居家照護病患之主要照顧者正負向照顧經驗及其相關因素之探討

Primary Caregivers of Home Nursing Care Recipients: Their Caregiving Experiences and Related Factors

10.6225/JNHR.7.2.127

蕭佳莉(Chia-Li Hsiao)；邱啟潤(Chii-Jun Chiou)

主要照顧者 ； 正負向照顧經驗 ； 健康狀況 ； 家庭功能 ； primary caregiver ； positive and negative caregiving experience ； health status ； family function

護理暨健康照護研究

7卷2期（2011 / 06 / 01）

127 - 139

繁體中文

背景　台灣人口快速老化，長期照護需求日漸增加，主要照顧者扮演著重要角色，欲瞭解主要照顧者在照顧過程中所感受到的照顧經驗，以利其照護品質的提升。 目的　本研究探討主要照顧者之正、負向照顧經驗及其相關因素。 方法　採橫斷性研究，以居家照護病患的主要照顧者為研究對象，共收案120位。以結構式問卷調查，內容包括：病患之疾病狀況、主要照顧者的個人屬性、健康狀況、家庭功能和其照顧經驗。量表之CVI值.91，Cronbach's α值.80~.91。 結果　在照顧者照顧過程中，感受到正向及負向的照顧經驗；正向照顧經驗裡，以「我真的願意照顧病人」得分最高，「我怨嘆必須照顧病人」得分最低，其預測因子為健康狀況、與病人之感情關係及家庭功能，共解釋變異量26.6%。負向照顧經驗中，以「時間的安排」得分最高，「缺乏家人支持」得分最低，其預測因子為健康狀況及每週照顧事項頻率，共解釋變異量34.0%。 結論／實務應用　接受居家照護病患之照顧者在照顧過程中，感受到正、負向照顧經驗，受到本身健康狀況、與病人感情關係、家庭功能及照顧事項之頻率所影響。在臨床實務時，應瞭解主要照顧者照顧現況，給予讚美及鼓勵，減少負向照顧經驗感受。

Background: Taiwan's rapidly aging population is increasing demand for long-term care delivered by primary caregivers. It is important to understand the care experience of primary caregivers in order to enhance quality of care. Purpose: The study explored the caregiving experiences of primary caregivers and assessed predictors of positive and negative caregiving experiences. Methods: Researchers conducted a cross-sectional study and recruited 120 primary caregivers of patients receiving home nursing care from hospital-based home care agencies. Structured questionnaires were used to collect data on subject personal attributes, health status, family function and caregiving experience as well as the disease status of patients. Content validity (CVI=.91) and internal consistency (Cronbach's α=.80-.91) were used to examine scale reliability. Results: Caregivers reported having both positive and negative experiences in caregiving, with ”I really want to care for the patient” reflecting the most positive and ”I complain about taking care of the patient” reflecting the most negative experiences. In terms of negative care experiences, ”timing” earned the highest and ”lack of family support” the lowest scores. Predictors of positive caregiving experiences included health status, emotional relationship with patient, and family function, which together explained 26.6% of variance; Predictors of negative caregiving experiences included health status and weekly frequency of care matters, which together explained 34.0% of variance. Conclusions/Practical application: The study suggests the positive and negative caregiving experiences among primary caregivers of patients receiving home care nursing are affected by personal health status, emotional relationship with patient, family function, and frequency of care. In clinical practice, medical staff should be aware of the status of primary caregiver and give praise and encouragement in order to reduce negative caregiver feelings toward their caregiving experience.

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