臺灣博碩士論文加值系統

本研究之主要目的在瞭解目前失智老人家庭照顧者之負荷及其支持性服務之需求，並探討負荷與支持性服務需求與其相關因素之關係。研究對象主要以南部某醫學中心之神經科門診患者，採立意取樣，有效樣本為110位。研究工具為結構式問卷，其內容包括七個部分，包括：（1）老人之日常活動功能量表；（2）老人問題行為與情緒量表；（3）照顧者負荷感受量表；（4）照顧者支持性服務需求量表；（5）照顧情形；（6）老人基本資料；（7）照顧者基本資料。統計方法包括：描述性統計、t檢定、單因子變異數分析、最小顯著性差異法、皮爾遜積差相關、及斯皮爾曼等級相關。
本研究結果發現：（1）照顧者之負荷感受度屬輕度至中等程度，以社會生活負荷及生理心理負荷最重；對於在職之照顧者而言，感受最重之工作層面負荷為：因擔心家中老人而無法專心工作。（2）失智症嚴重程度愈重、日常活動功能愈低、問題行為與情緒出現頻率愈高、因照顧老人而離職的照顧者、自覺家庭經濟狀況差的照顧者、照顧時數愈多、及獨自照顧老人之照顧者，照顧者所感受之負荷越重。（3）照顧者之支持性服務需求程度屬中等程度，其中以資訊層面及經濟層面需求最高，心理層面及喘息服務需求較低；在職之照顧者對於彈性上班時間的需求最高。（4）失智症嚴重程度愈重、老人罹患其他慢性疾病、日常活動功能愈低、問題行為與情緒出現頻率愈高、因照顧老人而離職的照顧者、自覺家庭經濟狀況差的照顧者、照顧者年齡愈低、照顧者教育程度愈高、及照顧時數愈多，照顧者對於支持性服務需求的程度亦愈高。

The purposes of this study are, firstly, to understand the burdens and needs of family caregivers with dementia elders; secondly, to explore the relationships between the burdens and related factors; and thirdly, to explore the relationships of the needs for supportive services and related factors.
The samples of this study come from the department of neurology of one medical center in the southern Taiwan. This study uses a purposive sampling strategy and the sample size is 110. This study uses a structural questionnaire that is composed of seven parts, including: (1) Activities of daily living rating scale; (2) Behavior and emotional disturbance rating scale; (3) Burden of caregiver rating scale; (4) Demand of supportive services of caregiver rating scale; (5) Care situation; (6) General information of elders; and (7) General information of caregiver. Statistic methods include descriptive statistic, T test, one-way ANOVA, Least-significant difference (LSD), Pearson''s correlation coefficient and Spearman rank correlation.
The results of this study are: (1) The caregivers with low-level to middle-level burden have the highest social life burdens and physical-psychological burdens. As for the employed caregivers, the highest level of work burden is worrying about the elderly and unable to concentrate on his own work. (2) The caregivers felt more heavier burden in such cases as more serious dementia of the elderly, lower daily-activity ability, greater frequency of abnormal behavior and emotion, quitting job in order to take care of the elderly, perceived poor income, spending more time on taking care the elderly, or take care of the elders alone. (3) The caregivers with middle-level needs for supportive services have the highest level of needs for information and financial support but lower level of needs for respite services and psychological support. The employed caregivers have the highest needs for a flexible work time. (4) The needs for supportive services are higher in such cases as more serious dementia of the elderly, the elders with other chronic disease, lower daily-activity ability, greater frequency of abnormal behavior and emotion, quit job in order to taking care of the elderly, perceived poor income, younger caregiver, higher education, or spending more time on taking care the elderly.

致謝................................................Ⅰ
中文摘要............................................Ⅲ
英文摘要............................................Ⅳ
目錄................................................Ⅵ
圖表目錄............................................Ⅷ
第壹章 緒 論.......................................1
第一節 研究動機與目的.....................1
第二節 解釋名詞...........................6
第貳章 文獻探討....................................7
第一節 失智症患者之特質...................7
第二節 生態系統觀點.......................11
第三節 家庭照顧者之負荷...................14
第四節 家庭照顧者對支持性服務之需求.......22
第參章 研究方法....................................30
第一節 研究架構...........................30
第二節 研究設計...........................37
第三節 研究工具...........................47
第四節 統計分析方法.......................54
第肆章 研究結果....................................56
第一節 老人之疾病特質與家庭照顧情形...............56
第二節 照顧者負荷與支持性服務之需求...............62
第三節 老人特質、照顧者特質、照顧情形
與照顧者負荷...............................67
第四節 老人特質、照顧者特質、照顧情形
與照顧者支持性服務需求.....................77
第伍章 討論、結論與建議............................87
第一節 結果與討論.................................87
第二節 研究限制...................................97
第三節 建議........................................99
參考文獻............................................102
附錄一 專家效度名單................................110
附錄二 研究工具同意書..............................111
附錄三 研究問卷....................................112
附錄四 社會階層評定表..............................121

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