居家照護病患主要照顧者人格韌性.健康狀況與生活品質相關性探討

The relationship between hardiness, health status, and quality of life among primary caregivers involved in home care

陳麗如(Li-Ju Chen)

指導教授 ： 邱啟潤

高雄醫學大學/護理學院/護理學系研究所/碩士(2004年)

摘要

本研究目的為探討居家照護病患主要照顧者健康狀況、人格韌性與生活品質之相關性，採橫斷式相關性研究設計，以台南縣某醫學中心附設居家護理所收案病患主要照顧者為研究對象，共收案105位。研究工具採結構式問卷，內容包括：病患及照顧者基本屬性、自覺健康量表、照顧者罹患慢性病情形及自覺不適症狀、與健康相關人格韌性量表及台灣簡明版世界衛生組織生活品質問卷，所得資料以SPSS/PC 10.0套裝軟體進行描述性及推論性統計。
研究結果主要發現如下：(1).居家照護病患主要照顧者整體生活品質平均值為51.81分(總分為80分)，其四個範疇滿分為20分，得分最高為生理健康範疇生活品質(13.52分)，最低為心理範疇生活品質(12.43分)；(2).主要照顧者人格韌性平均值為160.72分，中位數為160.00分，顯示主要照顧者擁有中等程度的人格韌性特質；(3).主要照顧者自覺健康狀況平均總分為5.10分，主要照顧者自覺健康狀況趨向於「尚可」等級；多數的照顧者未罹患慢性病、擔任照顧病患工作後，曾經出現自覺不適之身體症狀，其中以肌肉關節疼痛最多，其次為失眠；(4).主要照顧者自覺健康狀況、人格韌性、家庭月收入及照顧年數為整體生活品質之重要預測因子，可解釋整體生活品質總變異數的41.7%。
本研究結果可提供社區護理人員進一步瞭解主要照顧者健康狀況、人格韌性和生活品質相關性，並可作為護理實務、教學、研究及未來提升社區照顧者生活品質政策參考之依據。社區護理人員應將家庭主要照顧者視為照護體系的一環，應用「健康相關人格韌性量表」評估主要照顧者人格韌性之高低，並予以個別性的護理介入，鼓勵照顧者以正向、積極態度面對環境並運用資源；此外，可加強對照顧者的健康管理，提升其健康狀況，對於增進照顧者生活品質具有正面影響。

關鍵字

人格韌性 ； 健康狀況 ； 生活品質 ； 主要照顧者

並列摘要

The purpose of the research was to explore the relations among health status, hardiness, and quality of life in primary caregivers involved in home care. The study’s design was cross-sectional and correlational. Subjects consisted of 105 primary caregivers involved in home care, from the Home Nursing Unit at a medical center in Tainan. A structured questionnaire was used to collect data via a face to face interview. The questionnaire gave to the caregivers included patient characteristics, caregiver characteristics, self-perceived health status, presence of chronic illness, whether or not have self-rated symptom, The Health Related Hardiness Scale (HRHS), and a quality of life scale (WHOQOL-BREF). The data was analyzed using SPSS 10.0 for Windows.
The major findings of this study were as follows: (1) using the Taiwanese WHOQOL-BREF the mean score of overall quality of life of caregivers was 51.81 out of 80, in the domain of physical health quality of life got the highest score (13.52), in the psychological domain quality of life got the lowest score (12.43). (2) The mean of caregiver’s hardiness score was 160.72, the medium was 160.00, which indicated that the caregivers had a middle level of hardiness. (3) The mean of caregivers’ perceived health status score was 5.10, which rated as fair. Most of the caregivers did not have a chronic illness, and most of the caregivers had self-rated symptom.(4) The most important predictive variables for the quality of life were caregiver’s self-perceived health status, hardiness, household income, and years of caring. These variables explained 41.7% of the variance in caregiver’s quality of life.
The results of the study make a contribute to community health nurses to understanding of the relationships between caregivers’ health status, hardiness, and quality of life in caregivers. These findings could also serve as indices for nursing practice, education, and research to enhance quality of life in community caregivers further. Community health nurses should regard caregiver as a client. Use of the「The Health Related Hardiness Scale (HRHS)」to assess the hardiness of caregivers can augment the development of individual nursing interventions and encourage caregivers to make more active use of resources actively. Moreover, we can manage and improve caregivers’ health status, and enhance the quality of life of the caregivers.

並列關鍵字

hardiness ； health status ； quality of life ； caregiver

參考文獻

台灣版世界衛生組織生活品質問卷發展小組(2000)。台灣版世界衛生組織生活品質問卷之發展簡介。中華衛誌，19(4)，315-324。

林麗英、余幸澄、張碧華(2001)。血液腫瘤病患家屬生活品質之探討。榮總護理，18(3)，281-292。

江季蓁、駱麗華(2002)。新診斷白血病兒童住院期間主要照顧者之生活品質。護理雜誌，49(2)，42-49。

參考資料：

王亞妮(1999)。居家護理病患主要照顧者之負荷。國立台灣大學護理學研究所碩士論文。未出版，台北。