失智症主要照顧者在照顧過程中的逆境經驗與復原歷程
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2013
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Abstract
本研究之研究目的是為了呈現失智症主要照顧者從逆境中走向復原的歷程，探究主要照顧者面對壓力事件時的復原機制，期望能使其他的照顧者在面臨困境時，可參考其他人的成功經驗。本研究所採用之抽樣方法以「立意抽樣」為主，「滾雪球抽樣」為輔，共深入訪談8名主要照顧者。主要研究發現為：
每位受訪者成為主要照顧者的原因各不相同。至於主要照顧者在照顧過程當中的逆境經驗包括了心理、生理、社會與經濟四個層面，而其中又以心理層面的狀況最多。這些逆境壓力經長期累積，會影響照顧者的身心健康，使照顧者陷入崩潰邊緣。在另一方面，主要照顧者的特質、個性、能力、思考方式及價值觀，家庭在照顧工作與情感的支持，親友、其他患者家屬與專業人員的支持與協助，及支持性與替代性照顧服務的使用等則有助於主要照顧者克服逆境。
而經過「對照他人狀況後，感恩惜福」、「借鏡他人經驗」、「可信賴或是合適的外力進入」、「受到刺激而力圖振作」或「美好事物的感召」等不同狀況轉捩點的刺激，照顧者皆在心境上有所轉變，從逆境中走向復原，並認為自己從照顧過程中有所收穫。但本研究尚無法明確解答轉捩點由何而來，只能知道轉捩點的產生與照顧者本身的生活環境、生命脈絡息息相關。
研究者最後分別針對主要照顧者、實務工作者、政策規劃者及學術研究者提供建議。
The purpose of this study is to present the recovery journey from adversity of primary caregivers for dementia patients, and to explore primary caregivers’ recovery mechanisms in the face of stressful events. This study hopes that, when facing difficulties, other caregivers can reference the successful experience provided by this study. This study adopts purposive sampling as the primary sampling method and uses snowball sampling as the secondary method, and conducts in-depth interviews with a total of eight primary caregivers. The findings of this study are: The reason that each interviewee became the primary caregiver is different. The adversity experienced by a primary caregiver in the process of giving care includes psychological, physical, social and economical aspects, and it is the psychological aspect that makes up the bulk of each situation. The long-term accumulation of the adverse pressures affects the physical and mental health of caregivers, leading them to the verge of psychological collapse. On the other hand, the characteristics, personalities, capabilities, thought patterns, and sense of values of the primary caregivers, plus the care giving-duty assistance and emotional support from the family, the support and assistance from relatives, other families in the same situation and professionals, and the use of assistive and alternative care services are helpful to the primary caregivers in overcoming adversity. The stimulation of various turning points, such as “feeling grateful after comparing their situation with other’s situations”, “learning from others’ experience”, “the intervening of a reliable or appropriate external force”, “being encouraged to pull oneself together” or “being inspired by sublimity” all contribute to caregivers emotional changes, and their starting of recovery from adversity. They also think that they have gained a lot during the care giving process. However, this study cannot provide a clear answer as to when and where the turning point occurs, but is certain that the rising of such turning points are closely related to the caregivers’ personal living environment, and their energy. Lastly, the study offers recommendations specifically to the primary caregivers, work practitioners, policy planners, and academic researchers.
The purpose of this study is to present the recovery journey from adversity of primary caregivers for dementia patients, and to explore primary caregivers’ recovery mechanisms in the face of stressful events. This study hopes that, when facing difficulties, other caregivers can reference the successful experience provided by this study. This study adopts purposive sampling as the primary sampling method and uses snowball sampling as the secondary method, and conducts in-depth interviews with a total of eight primary caregivers. The findings of this study are: The reason that each interviewee became the primary caregiver is different. The adversity experienced by a primary caregiver in the process of giving care includes psychological, physical, social and economical aspects, and it is the psychological aspect that makes up the bulk of each situation. The long-term accumulation of the adverse pressures affects the physical and mental health of caregivers, leading them to the verge of psychological collapse. On the other hand, the characteristics, personalities, capabilities, thought patterns, and sense of values of the primary caregivers, plus the care giving-duty assistance and emotional support from the family, the support and assistance from relatives, other families in the same situation and professionals, and the use of assistive and alternative care services are helpful to the primary caregivers in overcoming adversity. The stimulation of various turning points, such as “feeling grateful after comparing their situation with other’s situations”, “learning from others’ experience”, “the intervening of a reliable or appropriate external force”, “being encouraged to pull oneself together” or “being inspired by sublimity” all contribute to caregivers emotional changes, and their starting of recovery from adversity. They also think that they have gained a lot during the care giving process. However, this study cannot provide a clear answer as to when and where the turning point occurs, but is certain that the rising of such turning points are closely related to the caregivers’ personal living environment, and their energy. Lastly, the study offers recommendations specifically to the primary caregivers, work practitioners, policy planners, and academic researchers.
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Keywords
失智症, 照顧者, 復原, dementia, caregiver, resilience