社區精神病患之主要照顧者的照顧負荷、身心健康與照顧需求之調查研究

Abstract

中文摘要 本研究旨在探討社區精神病患之主要照顧者的人口變項、病患人口變項與 照顧負荷、身心健康與照顧需求三者之間的關係。本研究採立意取樣，以台灣省北中南東各區之康復之友協會、精神科門診、日間留院與社區復健中心中之精神病患的主要照顧者為研究對象，共計310名。本研究採問卷調查法進行資料收集，所使用研究工具包括「主要照顧者基本資料」、「病患基本資料」、「照顧負荷量表」、「身心健康量表」與「照顧需求量表」。調查所得資料分別以描述統計、卡方檢定、點二系列相關、積差相關與逐步迴歸分析之統計方法進行處理。本研究主要發現如下： 1. 主要照顧者以女性為主，平均年齡為57歲，與患者的關係以父母為主，教 育程度以高中職較多，多為無職業者，平均照顧病患年數為15年，每日平均相處時數為12小時，平均使用2個社會資源。 2. 精神病患的性別，男女各半，平均年紀為38歲，初次發病年齡是22歲，四 分之三為無偶者，平均生病年數為15年，平均住院次數為3次，教育程度以 高中職居多，疾病的診斷以精神分裂症佔多數，半數以上領有身心障礙手冊與 重大傷病卡。 3. 父母的照顧者有較重的烙印感，且教育程度愈高，愧疚與照顧負荷亦愈重；經濟狀況愈不足、與病患每日相處時數愈長以及自覺身體狀況愈差的照顧者，其家庭干擾程度與照顧負荷愈重。 4. 病患的住院次數愈多與復健情況愈少的照顧者，其感到家庭干擾的程度愈 重，年齡愈小與無偶的病患之照顧者，感到烙印程度愈重；病患年齡愈長，照 顧者感到較多的依賴。 5. 照顧負荷與身心不健康呈顯著正相關，而身心不健康與照顧需求呈顯著正相關，照顧負荷與照顧需求呈顯著正相關；之後以逐步迴歸分析求出最佳預測照顧需求方程式，得到6個獨變項，分別為「照顧曾使用的社會資源數」、「照顧負荷」、「住院次數」、「生病年數」、「照顧者教育程度」、「同住年數」，可以解釋照顧需求變異的27.5％。

最後，研究者針對本研究結果加以討論，並提出具體建議，以提供相關領域工作者在心理衛生服務與相關法令和政策擬訂時之參考，並提出未來研究之建議。Abstract The purpose of this study is to investigate the relationship among the burden, health, and need of primary caregivers of mental illness in the community in Taiwan. The samples are comprised of 310 primary caregivers from four areas across Taiwan. Instruments used in this study were“ primary caregiver data”,“ mental illness patient data”, “Caregiver Burden Scale”, ”Chinese Health Questionnaire-12”, “Caregiver need Scale”, data obtained in this study were analyzed by descriptive analysis, chi-squire, point-biserial correlation, Pearson product moment correlation and stepwise regression analysis. The main findings are as follows: 1.The characters of primary caregivers: most of them are female,their average age are 57, most of them are parents, they are unemployed, average years of taking care patients is 15, they spend about 12 hours a day to be with patients, the average number of using the social resources is 2. 2.The characters of patients: half of male and half of female, their average age are 38, the average age of their first course is 22 years old, 3/4 of them are unmarried, average years of illness is 15, average times of inpatient is 3, most of them are graduated from senior high school, most of their diagnosis is Schizophrenia. 3.Correlation among primary caregivers’ characters and burden,health, and need. 4.Correlation among mental ill patients’ characters and burden,health, and need. 5.Burden and health are significantly associated with need; burden is significantly associated with health. After Stepwise regression analysis, there are six predictive variables could predict caregivers’ need. Finally, based on the results, implications of the study for doctors, psychologists, counselors, nurses, and social-workers and as well as suggestions for future research are proposed.

Keywords: mental illness , primary caregiver, burden, health, need