照顧自殺企圖者之照顧負荷與經驗

Care Burden and Care Experiences of Caregivers of Suicide Attempters

蔣秀容(Shiou-Rong Jeang) ； 王珮珩(Pei-Hern Wang) ； 齊美婷(Mei-Ting Chi) ； 顧艷秋(Yan-Chiou Ku)

《榮總護理》 33卷1期 (2016/03) Pp. 77-86

https://doi.org/10.6142/VGHN.33.1.77

摘要

本研究主在探討照顧自殺企圖者之照顧負荷與經驗，採質性研究法，以南台灣某醫學中心急性精神科病房自殺企圖主要照顧者為研究對象，以半結構式訪談大綱進行深度訪談，以質性方法分析資料，共收案8位，照顧者之負荷經驗分為情緒反應、生活狀況改變、接受現實三大主題；情緒反應涵蓋「緊張不安」、「擔心害怕」、「無奈」及「心痛難過」四個次主題，當個案出現自殺企圖行為時，照顧者出現緊張不安，進而擔心害怕，歷經幾次自殺行為後，照顧者深感無奈、心痛難過，甚至也出現負面想法；生活狀況轉變涵蓋「無形壓力」、「工作與家庭無法兼顧」及「睡眠紊亂」三個次主題，長期照顧自殺企圖者，身心俱疲造成無形壓力，處理自殺企圖者突發狀況，工作受到影響，陷入工作與家庭無法兼顧之窘境，但為了現實生活必須堅持下去，出現睡眠紊亂而求醫；接受事實涵蓋「面對現實」、「轉換想法」及「宗教力量支持」三個次主題，照顧自殺企圖者多年下來，照顧者告訴自己接受事實，一切終究要面對現實，轉換自己的想法，藉宗教力量支持，讓自己繼續走下去。建議臨床護理人員可依照顧者之負荷經驗貼切他們的心境，提供鼓勵與支持，不可忽略對照顧者的關心。

關鍵字

自殺企圖 ； 主要照顧者 ； 照顧負荷

並列摘要

This qualitative study investigated the overburden experiences of the caregivers of suicide attempters. Purposive sampling was used to select participants from the acute psychiatric ward of a medical center in Southern Taiwan. Eight caregivers of patients who had attempted suicide were evaluated using semistructured in-depth interviews. A qualitative approach was used to induce and analyze the text data. Three major dimensions of the overburden experiences of caregivers were detected: ＂emotional response,＂ ＂changes in living condition,＂ and ＂acceptance of reality.＂ Emotional response comprised four subthemes: ＂nervousness,＂ ＂worry and fear,＂ ＂helplessness,＂ and ＂heartbrokenness.＂ When the patients attempted suicide, the caregivers became nervous and then fearful for these patients. After experiencing several suicide attempts, the caregivers felt helpless and heartbroken and even developed negative thoughts. The changes in the living conditions included three subthemes: ＂invisible stress,＂ ＂work-family imbalance,＂ and ＂sleep disorders.＂ The caregivers exhibited physical and mental fatigue after caring for patients for a long period, with a large burden of invisible stress. The sudden suicide attempts of the patients affected the work life of the caregivers: when facing the dilemma of either caring for the patient or working, they chose caregiving. Nevertheless, the caregivers sought medical aid when they developed sleep disorders. Acceptance of reality included three subthemes: ＂facing reality,＂ ＂changing thoughts,＂ and ＂seeking religious support.＂ The caregivers preferred to accept reality after caring for the patients for a long period; they anticipated acceptance of reality to eventually change their thoughts. Moreover, they used religious forces to support themselves throughout the caregiving. In conclusion, clinical nursing staff should care for and provide more encouragement and support to family members of suicidal patients.

並列關鍵字

suicide attempter ； caregiver ； care overburden

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