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研究生:江姿穎
研究生(外文):Tzu-YingChiang
論文名稱:探討失智症家庭照顧者自覺健康狀態、照顧態度與照顧能力之關係
論文名稱(外文):Exploring the relationship among self-perception of health, attitudes toward caregiving, and caregiving competence in dementia family caregivers
指導教授:張文芸徐畢卿徐畢卿引用關係
指導教授(外文):Wen-Yun ChengBih-Ching Shu
學位類別:碩士
校院名稱:國立成功大學
系所名稱:護理學系
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:2016
畢業學年度:104
語文別:中文
論文頁數:102
中文關鍵詞:失智症家庭照顧者照顧能力照顧態度自覺健康
外文關鍵詞:dementiafamily caregivercompetenceattitudeself-perception of health
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失智症是老年人常見慢性病之一,隨著台灣人口快速老化,罹患失智症人數亦逐年上升。因疾病特殊性,失智症照顧較其他慢性疾病困難。多數失智症病人住在社區中接受家人照顧,因此,了解家屬是否有足夠能力照顧失智症病人相對重要。由於臨床工作繁忙或礙於時間限制等因素,家屬照顧能力評估易被忽略。此外,照顧者自身健康狀態與面對照顧的態度,亦會影響照顧品質。因而本橫斷性(cross-sectional)、相關性(correlational)研究,目的為探討家庭照顧者自覺健康狀態、照顧態度與照顧能力之現況,並分析失智症病人及家庭照顧者特性、照顧態度、自覺健康狀態與照顧能力間的關係。採立意取樣於南台灣醫院專科門診,以結構性量表收集研究資料,一共納入143對失智症病人與家屬,使用之工具包含基本資料問卷、臨床失智評量表、行為精神症狀檢核表、自我健康觀感評量表、簡式心理健康量表、失智症照顧態度量表、照顧者能力評估表等。所蒐集資料以SPSS 22.0 for Windows統計軟體進行描述性與推論性統計分析。
研究結果發現:(一)失智症病人性別、居住狀態、家庭照顧者經濟狀況、慢性病數目、與病人關係、與病人關係品質及有無親友協助對照顧者自覺健康狀態有統計顯著差異。病人行為精神症狀個數、照顧者照顧時間及每日照顧時數越少則照顧者自覺健康狀態越好。(二)失智症病人性別、教育程度、婚姻狀況、居住狀態、罹患失智症類型、家庭照顧者教育程度、與病人關係、與病人關係品質及有無親友協助對照顧者照顧態度有統計顯著差異。病人行為精神症狀個數越少則照顧態度越正向。(三)失智症病人教育程度、婚姻狀況、居住狀態、有無服用失智藥物、家庭照顧者教育程度、經濟狀況、慢性病數目、與病人關係、有無親友協助及有無使用照顧服務資源對照顧能力有統計顯著差異。照顧者年齡越小、自覺健康狀態越佳及照顧態度越正向則照顧能力越好。(四)以多元迴歸分析探討失智症病人與家庭照顧者人口學變項對照顧者自覺健康狀態、照顧態度與照顧能力之預測情況。照顧者自覺健康狀態部分分為自我健康觀感與身心適應狀況。分析結果顯示,病人與配偶及子女同住、行為精神症狀個數越少、照顧者慢性病數目越少及與病人關係品質越好,則自我健康觀感越佳,模型有28.7%的解釋力;病人行為精神症狀個數越少、照顧者與病人關係品質越好及每日照顧時數越少,則身心適應狀況越良好,模型有21.9%解釋力。病人無配偶、行為精神症狀個數越少及照顧者與病人關係品質越好,則照顧態度越正向,模型解釋力為31.3%。在照顧能力方面,病人有服用失智藥物、照顧者教育程度越高、經濟狀態充裕和有使用照顧服務資源,則照顧者能力越好,模型解釋力為26.4%。(五)以階段方式進行多元迴歸分析,了解自覺健康狀態與照顧態度對照顧能力的影響。在控制人口學變項後,自覺健康狀態可解釋照顧能力5%的變異量,而照顧態度則有2.4%的解釋力,將自覺健康狀態與照顧態度同時置入模型,則對照顧能力有7.8%的解釋力。
照顧者自覺健康狀態與照顧態度是影響照顧能力的因素。研究結果建議,在提升照顧能力時,亦應考量影響照顧能力之因素進行介入處置,以確保失智症病人於家庭中獲得良好照顧品質。

Most patients with dementia have been living in community and taken care by families. Therefore, it is relatively important to understand whether family caregivers are competent to take care of patients with dementia. In addition, caregivers’ perception of their health status and the attitudes toward caregiving affect their care quality. The purposes of this study were to explore the current situation of family caregiving competence and the relationship between patients with dementia and their family caregivers’ characteristics, attitudes toward caregiving, self-perceived health status and caregiving competence. The study was a cross-sectional and correlational study. Purposive sampling in outpatient departments of specialist hospitals in Southern Taiwan was used with structured questionnaires to recruit 143 dyads of patients with dementia and their family caregivers. The findings showed that dementia specific medication taking, caregiver’s education level, economic status, and social service usages had significant impact on caregiving competence. After controlling the demographic variables, self-perception of health and the attitudes toward caregiving explained 7.8% of variance in caregiving competence totally. Self-perception of health and the attitudes toward caregiving affect caregivers’ competence. Therefore, the results suggest that future interventions should put more emphasis on caregivers’ competence and related factors to improve dementia care quality at home.
中文摘要 I
Abstract III
致謝 VI
第一章 緒論 1
第一節 背景與重要性 1
第二節 研究目的 5
第二章 文獻查證 6
第一節 失智症病人之家庭照顧者 6
一、家庭照顧者概述 6
二、家庭照顧者之照顧困境 7
第二節 失智症家庭照顧者之自覺健康狀態 9
一、自覺健康狀態之概述 9
二、家庭照顧者自覺健康狀態之探討 10
第三節 失智症家庭照顧者之照顧態度 11
一、態度之概述 11
二、家庭照顧者照顧態度之探討 11
第四節 失智症家庭照顧者之照顧能力 12
一、家庭照顧相關概念 12
二、照顧能力之定義 13
三、家庭照顧者照顧能力之探討 14
總結 17
第三章 研究方法 18
第一節 研究架構 18
第二節 名詞界定 19
第三節 研究設計 21
第四節 研究對象與樣本估算 21
第五節 研究工具 22
第六節 收案過程 26
第七節 研究倫理 28
第八節 資料分析 29
第四章 研究結果 30
第一節 研究對象基本資料 30
第二節 失智症病人的基本屬性與家庭照顧者之自覺健康狀態、照顧態度與照顧能力關係 40
第三節 家庭照顧者的基本屬性與其自覺健康狀態、照顧態度與照顧能力關係 45
第四節 家庭照顧者自覺健康狀態、照顧態度與照顧能力之預測模型,及自覺健康狀態與照顧態度對照顧能力之影響 54
第五章 討論 64
第一節 失智症病人與家庭照顧者基本屬性 64
第二節 家庭照顧者自覺健康狀態與照顧態度現況分析及影響因素 67
第三節 家庭照顧者照顧能力現況分析及自覺健康狀態與照顧態度對其影響 70
第六章 結論與建議 73
第一節 結論 73
第二節 研究限制 74
第三節 研究應用與建議 75
參考文獻 77
一、中文部分 77
二、英文部分 82
附錄 89
附錄一 同意人體研究證明書 89
附錄二 量表同意函 90
附錄三 人體研究說明及同意書 95
附錄四 研究問卷 98

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楊惠芳、王鐘慶、吳立偉、江昇達、高東煒、羅慶徽、陳韋良(2012)‧分析居家護理照顧提供者工作壓力與自覺健康狀況相關性之研究‧中華職業醫學雜誌,19(3),135-145。
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