中風病人之非正式照顧者的社會支持狀態

Social Support Status in Informal Caregivers of Stroke Patients

10.6315/2015.43(3)01

李炎諭(Yan‐Yuh Lee)；吳宜華(Yee‐Hwa Wu)；陳怡璇(I‐Hsuan Chen)；張谷州(Ku‐Chou Chang)；黃裕淨(Yu‐Ching Huang)；洪禎雯(Jen‐Wen Hung)

中風 ； 照顧者 ； 社會支持 ； stroke ； caregiver ； social support

台灣復健醫學雜誌

43卷3期（2015 / 09 / 01）

141 - 147

繁體中文

目的：非正式照顧者在中風後照顧扮演重要角色，本研究旨在探討1.中風後的十八個月期間，照顧者之社會支持狀態2.照顧者健康狀態與社會支持程度之關係3.低社會支持度的預測因子。方法：研究個案來自一家醫學中心的首次缺血性中風病人和他們的非正式照顧者。在中風後3、6、18個月我們使用社會支持量表評估中風病人之非正式照顧者的社會支持度，並在第18個月用貝克憂鬱量表和簡短36健康量表工具評估照顧者之健康狀態。結果：45位中風病人(男性25 位，女性20位)和他們的非正式照顧者(男性14位，女性31位)完成了全部的評估。照顧者的社會支持度在病人中風3、6、18個月分別為66.56±9.14、66.47±9.17、59.00±11.62，在第18個月時有顯著下降(p＜0.001)。病人中風後第18 個月照顧者的社會支持量表分數與貝克憂鬱量表分數呈現負相關(r= -0.57; p＜0.05)，而與簡短36 健康量表工具內的身體綜合分數(r= 0.5，P＜0.05)與心理綜合分數(r= 0.49，p＜0.05)呈現正相關。迴歸分析顯示：非正式照顧者教育程度較低，照顧的病人認知功能較差與缺乏外籍看護工協助均為日後照顧者低社會支持度的預測因子(p＜0.05，R2 = 0.38)。結論：中風病人之非正式照顧者的社會支持狀況在中風慢性期顯著下降，並與照顧者的憂鬱情緒和生活品質有關。我們應針對教育程度較低，沒有外籍看護工和照顧認知功能較差的中風患者的照顧者強化其社會支持系統。

Objective: Informal caregivers play an important role in post-stroke care. In the present study, we aimed to investigate the social support status over an 18-month duration; the relationship between health status and social support level; and the predictors of low social support status in informal caregivers of stroke patients. Methods: We recruited eligible inpatients with first-ever ischemic stroke and their informal caregivers from a tertiary referral teaching hospital. The social support rating scale (SSRS) of the caregivers was determined at 3, 16, and 18 months after stroke onset. Beck depression inventory (BDI) as well as the physical and mental composite score (PCS and MCS) of the 36-Item Short Form Health Survey (SF-36) of caregivers were assessed at 18 months after stroke onset. Results: A total of 45 stroke survivors (men, 25; women, 20) and their caregivers (men, 14; women, 31) completed all the interviews. The SSRS score was 66.56±9.14, 66.47±9.17, and 59.00±11.62 at 3, 6, and 18 months after stroke onset, respectively, and the score at 18 months was significantly lower than that at 3 and 6 months after stroke onset(p＜0.001). The SSRS score showed a significant negative correlation with BDI (r=-0.570; p＜0.05) and positive correlation with PCS (r=0.5, p＜0.001) and MCS (r=0.494, p=0.001) of the SF-36 at 18 months after stroke onset. Regression analysis indicated that informal caregivers with a lower education level, caring for stroke patients with worse cognitive function, and the lack of help from a foreign caregiver were predictors of a poor social support status at 18 months after stroke onset (p=0.014, R2=0.380). Conclusions: The social support status of informal caregivers of stroke patients significantly declined at the chronic stage after stroke onset, and was associated with depression and the quality of life of informal caregivers. The social support system should be reinforced among caregivers with a lower education level, those caring for patients with worse cognition, and those lacking the assistance of a foreign caregiver.

1. 卓宜陵(2017)。外籍看護工社會支持與憂鬱之相關性探討。中山醫學大學護理學系學位論文。2017。1-54。