家庭照顧者使用喘息服務之成效及其相關因素探討

喘息服務是「長照十年計畫」政策中，為家庭照顧者量身訂製的「短暫休息」方案，研究目的為探討家庭照顧者使用喘息服務的成效與喘息服務使用情形之相關性。研究對象為高雄縣150位的家庭照顧者，採結構式問卷為主及半開放式問卷為輔的橫斷性研究。研究工具包括，家庭照顧者人口學特性、自覺健康狀況量表、家庭照顧者照顧情形、喘息服務使用情形、家庭照顧者效益量表(Chronbach's α值0.93)、使用滿意度量表(Chronbach's α值0.79-0.84)。研究結果主要發現如下：一、家庭照顧者自覺使用喘息服務之成效：(一)家庭照顧者效益：家庭照顧者自覺使用喘息服務效益平均值為102.57，得分指標為66.17。(1)生活品質效益平均值為79.89，得分指標為63.91。其中效益最高的為「照顧工作」，最低的效益為「社會關係」。(2)時間效益平均值為22.68，得分指標為75.6。時間效益較生活品質效益來得高。(二)使用滿意度：居家式喘息服務滿意度得分指標為78.2，機構式得分指標為72.4。居家式喘息服務滿意度高於機構式喘息服務。二、家庭照顧者使用喘息服務成效之預測因子：家庭照顧者使用月次數及非計畫性使用是家庭照顧者效益之重要預測因子；使用月次數及非計畫性使用、自覺健康狀況是生活品質效益之重要預測因子。家庭照顧者就業情形是機構式喘息服務滿意度之重要預測因子；自覺健康狀況是居家式喘息服務滿意度之重要預測因子。結論：1.居家式的喘息服務較機構式喘息服務的使用者多。2.以家庭照顧者效益和使用滿意度為成效指標，結果皆未達80分，仍有改善空間。3.喘息服務成效的重要預測因子有使用月次數及非計畫性使用、自覺健康狀況、就業狀況。建議：1.政府可積極推動喘息服務。2.家庭照顧者健康狀況的掌握。3.以家庭照顧者需求為中心的彈性化服務。4.建構家庭照顧者使用喘息服務的回饋機制。5.加強學生對「家庭照顧者與失能者」視為護理服務主體的概念。6.採大規模跨縣市取樣，將居家與機構式混合使用的照顧者納入研究群體，以獲得更廣的推論。

關鍵字

家庭照顧者居；家式喘息服務；機構式喘息服務；家庭照顧者效益；使用滿意度

並列摘要

Respite care is a solution in Ten-Year Plan for Long-term care policy to let family caregivers have some brief rest. The purpose of this study was exploring the relations among effects and utilizations of respite care for family caregivers. The subjects consisted of 150 caregivers living in Kaohsiung County. This study’s design was cross-sectional and correlational. A structured questionnaire is selected as a major tool and the semi-structured interview as an auxiliary. The study tools include the Demography of Family Caregivers, Self- Perceived Health Status, Family Care Condition, Utilization of Respite Service, Effect Scale of Family Caregivers (Chronbach's α: 0.93)and Satisfaction Scale of Service Utilization (Chronbach's α: 0.79∼0.84). The major findings of this study were as following: 1. Self-perceived effect of family caregiver on respite care utilization. (1) Family caregivers Efficacy : The mean score of subjective benefit of the respite service utilization for family caregiver is 102.57 and the score index is 66.17. 1st, the mean score of life-quality benefit is 79.89 and the score index is 63.91. The highest benefit is “care task” and the lowest benefit is “social relationship”. 2nd, the mean score of time benefit is 22.68 and the score index is 75.6. Time benefit is higher than life-quality benefit. (2) Utilizing Satisfaction: The score index of satisfaction for home respite care is 78.2 and 72.4 for institutional respite care. The satisfaction of home respite care is higher than institutional respite care. 2. The Predictive Factors of effect of respite care utilization for family caregivers. (1) The monthly frequency and non-planned usage for a provisional requirement or a trial are the important factors for the effects on family caregivers. Monthly frequency, non-planned usage, and self-perceived health status are the main factors of effects on the quality of life. (2) Employment conditions of family caregiver is the important factor of the satisfaction for the institutional respite care. Self-perceived health status is the main factor of the satisfaction for home respite care. Conclusions: 1. Home type respite care has more users than institutional type. 2. Using the effects on family caregivers and on utilizing satisfaction as the effect index, the score is under 80. Improvements are necessary. 3. The main predictive factors of respite care effects include monthly frequency, self-perceived health status, and Employment condition. Suggestions: 1. The government should carry out the respite care more positively. 2. Grasp the health statuses of family caregivers. 3. Flexible service to meet the requirements of family caregivers. 4. Build up the feedback schemes for the utilization of respite care by family caregivers. 5. Enhance the concept that family caregivers and disabilities are the subjects of nurse services in students’ education. 6. Take the extensively cross-area sampling that includes the mixing users of home and institutional services to achieve the more general inferences.