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研究生:黃寶珠
研究生(外文):Pao-Chu Huang
論文名稱:腸胃道癌症手術病人主要照顧者的負荷及相關因素
論文名稱(外文):Family Caregiver Burden and Its Correlatesin Surgical Patients of Gastrointestinal Cancer
指導教授:林佳靜林佳靜引用關係
指導教授(外文):Chia-Chin Lin
學位類別:碩士
校院名稱:臺北醫學大學
系所名稱:護理學研究所
學門:醫藥衛生學門
學類:護理學類
論文種類:學術論文
論文出版年:2007
畢業學年度:95
語文別:中文
論文頁數:152
中文關鍵詞:腸胃道癌症手術病人疼痛干擾主要照顧者主要照顧者焦慮憂鬱照顧者睡眠照顧負荷
外文關鍵詞:Surgical patients of gastrointestinal cancerpain interferencecaregivercaregiver’s anxiety and depressioncaregiver’s sleep statuscaregiving burden
相關次數:
  • 被引用被引用:17
  • 點閱點閱:372
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  • 下載下載:23
  • 收藏至我的研究室書目清單書目收藏:7
本研究是以橫斷式研究法,探討台北某醫學中心之腸胃道癌症手術病人主要照顧者的負荷及相關因素。共收集95位病人及其主要照顧者,收集資料包含病人人口學資料、病人疼痛狀況、主要照顧者焦慮及憂鬱情形及照顧者之人口學資料、照顧照顧型態與睡眠狀況,同時使用照顧者反應評估量表(CRA)測量照顧者的照顧負荷程度。資料分析方式包含描述性統計、t檢定、單因子變異數分析、皮爾森積差相關檢測與逐步迴歸分析結果發現:(1)主要照顧者負荷的嚴重程度依序為時間安排、健康負荷、經濟負荷及家人支持。(2)時間安排負荷的重要預測因子為主要照顧者的焦慮程度、照顧類型、主要照顧者睡眠狀況及病人性別為男性,其解釋時間安排負荷總變異量為35.2%(p<.000)。(3)主要照顧者焦慮程度、主要照顧者睡眠狀況及病人使用PCA第三天總量為健康負荷的主要預測因子,其解釋健康負荷總變異量為45.8%(p<.000)。(4)經濟負荷有關的重要的預測因子有照顧前收入高於支出、照顧後收入低於支出、主要照顧者年齡與照顧者憂鬱程度,其解經濟負荷總變異量為37.7%(p<.000)。(5)家人支持負荷重要預測因子為疼痛干擾與照顧類型為輪班照顧者,其解釋家人支持負荷總變異量為16.0%(p<.000)。(6)與主要照顧者自尊感受有關的因素為主要照顧者婚姻狀況。本研究結果可發現主要照顧者在照顧癌症手術病人時會有不同層面的照顧負荷,建議臨床專業人提供協助降低其照顧負荷,藉此照顧品質。
The cross-section study was designed to discuss that the burden and related factors of caregivers for patients with gastrointestinal cancer post surgery in certain medical center in Taipei.
It included 95 dyads of patents and their caregivers. The data includes of patients’ demographic, pain condition of patients(Belief Pain Inventory Short Form - Taiwan ,BPI-T), caregiver’s demographics and caregiver’s psychological distress(measured with The Hospital Anxiety and Depression, HADS), the type of care and caregiver’s sleep(measured with Karolinska Sleep Diary, KSD), and the caregiver’s burden(measured with the Caregiver Reaction Assessment, CRA).
The methods of analysis included descriptive statistics, independent t-test, one-way ANOVA, Pearson’s correlation, and stepwise regressions. The result shows that(1)The severity of care burden on the primary caregiver was in the order: disrupted schedual, health problems, financial problems, and lack of family support.(2)The main predictors of disrupted schedual were the anxiety of caregiver, type of care, the sleep of caregiver, and male gender.(3)The main predictors of caregiver’s health problems were caregiver’s anxiety, caregiver’s sleep status and total dose of PCA in the 3rd day.(4)The main predictors of financial problems included income more then expanse before care, income less than expanse after care,the caregiver’s age and depression.(5)The main predictors of lack of family support included the disturbance of pain, and the type of care was in shifts.(6)The factors related to caregiver’s feeling of self esteem included the caregiver’s marriage.
The result showed that there are different aspects of caregiver’s burden in caring for cancer patient post surgery; the recommendation is that clinical caregiver supplied the assistance to reduce the burden in order to improve caring quality.
致謝 Ⅰ
中文摘要 IV
英文摘要 VI
目錄 VIII
圖表目次 XI

第一章 緒論
第一節 研究動機 1
第二節 研究目的 3
第二章 文獻查證
第一節 照顧者負荷 4
第二節 影響照顧者負荷之病人因素 7
第三節 影響照顧者負荷之照顧者因素 14
第四節 負荷對照顧者的影響 22
第五節 測量照顧者負荷工具 25
第六節 操作型定義 27
第七節 概念架構 28
第八節 研究假設 30
第三章 研究方法
第一節 研究設計 31
第二節 研究場所與對象 33
第三節 研究工具 33
第四節 研究變項 39
第五節 研究進行步驟 39
第六節 研究對象的權益保護 40
第七節 資料分析 40
第四章 結果分析
第一節 病人之人口學特質與疾病相關資料 44
第二節主要照顧者人口學特質、照顧型態與睡眠狀態 48
第三節 病人疼痛 55
第四節 主要照顧者心理狀態 58
第五節 主要照顧者的照顧負荷程度 60
第六節 病人人口學、疾病特徵與照顧者負荷的相關 63
第七節 病人疼痛、照顧者心理狀態與照顧者負荷的相關 67
第八節 主要照顧者人口學、照顧型態、睡眠與照顧者負荷的相關 71
第九節 照顧者負荷的預測因素 81
第五章 討論
第一節 主要照顧者之照顧負荷現況 84
第二節 照顧者負荷之相關因素 88
第三節 其他 96
第六章 結論與建議
第一節 結論 99
第二節 研究限制 100
第三節 建議 101
參考資料
中文部份 103
英文部份 106
附錄
附錄一 病人參與研究同意書 124
附錄二 主要照顧者參與研究同意書 125
附錄三 病人基本資料與疾病特徵 126
附錄四 照顧者基本資料 128
附錄五 主要照顧者照顧型態 129
附錄六 台灣版簡明疼痛表 130
附錄七 醫院焦慮憂鬱表 133
附錄八 Karolinska Sleep Diary. 135
附錄九 照顧者反應評估量表 136





圖表目次

圖一 研究架構 29
表一 照顧者負荷評估工具比較 26
表二 收集資料與工具 32
表三 推論統計的方法 42
表四 病人人口學特質及疾病特徵 46
表五 主要照顧者人口學特徵、照顧型態與睡眠狀態 50
表六 病人手術後疼痛 56
表七 主要照顧者心理狀態 59
表八 主要照顧者的照顧負荷分析 62
表九 病人人口學及疾病特徵與照顧者之健康負荷、時間安排負荷、經濟負荷、家人支持負荷與自尊感受的差異性分析 64
表十 病人疼痛、疼痛干擾、主要照顧者焦慮憂鬱與照顧者之健康負荷、時間安排負荷、經濟負荷、家人支持負荷及自尊感受的相關分析 69
表十一 主要照顧者人口學照顧型態及睡眠特徵與照顧者之健康影響、時間安排、經濟影響、家人支持與自尊感受的差異性分析 74
表十二 預測照顧者時間安排負荷、健康負荷、經濟負荷與家人支持負荷相關變項之逐步迴歸分析 83
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