社區精神分裂症個案自我照顧能力與家屬負荷程度之研究

The Research on Community Schizophrenia Client’s Self-Care Ability and Family Members’ Degree of Load

10.6822/CTUST.2012.00062

余文雯

社區精神分裂症個案 ； 家屬負荷 ； 自我照顧能力 ； Community patients with schizophrenia ； Burden of family members ； Self-care ability

中臺科技大學護理研究所學位論文

2012年

碩士

黃心樹

繁體中文

本研究主要探討社區精神分裂症個案自我照顧能力與家屬照顧負荷之影響因素。以橫斷式調查研究，採立意取樣，以中部某精神科專科醫院精神分裂症門診及居家治療個案之家屬共150名為研究對象。以結構式問卷調查收集資料。研究工具包括：社區精神分裂症個案屬性、病患精神症狀檢查表、自我照顧量表、家屬屬性及照顧者負荷量表。 研究結果發現：（1）社區精神分裂症個案自我照顧能力以生理性最佳，其次是健康性，社會性自我照顧能力最差；教育程度大學較國中者佳、已婚較未婚者佳；有職業者較無職業者佳；精神疾病住院年數越久則自我照顧能力越差；有依醫囑規則服藥其自我照顧能力優於未規則服藥者；無藥物副作用者其自我照顧能力優於有藥物副作用者；精神症狀越嚴重則自我照顧能力越差。（2）精神分裂症個案的家屬負荷程度平均23.23±10.06分，為中度負荷，近兩年內精神科急性病房住院次數、門診或居家治療方式、是否依醫囑規則服藥、個案精神症狀及自我照顧獨立程度與家屬負荷達顯著相關。（3）家屬負荷解釋因子：個案近兩年內精神科急性病房住院次數、門診或居家治療方式、有無規則服用精神科藥物、個案其他行為症狀及自我照顧獨立程度。 依據以上研究結果，研究者提出社區精神醫療照顧的三點建議：（1）增加社區精神分裂症個案居家治療方式；（2）提升社區精神分裂症個案自我照顧能力；（3）落實減輕家屬負荷措施，進而減輕家屬的照顧負荷。

This study mainly investigated the factors affecting self-care ability and family care burden of community patients with schizophrenia. This cross-sectional study used purposive sampling to enroll 150 family members of patients attending the outpatient clinics of schizophrenia at a certain psychiatric hospital in central Taiwan and those receiving home treatment, and used a structured questionnaire to collect data. The research tools included community patients with a schizophrenia attributes scale, psychiatric symptoms checklist, self-care scale, family member attributes scale, and caregiver burden scale. The research results showed that (1) the physical self-care ability of community patients with schizophrenia was the best, followed by health and social self-care ability; the self-care ability of patients who were college graduates was better than that of those who were junior high school graduates; the ability of those who were employed was better than that of those who were not employed; the self-care ability of patients who were hospitalized for a longer period of time was poorer; the self-care ability of patients who took drugs regularly according to doctors’ orders was better than that of those who did not take drugs regularly; the self-care ability of patients who did not suffer from the side effects of the drugs was better than that of those who suffered from side effects; and the self-care ability of patients whose psychiatric symptoms were more severe was poorer; (2) the average level of burden of family members of patients with schizophrenia was 23.23±10.06 points, meaning at medium level; the patients’ number of acute hospitalization at the Division of Psychiatry within recent two years, whether patients receive the treatment at outpatient clinic or the home treatment, whether patients take drugs according to doctor’s orders, psychiatric symptoms, and level of self-care independence were significantly correlated with family members’ burden; and (3) the explanatory factors for family members’ burden were the number of times hospitalized in the acute psychiatric wards within the past two years, treatment methods at home or at the outpatient clinic, whether patients regularly take the drugs prescribed by the Division of Psychiatry, other behavioral symptoms of the patients, and patients’ level of self-care independence. The researcher proposed three suggestions for community mental health care according to the research results above: (1) to increase home treatments for community patients with schizophrenia; (2) to improve the self-care ability of community patients with schizophrenia; and (3) to implement the measures alleviating the burden of family members to further alleviate the burden of family members.

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