雙極性疾患與思覺失調症照顧負擔之比較研究

Comparative Study of Caregiver Burden between Bipolar Disorder and Schizophrenia

楊連謙(Lien-Chien Yang) ； 董秀珠(Hsiu-Chu Tung)

《北市醫學雜誌》 12卷4期 (2015/12) Pp. 297-307

https://doi.org/10.6200/TCMJ.2015.12.4.02

摘要

目的：比較雙極性疾患與思覺失調症的家庭照顧負擔。方法：徵募思覺失調症（n = 132）及雙極性疾患（n = 42）的患者及其照顧者，先比較兩診斷組之照顧系統，即患者、照顧者及照顧關係之差異，再用多元迴歸分析出兩診斷組主、客觀負擔的預測因子。結果：雖然兩組有不同的臨床特徵，但照顧負擔沒有統計學差異，都是中度。「每天照顧小時」同是兩組客觀負擔的預測因子，「照顧者的快樂感」同是兩組主觀負擔的預測因子，「外援」同是思覺失調症組主觀和客觀負擔的預測因子。結論：依據研究結果提出實務處遇建議如下：促進患者參與社區復健方案、鼓勵照顧者間交流、推行喘息服務政策、維護家庭內的照顧關係及功能，以及促進照顧者反思照顧的意義及價值。

關鍵字

思覺失調症 ； 雙極性疾患 ； 家庭照顧負擔

並列摘要

Objectives: To compare the caregiver burden between schizophrenia and bipolar disorder. Method: Patients with schizophrenia (n =132) and bipolar disorder (n = 42) and their primary family caregivers were recruited. The difference of care system between the two diagnostic groups, namely patients, caregivers, and care relationship, was examined initially, and then multiple regression was used to identify predictors of objective and subjective burden in each group. Results: Although the two diagnostic groups had different clinical characteristics, there were no statistical differences in burden scores. ＂Daily care hours＂ was the common predictor of objective burden, while ＂a sense of happiness＂ of caregivers was the common predictor of subjective burden. The ＂social supports” was the predictor of subjective and objective burden of schizophrenia group. Conclusions: According to these results, we recommend the following measures: encourage patients to use community rehabilitation resources, promoting transaction between caregivers, advancing the Respite Care Service supported by hospital, halfway house, and mutual help among caregivers, restoring intra-family relations and functioning of caregiving system, as well as prompting caregivers to explore the meaning and value of care-giving, and should not neglect care for themselves during care for their ill relatives.

並列關鍵字

schizophrenic disorder ； bipolar disorder ； family care burden