家庭照顧者之正、負向照顧經驗與健康相關生活品質關係探討

The Relationship among Caregiver's Positive Experience, Negative Experience and Health-related Quality of Life

陳品元(Pin-Yuan Chen) ； 李玉春(Yue-Chune Lee) ； 陳雅美(Ya-Mei Chen)

《長期照護雜誌》 21卷3期 (2017/12) Pp. 285-302

https://doi.org/10.6317/LTC.21.285

摘要

背景：隨著臺灣人口老化及少子化衝擊，家庭照顧者的照顧經驗、生活品質是未來長期照顧政策重要的評估指標。國內目前已有豐富研究探討照顧壓力與整體生活品質關係，但仍缺乏系統性瞭解家庭照顧者正向、負向照顧經驗對健康相關生活品質影響。因此，本研究探討家庭照顧者的正向、負向照顧經驗與健康相關生活品質的關聯性。方法：本研究以電訪形式調查向臺北市衛生局申請十年長照服務之家庭照顧者，並使用結構方程模型（SEM）探討家庭照顧者的照顧壓力、照顧的滿足感、照顧的熟練力、健康相關生活品質四者間的關係。結果：共計121位接受電話訪談，研究結果顯示家庭照顧者的照顧壓力越高，健康相關生活品質狀況越差（p＜ 0.001）；照顧的熟練力越佳，心理相關生活品質越好（p＜ 0.05）；照顧壓力和照顧的滿足感為負向顯著關係（p＜ 0.01）；照顧的滿足感和照顧的熟練力為正向顯著關係（p＜ 0.01）。結論：家庭照顧者的負向與正向經驗同樣影響家庭照顧者的健康相關生活品質。建議未來政策應建構多元的照顧者支持服務，除了降低負降照顧經驗，例如照顧壓力外，應同時給予服務支持正向照顧經驗，例如提供照顧訓練與諮詢服務，增加照顧的熟練力與滿足感，以提升其健康相關生活品質。

關鍵字

家庭照顧者 ； 正向照顧經驗 ； 照顧壓力 ； 健康相關生活品質

並列摘要

Background: In Taiwan, a fast-aging society, family caregivers' caregiving experiences and quality of life have become important issues for the development of long-term care services and policy. Despite significant past research on relationships between negative caregiving experiences (e.g., stress) and quality of life, studies on the relationships among positive caregiving experiences (e.g., caregiver mastery and satisfaction), negative caregiving experiences, and caregivers' quality of life are still limited. This study aimed to investigate the relationships among caregivers' positive experiences, negative experiences, and health-related quality of life. Methods: Data were collected through telephone interviews with family caregivers who had applied for the 10-year long-term care services from the Department of Health, Taipei City Government. Structural equation modeling (SEM) was applied to investigate the associations between caregiving strain, caregiving satisfaction, caregiving mastery, and health-related quality of life in caregivers living in Taipei. Results: A total of 121 caregivers were interviewed. Study findings showed the following: (1) The higher the level of perceived caregiving strain, the lower the level of perceived health-related quality of life (p＜0.001). (2) The higher the level of caregiving mastery, the higher the level of perceived psychological quality of life (p＜0.05). (3)Significant negative associations were identified between caregiving strain and caregiving satisfaction (p＜0.01). (4)Significant positive associations were identified between caregiving satisfaction and caregiving mastery (p＜0.01). Conclusions: This study found that positive and negative caregiving experiences were highly associated with caregivers' health-related quality of life. Although caregiving satisfaction was not associated with quality of life, it was highly associated with caregiving strain and caregiving mastery. These findings have implications for multi-aspect service programs that support family caregivers. In addition to decreasing negative caregiving experiences, such as by reducing caregiving strain, family caregiver support programs should also support positive caregiving experiences. For example, programs might offer caregiving training and psychological consultations that promote caregiving mastery and caregiving satisfaction. Such programs may increase family caregivers' health and health-related quality of life in the long run.

並列關鍵字

family caregiver ； positive caregiving experience ； caregiving strain ； quality of life

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