癌末病患主要家屬照顧者照顧負荷及其影響因素之探討

Factors Associated with Caregiver Burden in Families of Terminal Cancer Patients

洪淑惠(Shi-Hui Hong) ； 張肇松(Chao-Sung Chang) ； 林淑媛(Shu-Yuan Lin) ； 謝秀芳(Hsiu-Fang Hsieh)

《護理暨健康照護研究》 5卷3期 (2009/09) Pp. 163-172

https://doi.org/10.6225/JNHR.5.3.163

摘要

背景　癌末病患的家屬照顧者承受不少的照顧壓力，忽略家屬照顧者的壓力，導致其健康受損及影響病患的照護品質。
目的　在探討癌末病患主要家屬照顧者之自覺健康和疲憊與照顧負荷之程度，以及照顧負荷的預測因子。
方法　為橫斷式的相關性研究，在高屏地區的一家醫學中心、一家區域醫院及二家地區醫院，以立意取樣方式，選擇100位住院、罹患癌症第四期，醫師建議接受安寧療護的病患主要家屬照顧者為研究對象。
結果　主要家屬照顧者的照顧負荷平均值屬於中等程度，依標準化得分來看，以經濟負荷最高，其次依序為靈性負荷、生活負荷及身心負荷。主要家屬照顧者自覺健康屬於中上良好的狀態；照顧者有中度疲憊及輕度的疲憊干擾。照顧負荷的預測因子為主要家屬照顧者與病患的關係、經濟狀況、自覺健康和疲憊干擾的嚴重度，共可解釋照顧負荷的40%總變異量。
結論／實務應用　癌末病患家屬照顧者有中等的照顧負荷，故醫護人員應定期評估照顧負荷程度，並建議適時提供喘息服務，未來研究可以測試介入措施對減少照顧者照顧負荷的成效。

關鍵字

癌末病患 ； 主要家屬照顧者 ； 照顧負荷

並列摘要

Background: Those responsible for providing primary care to a family member suffering from terminal cancer face significant stress. Ignorance of such may deteriorate caregiver health and influence patient care quality.
Purposes: The purposes of this study were to describe the self-perceived health, fatigue and burden of family caregivers caring for terminal cancer patients and explore burden predictors.
Methods: The study employed a cross-sectional correlation design and was conducted at one medical center and three hospitals (1 regional and 2 district) in Kaohsiung and Pingtung. A purposive sampling method was used to select one hundred family caregivers of terminal cancer patients currently hospitalized and already referred to hospice care.
Results: Results showed the level of caregiver burden amongst participants to be moderate. In terms of importance, economic stress was the most significant stress faced by participants, followed, respectively, by spiritual, life, and physical-psychological stresses. As a group, respondents reported their self-perceived health as 'fair', their fatigue as 'moderate' and their fatigue interference as 'mild'. Predictors of caregiver burden included caregiver relationship with patients, economic status, perceived health and fatigue interference. These four predictors accounted for 40% of total caregiver burden variance.
Conclusions/Implications for Practice: Family caregivers of terminal cancer patients reported bearing a moderate burden. Clinicians are urged to assess regularly the degree of care burden in family caregivers. Study results suggest providing respite care to family caregivers as appropriate. The authors recommend conducting a prospective study to test the effectiveness of intervention in reducing caregiver burden.

並列關鍵字

terminal cancer patients ； family caregivers ； caregiver burden