Caregiver Efficacy and Efficacy Determinants for Elderly Care Recipients Who Accept Home Respite Care in Taiwan

台灣居家式喘息服務老人中其主要照顧者效益及其影響因素之探討

陳翠芳(Tsui-Fang Chen)；黃璉華(Lian-Hua Huang)

居家式喘息服務 ； 老人 ； 主要照顧者 ； 效益 ； in-home respite care ； elderly care recipients ； caregivers ； efficacy

The Journal of Nursing Research

18卷1期（2010 / 03 / 01）

18 - 25

英文

背景　本研究主要是在探討台灣地區居家式喘息服務的效益及影響效益的因素。目的　研究目的為瞭解居家式喘息服務老人，其主要照顧者的效益類型及影響各效益的相關因素，包括：老人特質與主要照顧者特質。 方法　居家式喘息服務慢性病之老人的主要照顧者共117位接受效益量表施測。本研究包含三項測量工具：（一）主要照顧者特質包括基本資料、與老人的關係、本身健康狀況、與照顧年限；（二）老人特質包括基本資料、患病種類、與自我照顧能力；（三）主要照顧者效益量表分五項次量表：生理健康、心理情緒壓力、社會關係、照顧工作、與家庭角色功能之五大層面。測量工具的效度採內容效度與表面效度；信度採用Cronbach's alpha係數測量其內在一致性的程度，前驅與正式研究的結果分別為.92與.90。 結果　研究結果顯示：(l)主要照顧者所感受到的效益高低排序為：照顧工作＞心理情緒壓力＞家庭角色功能＞生理健康＞社會關係。(2)主要照顧者特質中：年齡大於65歲以上、有偶、罹患慢性病、自覺目前健康差、與過去比較目前健康狀況較差、與照顧年限≥10年者，其所知覺的效益較高。(3)老人特質中：患病種類的多寡、工具性日常生活活動能力與效益呈現相關性。 結論／實務應用　本研究結果可提供給制訂政策者與受託單位，作為未來居家式喘息服務之政策規劃與執行的參考。

Background: This study examined the efficacies and the determining factors of respite care in an effort to assess the effectiveness of respite care policy implementation in Taiwan. Purpose: This study sought to identify the impact of home respite care on caregivers who used the service. Impact was defined to include the effects on the caregiver and considered the background characteristics of both caregivers and elderly care recipients. Methods: The efficacies of respite care in 117 caregivers, all of whom were currently caring for elderly care recipients suffering from chronic diseases, were rated on relevant efficacy scales. This research used three measures, including (1) caregiver data (demographics, relationship with care recipient, personal health status, and duration of care), (2) elderly care recipient data (demographics, number of distinct medical conditions, and self-care ability), and (3) efficacy scales consisting of the five subscales of physiological health, psychological emotion, social relationships, care tasks, and family roles. Content and face validity were used to evaluate the test instrument, and reliability was established through internal consistency testing. Cronbach's alphas for the pilot study and formal research were .92 and .90, respectively. Results: Efficacies identified by caregivers were, in order of importance, care tasks, psychological emotions, family roles, physiological health, and social relationships. Factors that positively and significantly affected respite care efficacy for caregivers included being 65 years of age or more, currently married, suffering from chronic illnesses, having a poor present health status, having a declining health status, and having cared for their elderly care recipient for 10 years or more. Elderly care recipient factors that significantly influenced respite care efficacy included health status and instrumental activities of daily living (IADL) score. Conclusions and Implications for Practice: The results of this study should be helpful to decision makers and home support service units in planning and implementing in-home respite care programs and policies in the future.

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