Influences of Mutuality, Preparedness, and Balance on Caregivers of Patients with Dementia

相互關係、準備度及平衡對失智症照顧者之影響

10.1097/JNR.0b013e3181ed5845

徐亞瑛(Yea-Ing Lotus Shyu)；楊清姿(Ching-Tzu Yang)；黃錦章(Chin-Chang Huang)；郭弘周(Hung-Chou Kuo)；陳獻宗(Sien-Tsong Chen)；徐文俊(Wen-Chuin Hsu)

照顧者相互關係 ； 照顧準備度 ； 照顧平衡 ； 照顧者角色緊張 ； 照顧酬賞 ； mutuality ； preparedness ； balance ； caregiver role strain ； caregiving rewards

The Journal of Nursing Research

18卷3期（2010 / 09 / 01）

155 - 163

英文

背景　目前文獻中，鮮有研究探討台灣失智老人的家屬在執行照顧角色上對照護過程的影響。 目的　本研究目的在於探討照顧者角色，執行變項包括：相互關係、準備度及競爭性需要之平衡與正向、負向照顧結果的關係。 方法　本研究為一橫斷相關研究，樣本取自北部某醫學中心及地區醫院的神經內科門診。共有176位失智老人的家屬照顧者完成家庭照顧量表(FCI)。 結果　在控制照顧者的年齡、性別以及失智老人的認知功能等變項，照顧者的相互關係與照顧者的角色緊張和憂鬱症狀呈負相關，但與其照顧酬賞和心理衛生情況呈正相關；具較佳準備度的照顧者也有較好的照顧酬賞感受和心理衛生狀況。較不易找到平衡點的照顧者出現較高的憂鬱傾向並具較差的心理衛生狀況。 結論／實務應用　醫療專業人員宜對低度相依關係、較少準備度、較差尋找平衡能力的照顧者，加以關注、支持和諮詢，發展相關介入措施。尤其是低度相互關係的家屬照顧者，常是照顧負荷和憂鬱的高危險群，更需要儘早確認並予以處置，也可進一步提升照顧者的準備度，以增進其照顧酬賞的感受和心理衛生狀況。

Background: There is a lack of research exploring the influence of the role implementation process of family caregivers of older people with dementia in Taiwan. Purpose: The purpose of this study was to investigate the predictive ability on positive and negative caregiving outcomes of several role implementation variables, including mutuality, preparedness, and balance between competing needs. Methods: A cross-sectional, correlational study design was used. Data were collected from family caregivers of patients with dementia from neurological clinics at a medical center and at local hospitals through a take-home mail survey. One hundred seventy-six family caregivers of patients with dementia completed the Family Caregiving Inventory. Results: After controlling for age and gender of the family caregiver and the cognitive function of the elderly patients, mutuality was found to associate negatively with role strain and depressive symptoms and positively with rewards and mental health. Higher preparedness was associated with higher caregiving rewards and better mental health. Less balance was associated with more severe depressive symptoms and poorer mental health. Conclusions/Implications for Practice: Greater attention, support, and consultation should be directed at caregivers with low mutuality, less preparedness, and less balance between competing needs. Specifically, family caregivers with low mutuality are at risk of higher role strain and more depressive symptoms. Those in such a category should be identified and should receive intervention as early as possible. Interventions to enhance family caregiver preparedness should be developed to increase caregiving rewards and to improve caregiver mental health.

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