartbrokenness." When the patients attempted suicide, the caregivers became nervous and then fearful for these patients. After experiencing several suicide attempts, the caregivers felt helpless and heartbroken and even developed negative thoughts. The changes in the living conditions included three subthemes: "invisible stress," "work-family imbalance," and "sleep disorders." The caregivers exhibited physical and mental fatigue after caring for patients for a long period, with a large burden of invisible stress. The sudden suicide attempts of the patients affected the work life of the caregivers: when facing the dilemma of either caring for the patient or working, they chose caregiving. Nevertheless, the caregivers sought medical aid when they developed sleep disorders. Acceptance of reality included three subthemes: "facing reality," "changing thoughts," and "seeking religious support." The caregivers preferred to accept reality after caring for the patients for a long period; they anticipated acceptance of reality to eventually change their thoughts. Moreover, they used religious forces to support themselves throughout the caregiving. In conclusion, clinical nursing staff should care for and provide more encouragement and support to family members of suicidal patients.

主题分类 醫藥衛生 > 預防保健與衛生學
醫藥衛生 > 社會醫學
参考文献
  1. 南玉芬(2013)。重生後的「我」-企圖自殺後的自我詮釋「I」。社會發展研究學刊,13,1-28。
    連結:
  2. 劉麗惠、張淑美(2010)。幼年時期父親自殺對子女的街擊與悲傷調適歷程之敘說研究。生命教育研究,2(2),33-73。
    連結:
  3. 鍾明勳、杜家興、蔣欣欣、張達人(2015)。幻想式的人際糾結-自殺企圖憂鬱症患者的人際模式。醫學與健康期刊,4(1),35-44。
    連結:
  4. International Association for Suicide Prevention (IASP) (2015). IASP Guidelines for Suicide Prevention. Retrieved from http://www.iasp.info/wspd/
  5. 行政院衛生署(2013,4 月15 日).十大死因統計.取自http://www.doh.gov.tw
  6. Chi, M. T.,Long, A.,Jeang, S. R.,Ku, Y. C.,Lu, T.,Sun, F. K.(2014).Healing and recovering after a suicide attempt: A grounded theory study.Journal of Clinical Nursing,23(11-12),1751-1759.
  7. Deisenhammer, E. A.,Huber, M.,Kemmler, G.,Weiss, E.M.,Hinterhuber, H.(2007).Psychitaric hospitalizations during the last 12 months before suicide.General Hospital Psychiatry,29(1),63-65.
  8. Drum, D. J.,Brownson, C.,Denmark, A. B.,Smith, S. E.(2009).New data on the nature of suicidal crises in college students: Shifting the paradigm.Professional Psychology: Research and Practice,40,213-222.
  9. Frances, R.,Michael, C.,Patricia, C.(2007).Step-by-step guide to critiquing research. Part 2: Qualitative research.British Journal of Nursing,16(12),738-744.
  10. Kenneth, I. P.(2012).Caregiving tasks in caring for an adult with mental illness and associations with adjustment outcomes.International society of behavioralmedicine,19(2),186-198.
  11. Krug, E.G.,Dahlberg, L.L.,Meary, J.A.,Zwi, A.B.,Lozano, R.(2002).World Report on Violence and Health.Geneve:World Health Organization.
  12. Nosek, C. L.(2008).Managing a depressed and suicidal loved one at home: Impact on the family.Journal of Psychosocial Nursing and Mental Health Services,46(5),36-44.
  13. Parahoo, K.(2006).Nursing Research: Principles, Process and Issues.Houndmills:Palgrave Macmillan.
  14. Stajduhar, K. I.,Nickel, D. D.,Martin, W. L.,Funk, L.(2008).Situated being situated: Client and co-worker roles of family caregivers in hospice palliative care.Social Science and Medicine,67(11),1789-1797.
  15. Sun, F. K.,Long, A.,Huang, X. Y.,Huang, H. M.(2008).Family care of Taiwanese patients who had attempted suicide: A grounded theory study.Journal of Advanced Nursing,62(1),53-61.
  16. Tzeng, W. C.,Lipson, J. G.(2004).The cultural context of suicide stigma in Taiwan.Qualitative Health Research,14(3),345-358.
  17. Wekstein, L.(1979).Handbook of Suicidology.NY:Brunner/Mazel.
  18. 卞鳳珍、馮欣蓓、曾雯琦(2013)。燒炭自殺企圖者之家庭照護。護理雜誌,60(6),84-89。
  19. 王俊堯(2014)。自殺防治經驗分享(II)。自殺防治網通訊,9(3),7-8。
  20. 台灣自殺防治學會暨全國自殺防治中心國際事務團隊(2014)。自殺防治 全球串連。自殺防治網通訊,9(1),2-3。
  21. 朱翠燕、李素卿、王祖琪、謝瑞雲、李秋玉、林秀麗(2010)。女性照顧者負荷之質性研究。北市醫學雜誌,7(2),144-153。
  22. 余麗華、陳文意、譚利光、林玉惠(2012)。台灣地區自殺死亡率相關因子探討。澄清醫護管理雜誌,8(1),26-35。
  23. 吳曉芸、伍碧琦(2009)。一位憂鬱症患者面對母親自殺身亡之護理經驗。長庚護理,20(3),393-401。
  24. 孫凡軻、黃惠滿、葉淑惠、林秀玲、郭雅玲、李昱(2009)。精神疾病自殺企圖者出院後被照顧者照護的經驗。長庚護理,20(1),37-50。
  25. 陳楚杰、葉瑞垣、李中一(2010)。台灣地區自殺身亡率及其相關因素之研究1997-2003。長庚護理,29(3),201-205。
  26. 楊嘉玲、孫惠玲(2003)。「照顧者負荷」概念分析。馬偕學報,3,15-27。
  27. 廖士程(2010)。自殺事件-從醫院到社區。台灣醫界,53(5),33-36。
  28. 蔣秀容、林梅鳳、齊美婷(2013)。成年自殺企圖者之自殺行為分析。高雄護理雜誌,30(1),8-20。
  29. 蔡紀葦(2010)。燒炭自殺個案及其照顧者經驗分享。自殺防治網通訊,5(4),14-17。
  30. 盧鴻文(2011)。從「難以承受的告別」一書來看自殺遺族的心路歷程。諮商與輔導,307,38-41。
被引用次数
  1. 盧美言,邱真如,朱慶文(2023)。一位長期血液透析患者食用楊桃汁自殺之急診護理經驗。長庚護理,34卷增訂刊,1-9。
  2. (2023)。《精神衛生法》修法後的電車難題。社區發展季刊,184,453-467。