長照服務使用情形與其健康狀態、照顧者負荷之相關研究-以北部某醫院個案為例

Abstract

本研究採用次級資料庫分析法，研究資料來源為北部某醫院2018年3月1日至2019年6月30日之資訊系統中接受長期照顧服務失能者的長照個案管理系統資料分析，初評個案為499人，經半年後複評仍在案者為263人，內容包含個案基本資料、評估內容、訪視紀錄及連結的服務項目，進行資料處理及統計分析。本研究發現，年齡越大，依賴程度越高、女性的日常生活活動較男性需協助，且多數主要照顧者有需分配時間照顧其他家人之負荷、一般戶的主要照顧者多數有睡眠受到干擾之負荷、多數需依賴的研究對象屬有家人照顧的非獨居者、多數持有身障證明者依賴程度高，且其照顧者對於睡眠受到干擾及無法承受照顧壓力有明顯負荷、整體照顧負荷與健康狀態有顯著相關；使用長照服務後，個案健康狀態無顯著改善、使用居家服務後，主要照顧者整體照顧負荷層面有顯著改善、使用居家醫療後，主要照顧者對個案的行為感到困擾之負荷有顯著改善，而同時有使用居家服務及居家醫療後，對於照顧者對個案行為感到困擾之負荷有顯著改善。本研究建議長照政策擴編補助項目及加強推動環境改善服務措施，進一步紓緩照顧壓力及讓高齡在宅更安心。This study used a secondary database analysis method. The data source for this study was the long-term care case management system of the disabled receiving long-term care services in the information system of a northern hospital from March 1, 2018 to June 30, 2019. The initial evaluation case was 499 people, and there are 263 people who are still in the case after re-evaluation after half a year. The database contains basic case information, evaluation content, visit records and services of links to data processing and statistical analysis. This study found that the older the person, the higher the degree of dependence, the women need more assistance in activities of daily living than men, and most primary caregivers have the burden of allocating time to take care of other family members, and most of the primary caregivers in general households have sleep disturbance Load, most of the research subjects who need to be dependent are non-single people who are cared for by family members, most of the people with disabilities have a high degree of dependence, and their caregivers have a significant load of sleep disturbance and unable to bear the pressure of care, overall care load and health status There is a significant correlation. After using the long-term care service, the patient's health status did not improve significantly. After using the home service, the overall care load level of the primary caregiver was significantly improved. After using both home services and home medical care, there was a significant improvement in the burden of caregivers' troubles with the client's behavior. This study suggests that the long-term care policy should expand the subsidy program and strengthen the promotion of environmental improvement service measures, so as to further relievethe pressure of caring and make the elderly feel more at ease at home.