探索失智症成年女兒照顧者的正向照顧經驗

Explore the Positive Aspects of Caregiving Experience in Adult Daughter Caregivers of Dementia

邱瀅年(Ying-Nien Chiu) ； 張玲慧(Ling-Hui Chang)

《職能治療學會雜誌》 36卷1期 (2018/06) Pp. 72-95

https://doi.org/10.6594/JTOTA.2018.36(1).04

摘要

前言：家屬照顧者在社區失智照顧扮演重要角色。過去研究專注照顧壓力相關因素及壓力處理，對於正向照顧經驗本質了解較少。本研究從日常生活照顧活動中探索失智症成年女兒照顧者的正向照顧經驗之樣貌、特質及其發生的情境脈絡，結果可供發展促進正向經驗之介入參考。方法：採用立意取樣共招募到六位女兒照顧者，藉由半結構式深度訪談、職能日誌與參與觀察收集資料。訪談錄音成逐字稿，以紮根理論為分析架構。結果：女兒照顧者的正向經驗來自執行日常照護活動中，對此經驗的過程與結果有正向評值。特質之面向包含聯繫親情、成就感、生活樂趣、個人成長、善盡孝道與維護家庭、和安心自在等。個人對解讀事件和照顧相關價值觀影響照顧者的正向照顧經驗。如照顧者因應失智者變化而調整照顧模式，常以兩害相權取其輕的原則取代事事順從父母的傳統思維，對孝道重新解釋達到安心自在。結論：正向照顧經驗與安適感的特質多有重疊，社會價值觀對於已婚女兒照顧者照顧原生父母仍有牽絆。促進正向經驗之介入設計必要考慮如何避免強化照顧性別化的負面影響。

關鍵字

失智症 ； 照顧者 ； 正向照顧經驗

並列摘要

Introduction: Family caregivers play a vital role in community dementia care. Most studies have assumed caregiving as a stressful process and focused on stress management strategies. Only a few aimed to understand the positive aspects of caregiving. This study explored the features of positive experiences for adult daughter caregivers via routine caregiving activities, as well as the contexts in which these experiences were situated. The results can be used to develop related interventions. Methods: A purposive sample of six adult daughter caregivers were recruited. Data derived from participant observations, in-depth semi-structured interviews, and occupational dairies. The interviews were audiotaped and transcribed verbatim. Data analysis was guided by grounded theory. . Results: Adult daughter caregivers attained positive caregiving experiences from their evaluation of the caregiving results and the processes. The features included a sense of familial relatedness, accomplishment, enjoyment of life, personal growth and filial piety fulfillment, as well as a state of mindfulness. The interpretations of the caregivers and the socio-cultural contexts influenced the experiences. For example, caregivers adapted caregiving patterns to meet the changing needs of their parents and often were made to choose the “the lesser evil among two unfavorable choices.” They re-invented the interpretation of filial piety to not always follow the parents’ commands. Conclusion: The features of positive caregiving overlap much with well-being. Conventional norms hinder married daughters caring for their birth parents. We also need to be mindful for inadvertently promoting gender-typing caregiving with interventions that aim to promote positive caregiving.

並列關鍵字

Caregivers ； Dementia ； Positive Caregiving