呼吸器居家病人家屬照顧者之生活經驗

The Lived Experience of Family Caregivers Caring for Ventilator-Dependent Patients at Home

吳英旬(Ying-Hsun Wu) ； 曾月霞(Yueh-Hsia Tseng)

《長期照護雜誌》 13卷2期 (2009/09) Pp. 169-189

https://doi.org/10.6317/LTC.200909_13(2).0005

摘要

由於呼吸器依賴病人滯留於急性或加護病床，健保局於2000年實施「整合照護計劃」，以推動呼吸器依賴病人之居家照護。然而參加此計畫而返家照護的病人及家屬的經驗很少被探討，以致無法了解這些家屬是否有照護上的困難或需求。本研究目的是探討呼吸器依賴病人返家接受呼吸器居家照護，其家屬照顧者之照護經驗。採質性研究，以深度訪談法進行資料收集。採立意取樣，共訪談15位中部地區呼吸器居家照護病人的家屬。訪談後依據訪談錄音文稿做質性資料分析。資料分析後結果呈現的生活經驗共有八個類別，包含：1.對親情的不捨而決定返家；2.準備迎接新生活；3.發展減少照顧工作負荷的策略；4.經歷各種突發狀況；5.自行執行醫療處置；6.承受沉重身心社會負荷；7.持續照護的「美」中「不足」；8.對呼吸器的愛恨情結。本研究的結果，有助於護理人員對家屬在居家照護期間生活經驗的了解，可作為未來進行呼吸器居家照護出院準備服務之參考，以規劃更符合病人及家屬需求的呼吸器長期安置方案，使病人家屬得到持續性的服務。家屬居家照護之經驗也可提供給其他呼吸器依賴病人之家屬進行安置決策時的意見。

關鍵字

呼吸器依賴 ； 居家照護 ； 家屬照顧者

並列摘要

Due to the ventilator-dependent patients occupied hospital acute-care or intensive care beds, Bureau of National Health Insurance has carried out the 'Integrated Delivery System Plan' since year 2000 to facilitate ventilator-dependent home care. The lived experience of the patients and family caregivers after joining the plan and caring at home was little explored. Thus, it was hard to understand care problems or needs for the family caregivers. The purpose of this study was to illuminate lived experience of caregivers caring for ventilator-dependent patients at home. A qualitative research design was used. Data were collected by in-depth interviews. Fifteen family caregivers who had the ventilator-dependent care experiences were invited to participate in this study by purposive sampling. The interviews were tape-recorded and then transcribed verbatim. Content analysis was used to analyze the data. The result of the study emerged 8 categories of the experience of caregivers: (1) Deciding to care at home because of the intimacy relationship. (2) Preparing for a new life. (3) Developing strategies to reduce care loadings. (4) Experiencing various sudden/emergent events. (5) Performing medical treatments without medical orders. (6) Having heavy burdens on physical, mental, and social aspects. (7) Insufficiency in the fair of home care. (8) Contradictory feelings to the ventilator. The results of this study could be used to refine discharge plan for home care of ventilator-dependent patients and their caregivers. The experience of the caregivers could be used by other families to make decision for home care.

並列關鍵字

ventilator-dependent ； home care ； family caregiver