臺灣博碩士論文加值系統

失智症多發生在65歲以上，為慢性且不可逆的疾病。隨著病情惡化，失智
症者需要被照顧時間也愈來愈長，對照顧者的依賴愈來愈重。照顧的辛勞使照
顧者產生不同層面的負擔，並出現相對應的照顧需求，照顧者的身心健康出現
困擾。有鑑於 ，臺灣政府推出長照十年計畫並結合地方相關機構，提供失智
症家庭服務，然而這些服務是否實際降低照顧者的負擔，及滿足照顧者的需求
，尚需進一 檢視。本研究欲了解失智症照顧者之負擔、需求與身心健康，探
討資源與實際需求之間的落差。本研究提出之假設如下：(一)失智症照顧者負擔
能預測照顧者需求；(二)照顧者需求愈高，身心健康較不佳；(三)使用長照資源
之照顧者，可減低照顧負擔，照顧需求亦較獲滿足，進而使身心健康較佳。
本研究以問卷調查，研究工具包含照顧者基本資料、照顧者負擔量表
(Caregiver Burden Inventory, CBI)、功能性社會支持量表，及健康生活品質量表
(12-Item Short Form Health Survey; SF-12)。統計方法以SPSS進行描述性統計、
Pearson積差相關、獨立樣本T檢定，並以Process模組分析調節與中介效果，以
驗證研究假設。研究對象為20歲以上之臺灣失智症照顧者(親屬)，研究地點分佈
於花蓮縣、高雄市及宜蘭縣之神經內科門診、日照機構、失智據點等，亦透過
網路搜集資料。有效問卷共164份，其中照顧者近七成為女性、三成為男性，年
齡多分佈在中年階段，親屬關係以子女為最多。
研究結果發現，當失智症照顧者負擔愈高時，照顧者需求也愈高。再來，
照顧者需求愈高，其生理、心理健康皆較不佳。最後，使用照顧者支持服務頻
率較高，可調節照顧者負擔對需求的影響，進一 可 向影響心理健康。建議
提供服務之相關人員多主動關心照顧者心理健康狀況，並將照顧者與失智症者
視做一體，彈性提供符合照顧者需求之項目。服務規劃之相關單位與人員可合
併目前科技與網路，開發整合性高且更易於取得的資源(如：手機應用軟體)，以
利照顧者方便獲得相關資料(如：照顧技巧、照顧資源等)。
關鍵字：失智症照顧者、照顧者需求、照顧者負擔、長照服務、照顧者生理健
康、照顧者心理健康

Dementia commonly occurs in individuals aged 65 and older. It is a chronic and irreversible disease. As the condition worsens, individuals with dementia require increasingly long periods of care and become more dependent on their caregivers. The strain of caregiving results in various kind of burden for caregivers and leads to corresponding caregiver needs, causing challenges to their physical and mental health. In light of this, the Taiwan government has implemented a ten-year long-term care plan in collaboration with local agencies to provide services to families affected by dementia. However, it is necessary to further examine whether these services effectively reduce the burden on caregivers and meet their needs. This study aims to understand the burden, needs, and physical and mental health of dementia caregivers and explore the gap between available resources and actual needs. The hypotheses proposed in this study are as follows: (1) Caregiver burden predicts caregiver needs; (2) Higher caregiver needs are associated with poorer physical and mental health; (3) Caregivers who use long-term care resources can reduce their caregiver burden and have their caregiver needs met, which in turn leads to better physical and mental health.
This study employs a questionnaire survey with research instruments including caregiver demographics, the Caregiver Burden Inventory (CBI), Functional Social Support Scale, and the 12-Item Short Form Health Survey (SF-12) to validate the research hypotheses through descriptive statistics, Pearson correlation, independent samples t-test, and the Process module were conducted in SPSS to analyze moderation and mediation effects. The study participants are dementia caregivers (family members) aged 20 and above in neurology clinics, day care centers, and community-based dementia care centers in Hualien County, Kaohsiung City, and Yilan County, Taiwan. Data collection was also collected online. A total of 164 valid questionnaires were collected, with nearly 70% of caregivers being female and 30% being male. The majority of caregivers are in the middle-aged range, and the most common relative relationship is children caring for their parents with dementia.
The study findings indicate that as caregiver burden increases, caregiver needs also increase. Furthermore, higher caregiver needs are associated with poorer physical and mental health. Lastly, higher utilization of caregiver support services was found to moderate the impact of caregiver burden on caregiving needs, leading to positive effects on mental health. It is recommended that service providers take the initiative to care for the physical and mental health of the caregivers, and treat the caregivers and the dementia patients as one, and flexibly provide programs that meet the needs of the caregivers. Service planning units and personnel can integrate current technologies and networks to develop highly integrated and easily accessible resources (e.g., cell phone applications) to facilitate caregivers' access to relevant information (e.g., caregiving skills, caregiving resources, etc.).
Keywords: dementia caregivers, caregiving needs, caregiver burden, long-term care services, caregiver physical health, caregiver mental health.

致謝 I
摘要 III
ABSTRACT IV
圖表目錄 VIII
第壹章 緒論 1
第一節 研究動機 1
第二節 研究目的 3
第三節 名詞釋義 5
第貳章 文獻回顧 6
第一節 失智症 6
一、失智症盛行狀況 6
二、失智症類型與病程 6
第二節 照顧者負擔 9
一、時間依賴層面 9
二、發展層面 10
三、經濟層面 10
四、生理層面 11
五、社會層面 12
六、情緒壓力層面 13
第三節 照顧者需求 15
第四節 照顧者需求與資源間的落差 17
一、國外提供的資源 17
二、臺灣提供的資源 17
三、照顧者需求與可用資源之間的落差 19
第參章 研究方法 22
第一節 研究架構 22
第二節 研究對象 22
第三節 研究假設 23
第四節 研究方法 23
第五節 研究工具 24
第肆章 研究結果 27
第一節 受試者基本資料 27
第二節 失智症家庭使用與申請服務情形 30
第三節 照顧者負擔、照顧者需求及身心健康現況探討 35
第四節 失智症照顧者負擔、照顧者需求、身心健康與長照資源使用頻率之差異分析 37
第五節 失智症照顧者負擔、照顧者需求、身心健康與長照資源使用頻率之相關分析 40
第六節 照顧者負擔、照顧者需求、身心健康及使用長照資源之中介與調節分析 42
第伍章 討論與建議 48
第一節 研究結果與討論 48
第二節 結論與建議 55
參考文獻 58
附錄 77
附錄一、研究許可書 77
附錄二、研究對象同意書(書面填寫版本) 78
附錄三、研究對象同意書(網路填寫版本) 83
附錄四、照顧者負荷量表使用同意書 87
附錄五、SF-12授權同意書 88
附錄六、功能性社會支持量表同意使用 90
附錄七、研究問卷 91

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