题名

失智症家庭照顧者的社會支持與生活品質之相關性研究

并列篇名

Exploring the relationship between social support and quality of life among family caregivers of patients with dementia

DOI

10.6288/TJPH.202302_42(1).111081

作者

謝寧惠(Ning-Huei Sie);鍾國彪(Kuo-Piao Chung);曹汶龍(Wen-Long Tsao)

关键词

失智症 ; 家庭照顧者 ; 社會支持 ; 生活品質 ; dementia ; family caregiver ; social support ; quality of life

期刊名称

台灣公共衛生雜誌

卷期/出版年月

42卷1期(2023 / 02 / 24)

页次

100 - 116

内容语文

繁體中文;英文

中文摘要

目標:本研究探討台灣失智症家庭照顧者的社會支持與生活品質之現況與相關性。方法:採「人際支持評估量表簡版量表」問卷與「世界衛生組織生活品質問卷台灣版」進行橫斷性調查,包括社會支持來源與情感性、資訊性、工具性與評價性社會支持,及生理健康、心理健康、社會健康與環境等生活品質構面,同時納入家庭照顧者人口學特性與照顧型態。調查對象為雲林嘉義地區失智症患者之家庭照顧者。應用雙變量與複迴歸模型來探討社會支持對於生活品質的影響。結果:完成384位失智症家庭照顧者調查,回收率86.7%。平均照顧者的年齡為58.08歲、女性佔61.72%,平均照顧年數3.97年。醫療專業人員社會支持較家人親友高,生活品質以生理健康最高分,女性的心理健康較差,配偶與全職照顧者其生活品質的各面向皆顯著較低。家人親友社會支持皆與生活品質各範疇滿意程度有顯著正相關。結論:此研究指出雲嘉地區失智病患家庭照顧者的社會支持程度較高其生活品質較佳,因此社區結合居家的共同照顧,並以醫療為後盾,可作為偏鄉制定失智症照顧政策之參考。

英文摘要

Objectives: To investigate the correlation between social support and quality of life (QoL) among family caregivers of patients with dementia in Taiwan. Methods: A cross-sectional survey was conducted using the Interpersonal Support Evaluation List and WHOQOL-BREF questionnaires to investigate the sources of social support (emotional, informational, instrumental, and appraisal support) and to analyze QoL in several domains (physical health, psychological health, social relationships, and environment) among family caregivers of patients with dementia in Yunlin and Chiayi, Taiwan. Demographic variables and care patterns were also analyzed. Bivariate and multiple regression analyses were performed to evaluate the correlations between the factors associated with social support and QoL. Results: A total of 384 family caregivers of patients with dementia completed the survey. The response rate was 86.7%. The average age of the participants was 58.08 years, and 61.72% of the participants were women. The average care duration was 3.97 years. The participants reported receiving more social support from healthcare professionals than from family and friends. Among the QoL domains, physical health had the highest score and psychological health was higher among men than among women. The QoL scores in all four domains were significantly lower for spouses and full-time caregivers than for the other types of caregivers. Conclusions: The family caregivers of patients with dementia in rural areas receive more social support and have a better QoL than those in urban areas. Cooperation among medical professionals, the community, and family members is essential for effective dementia care. These findings can be used as a reference for the development of dementia care policies.

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. Wang, YN,Hsu, WC,Shyu, YL(2020).Job demands and the effects on quality of life of employed family caregivers of older adults with dementia: a cross-sectional study.J Nurs Res,28,e99.
    連結:
  2. Yeh, TY,Su, JA,Chang, CC(2022).Factors associated with the quality of life in family caregivers of people with dementia in Taiwan.Taiwanese J Psychiat,36,124-130.
    連結:
  3. 邱啟潤, CJ,許淑敏, SM,吳淑如, SZ(2003)。居家照護病患之主要照顧者綜合性需求調查。醫護科技學刊,5,12-25。
    連結:
  4. 施姵宇, PY,古鯉榕, LJ,白明奇, MC,劉立凡, LF(2017)。失智症家庭使用長期照顧服務的情形與不使用的原因。台灣衛誌,36,375-385。
    連結:
  5. 詹書媛, SY,游曉微, HW,楊銘欽, MC,李玉春, YC,陳雅美, YM(2018)。失智症與非失智症長者之照顧者醫療服務利用之比較。台灣衛誌,37,664-675。
    連結:
  6. Baumgarten, M,Battista, RN,Infante-Rivard, C,Hanley, JA,Becker, R,Gauthier, S(1992).The psychological and physical health of family members caring for an elderly person with dementia.J Clin Epidemiol,45,61-70.
  7. Biderman, A,Carmel, S,Amar, S,Bachner, YG(2021).Care for caregivers- a mission for primary care.BMC Fam Pract,22,227.
  8. Bruvik, FK,Ulstein, ID,Ranhoff, AH,Engedal, K(2012).The quality of life of people with dementia and their family carers.Dement Geriatr Cogn Disord,34,7-14.
  9. Clyburn, LD,Stones, MJ,Hadjistavropoulos, T,Tuokko, H(2000).Predicting caregiver burden and depression in Alzheimer’s disease.J Gerontol B Psychol Sci Soc Sci,55,S2-S13.
  10. Cohen, S,Syme, SL(1985).Social Support and Health.San Diego, US:Academic Press.
  11. Dixit, D,Spreadbury, J,Orlando, R,Hayward, E,Kipps, C(2021).Quality of life assessments in individuals with young-onset dementia and their caregivers.J Geriatr Psychiatry Neurol,34,426-433.
  12. Dooley, NR,Hinojosa, J(2004).Improving quality of life for persons with Alzheimer’s disease and their family caregivers: brief occupational therapy intervention.Am J Occup Ther,58,561-569.
  13. Farina, N,Page, TE,Daley, S(2017).Factors associated with the quality of life of family carers of people with dementia: a systematic review.Alzheimers Dement,13,572-581.
  14. Gauthier, S,Rosa-Neto,Morais, JA,Webster, C(2021).World Alzheimer Report 2021: Journey through the Diagnosis of Dementia.London, UK:Alzheimer’s Disease International.
  15. Holopainen, A,Siltanen, H,Pohjanvuori, A,Mäkisalo-Ropponen, M,Okkonen, E(2019).Factors associated with the quality of life of people with dementia and with quality of life-improving interventions: scoping review.Dementia,18,1507-1537.
  16. Hough, ES,Magnan, MA,Templin, T,Gadelrab, HF(2005).Social network structure and social support in HIV-positive inner city mothers.J Assoc Nurses AIDS Care,16,14-24.
  17. Igarashi, A,Fukuda, A,Teng, L,Ma, FF,Dorey, J,Onishi, Y(2020).Family caregiving in dementia and its impact on quality of life and economic burden in Japan-web based survey.J Mark Access Health Policy,8,1720068.
  18. Kasai, M,Meguro, K(2018).Patients with very mild dementia may confuse objective cognitive impairments with subjective physical health of quality of life: the Tome City Project in Japan.Front Psychol,9,533.
  19. Langford, CPH,Bowsher, J,Maloney, JP,Lillis, PP(1997).Social support: a conceptual analysis.J Adv Nurs,25,95-100.
  20. Lethin, C,Renom-Guiteras, A,Zwakhalen, S(2017).Psychological well-being over time among informal caregivers caring for persons with dementia living at home.Aging Ment Health,21,1138-1146.
  21. Leung, AYM,Molassiotis, A,Zhang, J(2020).Dementia literacy in the Greater Bay Area, China: identifying the at-risk population and the preferred types of mass media for receiving dementia information.Int J Environ Res Public Health,17,2511.
  22. Li, Y,Hu, L,Mao, Xe(2020).Health literacy, social support, and care ability for caregivers of dementia patients: structural equation modeling.Geriatr Nurs,41,600-607.
  23. Lucas-Carrasco, R,Skevington, SM,Gómez-Benito, J,Rejas, J,March, J(2011).Using the WHOQOL-BREF in persons with dementia: a validation study.Alzheimer Dis Assoc Disord,25,345-351.
  24. Miller, B,Guo, S(2000).Social support for spouse caregivers of persons with dementia.J Gerontol B Psychol Sci Soc Sci,55,S163-S172.
  25. Ryan, KA,Weldon, A,Huby, NM(2010).Caregiver support service needs for patients with mild cognitive impairment and Alzheimer disease.Alzheimer Dis Assoc Disord,24,171-176.
  26. Santos, RL,Sousa, MF,Simões-Neto, JP(2014).Caregivers’ quality of life in mild and moderate dementia.Arq Neuropsiquiatr,72,931-937.
  27. Takahashi, M,Tanaka, K,Miyaoka, H(2005).Depression and associated factors of informal caregivers versus professional caregivers of demented patients.Psychiatry Clin Neurosci,59,473-480.
  28. Takai, M,Takahashi, M,Iwamitsu, Y,Oishi, S,Miyaoka, H(2011).Subjective experiences of family caregivers of patients with dementia as predictive factors of quality of life.Psychogeriatrics,11,98-104.
  29. Tay, KC,Seow, CC,Xiao, C,Lee, HM,Chiu, HF,Chan, SW(2016).Structured interviews examining the burden, coping, self-efficacy, and quality of life among family caregivers of persons with dementia in Singapore.Dementia,15,204-220.
  30. The WHOQOL Group(1995).The World Health Organization Quality of Life Assessment (WHOQOL): position paper from the World Health Organization.Soc Sci Med,41,1403-1409.
  31. Thoits, PA(1995).Stress, coping, and social support processes: where are we? What next?.J Health Soc Behav,35,53-79.
  32. Thomas, P,Lalloué, F,Preux, P-M(2006).Dementia patients caregivers quality of life: the PIXEL study.Int J Geriatr Psychiatry,21,50-56.
  33. Vellone, E,Piras, G,Talucci, C,Cohen, MZ(2008).Quality of life for caregivers of people with Alzheimer’s disease.J Adv Nurs,61,222-231.
  34. Wang, WF,Su, YY,Jhang, KM,Chen, CM(2021).Patterns of home- and community-based services in older adults with dementia: an analysis of the long-term care system in Taiwan.BMC Geriatrics,21,290.
  35. Warrick, N,Prorok, JC,Seitz, D(2018).Care of community-dwelling older adults with dementia and their caregivers.CMAJ,190,E794-E799.
  36. Zhang, S,Edwards, H,Yates, P,Li, C,Guo, Q(2014).Self-efficacy partially mediates between social support and health-related quality of life in family caregivers for dementia patients in Shanghai.Dement Geriatr Cogn Disord,37,34-44.
  37. 中華民國家庭照顧者關懷總會:研究-2007家庭照顧者現況調查。https://www.familycare.org.tw/policy/10635。引用2019/03/06。 Taiwan Association of Family Caregivers. Survey of the current status of family caregivers in 2007. Available at: https://www.familycare.org.tw/policy/10635. Accessed March 6, 2019. [In Chinese]
  38. 台灣版世界衛生組織生活品質問卷發展小組=The Whoqol-Taiwan Group(2000)。台灣版世界衛生組織生活品質問卷之發展簡介。中華衛誌,19,315-324。
  39. 汪素敏, SM,顧乃平, NP,林幸台, HT,魏崢, J(1998)。心臟移植術後病人症狀困擾、社會支持與自我照顧行為相關之探討。護理研究,6,4-18。
  40. 邱啟潤, CJ,陳武宗, WT,陳宜品, IP(2005)。以Andersen模式探討家庭照顧者對正式支持系統的利用。長期照護雜誌,9,331-348。
  41. 姚開屏, KP(2002)。健康相關生活品質概念與測量原理之簡介。台灣醫學,6,183-192。
  42. 姚開屏, KP.台灣簡明版世界衛生組織生活品質問卷之發展及使用手冊.
  43. 陳貞吟, CY,陳楚杰, CC,蔡明足, MT,沈玉卿, YC,周歆凱, HK,翁林仲, LC(2008)。影響居家長期照護病患主要照顧者生活品質因素之研究。長期照護雜誌,12,267-283。
  44. 湯麗玉, LY,葉炳強, PK,陳良娟, LC,謝碧容, PJ(2000)。失智症家屬支持團體成效初探。應用心理研究,7,171-190。
  45. 歐陽文貞, WC(2021)。失智症疾病照護品質認證:病人為中心的照護觀點。醫療品質雜誌,15,20-25。
  46. 衛生福利部, R.O.C. (Taiwan)(2021)。衛生福利部:失智症防治照護政策綱領暨行動方案2.0。台北:衛生福利部,2021。 Ministry of Health and Welfare, R.O.C. (Taiwan).Dementia Prevention, Treatment, and Care Policy Guidelines and Action Plan 2.0. Taipei: Ministry of Health and Welfare, R.O.C. (Taiwan), 2021. [In Chinese]。
  47. 衛生福利部:106年老人狀況調查報告。台北:衛生福利部,2017。 Ministry of Health and Welfare, R.O.C. (Taiwan). Report of the Senior Citizen Condition Survey in 2017. Taipei: Ministry of Health and Welfare, R.O.C. (Taiwan), 2017. [In Chinese]
  48. 盧鴻毅, HY,劉珈瑄, CH,曹汶龍, WL(2017)。在真實與虛擬之間相互取暖:社會支持對失智症病人照顧者的意義。傳播與社會學刊,142,145-188。