患者與照顧者間照顧覺知落差對雙方心理與生活適應之影響：以婦癌病患為例

The Effects of Discrepant Views on Care Giving between Gynecological Cancer Patients and their Primary Caregivers

林耀盛(Yaw-Sheng Lin) ； 羅愔愔(Yin-Yin Lo)

《中華輔導與諮商學報》 27期 (2010/03) Pp. 161-197

https://doi.org/10.7082/CJGC.201003.0161

摘要

本研究以婦癌為例，採取「病患」與「主要照顧者」配對單位，探討雙方對照顧覺知落差、憂鬱傾向和生活品質間關係，以及雙方關係屬性是否具有調節作用。以研究者自編的「照顧覺知量表」，瞭解患者與照顧者，雙方對照顧行為及照顧需求的覺知；以美國「流行病學中心－憂鬱量表」中文版，評估患者和照顧者的憂鬱傾向；以「台灣簡明版世界衛生組織生活品質量表」，評估雙方的生活品質。研究樣本各蒐集92位患者和65位照顧者資料，其中「病患及其照顧者」共61對配對成型。結果顯示：(1)病患與照顧者共存普遍性憂鬱傾向與較差生活品質。(2)關係類型的調節作用分析，對病患及其照顧者的憂鬱傾向或生活品質無預測力，顯示病人角色和照顧角色的因素，甚於關係屬性的影響。(3)配對路徑分析發現，雙方對覺知照顧行為落差，會影響病患憂鬱，進而影響病患生活品質及照顧者生活品質。病患生活品質不良會造成照顧者憂鬱，進而影響照顧者生活品質。

關鍵字

生活品質 ； 婦癌患者 ； 照顧者 ； 照顧覺知落差 ； 憂鬱

並列摘要

The purpose of this study was to investigate the relationship among depressive tendency, quality of life, and the perceived discrepancy between the care given and received in gynecological cancer patients and their primary caregivers and to explore the moderating effect on the caregiver-patient relationship. In order to evaluate depressive symptoms, quality of life, and awareness of caring behavior and care needs, Care-Awareness Scale (CAS), the American Center of Epidemiology Study-Depression Scale (CES-D)-Chinese edition, and The World Health Organization Quality of Life shorter version (WHOQOLBREF) Taiwan version were administered. Ninety two patients suffering from the illness for at least three years and sixty five caregivers holding this role for at least six months (61 dyad units paired) were included as participants. There were three major findings. First, both the patients and their caregivers were characterized by elevated depressive symptoms and low quality of life. Second, the caregiver role and the patient role are more important factors than the relationships between the patients and the caregivers in moderating the patients and their caregivers' emotional states. Third, path analysis indicated that depressive mood was the most important mediator variable accounting for the perceived discrepancy between care given and received. Perceived discrepancies from the dyadic caring behavior given and received affected the patients' depression, patients' depression affected patients' and caregivers' quality of life, and finally, caregivers' depression affected caregivers' quality of life. The implications and limitations of the findings were discussed further.

並列關鍵字

depressive tendency ； gynecological cancer patient ； primary caregiver ； quality of life ； discrepancy

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