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  • 學位論文

早產兒出院ㄧ個月內主要照顧者的生活品質及相關因素探討

The Quality of Life and Related Factors in Primary Caregivers of Preterm Infant Within One Month After Discharge

指導教授 : 陳月枝

摘要


研究目的及方法:本研究目的在探討早產兒主要照顧者的生活品質及影響的相關因素,研究採用縱貫性研究方式,以立意取樣收集資料,於2008年4月25日至2009年4月1日期間收集早產兒主要照顧者為研究對象,採用結構式問卷,分別在早產兒出院前、出院後7~10天以及出院後28~30天收集早產兒基本資料、主要照顧者基本資料、社會支持量表、照顧負荷量表、台灣簡明版世界衛生組織生活品質問卷(WHOQOL-BREF)等,追蹤早產兒主要照顧者44人,完成三份問卷者有32人,有效問卷完成率為73%,所得的資料經編譯建檔後使用SPSS13.0 for Windows進行統計資料分析。 研究結果如下:(一)、早產兒性別多數為女嬰,出生體重平均為1,277公克,出生週數平均為29週,有合併症者佔56%,總住院天數平均為64.4天。探討早產兒基本資料中以早產兒出生週數、合併症數、是否使用監視器、住院天數與主要照顧者生活品質有相關。(二)主要照顧者的性別以女性為多數佔97%,平均年齡為33歲,早產兒出院前仍在工作者佔62%,教育程度以專科或大學為多數佔53%,家中子女數以兩個為多數佔53%,家庭月收入以60,001~90,000元為多數佔41%,探討主要照顧者基本資料中發現主要照顧者的子女數愈多,會使其生理健康範疇變差。(三)探討生活品質得分以社會關係範疇最高,心理範疇得分最低。生理範疇、社會範疇以及環境範疇在不同時間上達到顯著性差異,其中以生理範疇在早產兒出院後28~30天差異最大。(四)、主要照顧者社會支持需求程度與環境範疇成負相關;社會支持足夠情形與生活品質四大範疇均成正相關,顯示社會支持愈好主要照顧者生活品質愈好(五)、照顧負荷以心理負荷得分最高,財務負荷得分最低,不同時間測量主要照顧者照顧負荷達到顯著性差異,其中以出院後7~10天差異最大,主要照顧者的照顧負荷與生活品質呈負相關,與社會支持需求程度呈正相關,表示當照顧負荷愈大而社會支持愈差則主要照顧者生活品質變差。(六)、主要照顧者生活品質預測因子為出生體重、胎別、協助人數多寡、資訊性需求程度、情緒性協助程度、社會支持足夠程度總分、財務負荷、照顧負荷總分。 結論:根據本研究結果提出以下:建議醫護人員需在早產兒出院前,除了提供主要照顧者所需要的照顧知識外,還需要評估其社會支持情形、照顧上負荷程度,適時給予所需要的支援,以幫助主要照顧者能及早回復原本生活次序,改善其生活品質。

並列摘要


Purpose and method:The purpose of this study was to understand the quality of life and related factors of the primary caregivers of preterm infant. This study was designed as longitudinal study, the data were collected by purposive sampling. During April.25, 2008 to April 1. 2009, the study group was the caregivers of preterm infant. The data collection were conducted in the form of questionnaires , collected before discharge, 7~10 days after being discharged and 28~30 days after being discharged. The questionnaire enrolled the basic information on preterm. We enrolled 44 people and 32 of them completed the 3 parts of the questionnaire . the complete rate of effective questionnaire was 73%. These data were analyzed by SPSS13.0 for Windows . Result : 1. The majority was female infant, average birth weight was 1277g, average gestation age was 29 weeks. 56% of them got complication, the average duration of hospitalization was 64.4 days. The gestation age , complication, monitor usage and length of hospitalization had correlation with the life quality of the primary caregiver. 2. 97% of the primary caregivers were female . The average age was 33 year-old. 62 % of the caregivers kept working before the preterm infant was discharged. 53% of the caregiver graduated from the Junior College or Bacholor. 53% of them had 2 children and 41% of the family had monthly income between NT 60,001~90,000 . From the analysis of the data, we found that the more children they had in the family , the worse physical health the caregiver get . 3. In analysis the life quality , the social relationships domain got the highest score and the psychological domain got the lowest . The physical health, social relationships and environment domains reached the significant deference in deferent time point and the physical health domains got the worst performance at the post-discharge day 28~30. 4. The requirement of social support and the environment domain showed a significantly negative correlation. But the level of social support had direct proportion to the four domains of life quality which means the more social support they had, the better life quality of the primary caregiver. 5. The psychological burden got the highest score of the caregiver burden while the financial burden got the lowest . The major deference of caregiver burden was at the post-discharge day 7~10. The caregiver burden had showed a negative correlation to the quality of life and positive to the requirement of social support. These means that the biggest the care loading and the poor social support were , the worse the quality of life. 6. The predictive factors of the quality of life were: birth weight, gestation number, the number of assistant , the degree of information requirement, the degree of emotional support, the score for social support , financial burden and caregiver burden. Conclusion: We suggested the medical staff to evaluate the social support , caregiver burden before the preterm infant was discharged in addition to offer the basic knowledge of baby care. We also help the primary caregivers to return to their original life and improve the quality of life.

參考文獻


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