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  • 學位論文

躁鬱症主要照顧者因照顧患者 所引發需要之探討

A Qualitative Study on the Induced Needs of Primary Caregivers with Bipolar Disorder.

指導教授 : 葉玲玲
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摘要


躁鬱症是僅次精神分裂症常見的精神疾病,患者會反覆出現躁期 及鬱期症狀。有別於其他嚴重精神患者的不佳預後,躁鬱症患者在穩 定時可恢復正常生活,而發作時卻嚴重到影響患者生活和社會功能, 患者及主要照顧者在各方面都面臨很大考驗與煎熬。因此瞭解其需要 並提供服務對患者及主要照顧者在維持生活品質是重要的。本研究探 討躁鬱症主要照顧者因照顧患者所引發健康照護與社會照顧需要為目 的,以北部精神專科醫院門診、日間留院,及北部康復之友協會躁鬱 症主要照顧者為研究對象,在通過人體實驗委員會核准後進行收案, 以深度訪談收集訪談資料,並以質性研究方法的紮根理論研究法進行 資料分析與整理。 研究結果發現主要照顧者因照顧患者所引發的健康照護需要,包 括精神醫療照顧知識、二十四小時精神科急診、二十四小時緊急醫 療、精神科急性病床、精神科加護病床、協助入院後的看護、居家治 療、日間留院、社區復健中心,及精神科慢性住院服務。主要照顧者 因照顧患者所引發社會照顧需要,包括家事服務、居家喘息、機構喘 息、經濟補助、轉介工作、安置場所、家屬團體及個案管理服務。其 中多數主要照顧者表示對精神健康照護體系感覺是混亂、不知如何使 用服務,因此會希望透過個案管理服務窗口獲得連續及整體性的服 務。 依照本研究結果建議規劃完整且整合性的照顧服務模式,透過以 個案評估方式,彈性提供患者及主要照顧者所需服務,並積極改善不 符合臨床現況強制就醫及住院相關規定,及對民眾與主要照顧者提供 iv 躁鬱症相關知識,提高對躁鬱症認識。在未來研究則建議依不同地理 區域或年齡層來探討主要照顧者照顧患者需要,及透過瞭解躁鬱症患 者的需要來進行談討比較,以作為精神健康照護體系發展的參考。

並列摘要


Background: Bipolar Disorder is second most common illness for psychosis. Patients with bipolar disorder sometimes are on stable condition, rather than patients with schizophrenia most of time have poor outcome, which result in heavy burden for caregivers. The purpose of this research is to explore the induced needs of health care and social care for chief caregiver with bipolar disorder. Methods: Face to face interviews are carried out for twelve chief caregivers with bipolar disorders after adopting the Institution Review Board (IRB) recommendations. The study subjects recruit from the Psychiatric Hospital and Mental Rehabilitation Association in Taipei city. The interviews were recorded and transcribed, and the data analysis based on grounded theory. Results: The study results found that chief caregivers with bipolar disorder induced healthcare needs from the process of taking care of patients, which include the information for psychiatric diseases, twentyfour hours psychia-tric emergency services, consultation for patient care by telephone, psychiatric acute wards, intensive care unit for psychiatry, a helper at admission, home care, day care services, rehabilitation services and psychiatric chron-ic wards. The induced social care needs for chief caregivers include house-keeping, respite care, institutional respite care, subsidize, job arrangement, living replacement, family group and case management. Most caregivers are not aware of mental healthcare system and unsure how to seek for ser-vices. Conclusions: This study suggests offering the compressive and continuity services for patient and caregivers with bipolar. Further, to provide more information about bipolar disorder for the publics and vi caregivers with bipolar disorder. In future research, this study advances to elucidate induced needs for caregivers with bipolar disorder amongst different area and demographic characteristics of patients.

參考文獻


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被引用紀錄


Kuo, F. J. (2013). 精神障礙者家屬之照顧經驗 [master's thesis, National Taiwan Normal University]. Airiti Library. https://www.airitilibrary.com/Article/Detail?DocID=U0021-0801201418033629

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