|
本研究採橫斷式調查研究，主要目的在瞭解台北市居家照顧之植物人與主要照顧者的基本特質，及主要照顧者的社會支持、壓力與健康狀況，並進一步探討壓力的影響因素及壓力與健康狀況的關係。訪談期間於民國86年3月1日至6月25日以台北市植物人居家主要照顧者為研究對象，利用結構式問卷訪問之方式，進行研究資料的收集，計收得有效樣本56人，本研究重要發現歸納如下：
一、台北市居家照顧之植物人患者平均年齡56.09歲，無意識期間平均7.77年，女略多於男，以不識字、小學或國(初)中程度較多，病因主要為腦中風、腦外傷，採在家照顧方式的主要原因為機構的花費太大、因家裡有人可以照顧與機構照顧不佳。主要照顧者平均年齡51.46歲，照顧期間平均7.32年，多為女性、有偶、與病患同住、信仰佛教、無職業及小學程度，照顧者與病患間的關係主要有配偶、父母、女兒與媳婦。
二、社會支持的需要程度在「有些需要」之程度，社會支持的足夠度在「略不足」之程度。社會支持系統以「有人提供您所需要的書面資料」最缺乏，社會支持系統的來源主要為家人。
三、主要照顧者的壓力，以「病患身體症狀」所造成的壓力最高，「社交活動改變」次之，「照顧病患的認知與能力」的壓力感受最低。
四、主要照顧者的健康狀況以「焦慮」最常發生、其次依序為「社會功能不良」、「身體症狀」、及「憂鬱」。
五、主要照顧者年齡、照顧期間、與病患感情等與社會支持需要程度有關。病患年齡、居家照護服務情形，及主要照顧者的照顧期間、輪流照顧者、罹病情形等與社會支持足夠度有關。
六、影響主要照顧者整體壓力之因素有主要照顧者性別、罹病情形、輪流照顧者、病患年齡、居家照護服務、社會支持需要程度、社會支持足夠度等。
七、主要照顧者的壓力與身體症狀、焦慮、憂鬱等健康狀況呈負相關
八、主要照顧者壓力的重要影響因素有：社會支持足夠度、社會支持需要程度、及照顧者為女性等三個變項。
建議針對植物人病患與主要照顧者之基本特性、社會支持的需要程度及足夠度，提供居家照護服務，以減輕主要照顧者之壓力。
The purposes of this cross-sectional study were to understand the demographic characteristics, social support, stress and health status for the homebound Persistent Vegetative State (PVS) patients'' caregivers in Taipci and to expore how primary caregivers'' stress correlated with their demographic characteristics, social support and health status. Subjects of this study consisted of 56 PVS patients and their caregivers were selected from 12 public health departments in Taipei. The research period was from March to June, 1997. A structural questionnaire was utilized by the technique of face to face interview. The important results were summarized as followed:
1. The mean age of patients was 56.09. A mean of 7.77 years of unconscious period for PVS patients was significant. The majority of patients were female with a lower educational level. The causes of PVS were CVA and brain injure. Reasons that incurred patients stayed at home for receiving services were institutional care was too expensive and not satisfied by family caregivers. The mean age of caregivers was 51.46. The average duration for providing care to the sick family was 7.32 years. Most of them were female with unemployment status and had primary school education. The relations between caregiver and patient were spouse, parent, daughter and daughter-in-law.
2. The caregivers had a little degree need of social support and received it adequately. The most needy kind of social support was information related to PVS. The family support was main resource of social support.
3. Caregivers'' stress was related to patients'' physical symptoms which was the first one, changes of social activities was the second, and the last one was the cognition and capability of caring patients.
4. The happen frequency of caregivers'' health problems by orderly were anxiety, dysfunction of social activities, physical symptoms, and depression.
5. Caregivers'' age, the duration of providing care, and the good relationship between patients'' were correlated with the need level of social support. Patients'' age, receiving home care service, the duration of providing care, rotate caring with other family members and types of illness were correlated with the adequacy degree of social support.
6. The variables influenced caregivers'' stress were their gender, health status, whether received home care services, providing care by rotating, patients'' age, the need level of social support, and the adequacy degree of social support.
7. Physical symptoms, anxiety and depression were negatively correlated with caregivers'' stress.
8. The most important factors related to caregivers'' stress were the adequacy degree of social support, the need level of social support, and female caregiver.
It proposed to provide home care services could lessen the stress of caregiver''s which was based on findings of PVS patients and their caregivers'' characteristics and the different kinds, levels, and degree of social support.
|