家庭照顧者之正、負向照顧經驗與健康相關生活品質關係探討

The Relationship among Caregiver’s Positive Experience, Negative Experience and Health-Related Quality of Life

陳品元(Pin-Yuan Chen)

指導教授 ： 陳雅美

國立臺灣大學/公共衛生學院/健康政策與管理研究所/碩士(2016年)

https://doi.org/10.6342/NTU201602920

摘要

研究背景與目的：隨著台灣人口老化及少子化衝擊，社會結構與家庭結構改變，家庭照顧者的照顧經驗、生活品質是未來長期照顧政策重要評估指標。國內目前已有豐富的負向照顧經驗與生活品質關係探討，但仍缺乏系統性瞭解家庭照顧者正向經驗、負向照顧經驗對生活品質影響，也較少探究正向經驗、負向照顧經驗兩者間的相關性。因此，本研究探討家庭照顧者的正向、負向照顧經驗與生活品質的關聯性。
研究方法：本研究採取橫斷式立意取樣，以電訪形式調查向台北市衛生局申請長期照顧十年計畫之家庭照顧者。並使用雙變項分析、複廻歸、結構方程模型探討家庭照顧者的照顧壓力、照顧的滿足感、照顧的熟練力、生活品質三者間的關係。
研究結果：在控制家庭照顧者、被照顧者的社會人口學特質情況下，家庭照顧者的照顧壓力越高，整體生活品質狀況越差；照顧的熟練力越佳，心理相關之生活品質越好；照顧的滿足感對整體生活品質沒有顯著影響；照顧壓力和照顧的滿足感為負向顯著關係；照顧的滿足感和照顧的熟練力為正向顯著關係；照顧的熟練力與照顧壓力沒有顯著關係。
結論：家庭照顧者的照顧壓力對整體生活品質具有負向影響，正向照顧經驗則受到華人文化影響，對於生活品質影響程度不同。未來研究可對照顧關係在其它層面之照顧結果影響進行評估；以及照顧熟練力對照顧壓力關係探討。建議政策制定者對家庭照顧者應建構多元的支持服務來降低照顧壓力；並給予照顧訓練與諮詢服務，增加家庭照顧者的照顧熟練力，以提升生活品質，達到政府、家庭照顧者、被照顧者三贏政策。

關鍵字

家庭照顧者 ； 正向照顧經驗 ； 照顧壓力 ； 照顧的滿足感 ； 照顧的熟練力 ； 生活品質

並列摘要

Background: As population caging and family structures changes in Taiwan, caregiving experience and quality of life of family caregivers become an important issue for long-term care services development and policy making. Despite abundant researche studies on the relationsip between negative caregiving experience and quality of life, research studies on the relationships among positive and negative caregiving experiences, and caregivers’ quality of life. Thus, this study aimed to investigate the relationship among caregiver’s positive experience, negative experience, and quality of life.
Methods: The survey was done by purposive sampling. The data were collected through telephone interviews with the family caregivers who have applied for the 10-year long-term care services from the Department of Health, Taipei City Government. Structural equation modeling (SEM) was applied to investigate the associations between caregiving strain, caregiving satisfaction, caregiving mastery, and quality of life in caregivers living in Taipei.
Results: By controlling the family caregivers and care recipients’ demographic related factors , the current study found that : (1) the higher the levels of caregiving strain perceived by family caregivers, the lower the levels of overall quality of life perceived by family caregivers; (2) the higher the levels of caregiving mastery, the better psychological quality of life perceived by family caregivers; (3) no significant associations were identified of caregiving satisfaction on overall quality of life; (4) significant negative associations were identified between caregiving strain and caregiving satisfaction; (5) significant positive associations were identified between caregiving satisfaction and caregiving mastery; and (6) no significant associations were identified between caregiving mastery and caregiving strain.
Conclusions: The study identified that caregiving strain was negatively associated with overall quality of life whereas positive caregiving experience can be associated with family caregivers’ quality of life differently. The authors suggested that future studies to focuse on evaluating the impacts of caregiving experienceds on caregiving outcomes and include caregiving mastery and caregiving strain for program evaluation. Stud findings also suggested that our future family caregiver policy shall offer multiple support services to reduce caregiving strain and provide caregiving training programs and consultation services to increase caregiving mastery, and therefore improve famiy caregivers’ quality of life.

並列關鍵字

family caregiver ； positive caregiving experience ； negative caregiving experience ； caregiving strain ； caregiving satisfaction ； caregiving mastery ； quality of life

參考文獻

王玉女, 徐亞瑛, 姚開屏, & 吳淑瓊. (1998). 失能老人家庭尋找平衡點的照顧過程及相關因素探討. [A Correlational Study of "Finding a Balance Point" in Family Caregiving Process for Frail Elders]. 護理研究, 6(6), 489-500.

王麗雪, 何美瑤, 呂桂雲, & 葉淑惠. (2007). 照顧者社會支持、照顧評價和失能老人家庭照顧品質的相關性探討. [The Relationships between Caregivers' Social Support, Appraisal of Care and Quality of Family Care among the Disabled Elderly]. 實證護理, 3(3), 177-187. doi:10.6225/jebn.3.3.177

行政院衛生署長期照護保險籌備小組. (2011). 99年國民長期照護需要調查.

李玉春, 林麗嬋, 吳肖琪, 鄭文輝, 傅立葉, & 衛生署長期照護保險籌備小組. (2013). 臺灣長期照護保險之規劃與展望. 社區發展季刊, 141.

李佳綺, 胡淑貞, & 李中一. (2015). 臺灣活躍老化政策的現狀與未來發展. [Active Ageing Policy in Taiwan: Present and Future Development]. 長期照護雜誌, 19(2), 117-126. doi:10.6317/ltc.19.117