主要照顧者對病患加護治療期之照護需求與壓力感探討

A Study of Caring Needs and Stress Perception of Primary Caregivers to ICU Patients

陳美琴(Mei-Chin Chen)

指導教授 ： 李選

中山醫學大學/護理學院/護理研究所/碩士(2006年)

摘要

本研究目的在探討主要照顧者對病患加護治療期之壓力感與其醫療照護、情感支持照護需求之相關性。採橫斷式相關性研究設計，便利性取樣法，於民國94年10月至95年3月，使用「主要照顧者壓力感量表」、「主要照顧者對醫療照護、情感訊息需求」為研究工具。取樣對象為南部某醫學中心成人內科加護病房之胸腔科病患之主要照顧者，以問卷方式收集資料。有效問卷85份（檢力.83）。
結果發現主要照顧者平均年齡46.78歲，以女性為主。主要照顧者對醫療照護、情感訊息需求程度最高之前三項為有關疾病發展、診斷及併發症、有關突發狀況處理及疾病症狀監測知識、有關藥物指導；照護需求被滿足的情形，以情感訊息被滿足程度普遍偏低，在各項自覺照護能力中，最有能力的前三項依次為口腔清潔、足部護理及穿衣。主要照顧者之整體壓力感介於「中度壓力」至「很大壓力」間，壓力感最高的項目為「病患疾病特性」，其次為「個人」，再次為「人際」，最低的為「環境」。整體壓力感各單項得分最高的前三項分別為「當病情有變化時」，為「看見他接受針劑、注射及其它的管路（如氣管內管、氣切、鼻胃管等）」，「生病後幾乎變成另一個人」。主要照顧者疾病壓力感預測變項為病人的照護需求、私人保險、家庭月收入、其他家人或親友協同照顧、是否與病患同住、住進加護病房天數，可預測變異量的58.7%。本研究針對研究設計、護理實務及護理教育等方面提出建議，作為日後改善服務品質之參考。

關鍵字

加護病房 ； 主要照顧者 ； 照護需求 ； 壓力感

並列摘要

The purpose of this study was to investigate the relationship between main primary caregiver’s stress perception during intensive care period and need for medical care and affective support. A cross-sectional correlation study was designed, and convenience sampling was adopted. The sampling period spanned from Oct 2005 to May 2006. “Primary Caregiver’s Stress Perception Scale”, “Primary Caregiver’s Need for Medical Care and Affective Information” were used as research tools. The research subjects were primary caregivers for patients in a chest medicine ICU of a medical center in southern Taiwan. Questionnaires were distributed to collect research data. A total of 85 valid questionnaires were collected (response rate 0.83).
It was discovered the primary caregivers had an average age of 46.78 years old, and most of them were female. As to their need for medical care and affective information, the top 3 items were about (1) disease development, diagnosis, and complications, (2) treatment of emergency and knowledge about symptom monitor, and (3) medicinal guidance. In the satisfaction over need for medical care, a generally low level of satisfaction over affective information was observed. In various self-aware care abilities, the top 3 items included oral hygiene, foot care, and dressing. Primary caregivers’ overall stress perceptions were in between “mid stress" and “tremendous stress”. The most stressful item was “disease characteristics”, followed by “individual”, “interpersonal relationship”, and “environment”. In terms of ratings in stress perception, the top 3 items were “when illness condition varies”, “witness the patient receive injection, infusion, and tube connections (endotracheal intubation, tracheostomy, and insertion of nasogastric tube), and “the patient has changed so much since he fell sick”. The prediction variables for primary caregivers' stress perception were need for medical care, personal insurance, monthly income of the family, coordinated care by other family members or relatives, whether living with the patient, and number of days staying in the ICU. The predicted variance was 58.7%. Based on the research design, nursing practice, and nursing education, this study proposed suggestions as a reference for improving service quality in the future.

並列關鍵字

intensive care unit ； primary caregiver ； caring needs ； perceived stress

參考文獻

文，台北：國立陽明大學護理學研究所。

吳淑瓊、林惠生（1999）•台灣功能障礙老人家庭照護者的全國概況剖析•中華衛誌，

經驗•長期照護，3（2），54-62。

劉欣宜（2000）•居家失能老人其主要照顧者的生活品質及其相關因素探討•未發表碩

羅淑芬、黃秀梨、姚開屏、劉雪娥（2001）•探討復健期燒傷病患照顧者壓力感受、社