安寧共同照顧模式對改善癌末主要照顧家屬照顧負荷之成效

The Efficacy of a Hospice Shared-Care Model on the Care Overload of Primary Caregivers of Terminal-Stage Cancer Patients

劉梅英(Mei‐Ying Liu) ； 劉雪娥(Hsueh‐Erh Liu) ； 王宏銘(Hung‐Ming Wan) ； 蔡培癸(Pei‐Kwei Tsay) ； 簡淑慧(Sui‐Whi Jane) ； 林怡欣(Yi‐Hsin Lin)

《護理暨健康照護研究》 11卷4期 (2015/12) Pp. 257-266

https://doi.org/10.6225/JNHR.11.4.257

摘要

背景：癌末病人症狀困擾趨向多重與複雜，家屬除了困難的照顧工作外，同時面臨喪親的傷痛，因此出現不等程度的照顧負荷。目的：探討癌末病人其主要照顧家屬於接受安寧共同照顧前後的負荷項目、嚴重度與嚴重度之變化。方法：採單組前瞻、類實驗縱貫性研究，對象為北台灣某教學醫院接受安寧共同照護個案之主要照顧家屬，採方便取樣，共52個樣本。以「癌末安寧共同照護主要家屬照顧負荷監測紀錄表」為工具，以描述性統計呈現照顧負荷的項目及嚴重度；以廣義估計方程式驗證安寧共照後主要家屬照顧負荷之連續性變化。結果：依照顧負荷項目出現的頻率高低，排序為「擔心病情」、「瀕死的分離哀傷」、「照顧人力的問題」等。嚴重度依序為「瀕死的分離哀傷」、「家人意見分歧」、「照顧人力的問題」等。安寧共同照顧模式對主要家屬負荷的嚴重度，在照顧後48小時持續至12日期間皆有顯著性改善（p ＜ .05）。結論：安寧共同照顧模式能輔助原醫療團隊，改善主要家屬的照顧負荷。

關鍵字

安寧共同照顧 ； 主要照顧家屬 ； 照顧負荷

並列摘要

Background: The symptoms of patients tend to multiply and become more complex during the advanced stages of cancer. Care overload often occurs when family caregivers are concurrently affected by grief or bereavement. Purpose: To explore care overload, severity, and the severity of changes for family caregivers who participate in hospice shared‐care programs. Methods: This was a single‐group, prospective, quasi‐experimental study. Participants included the family caregivers that participated in hospice shared care with terminal cancer patients in northern Taiwan. Convenience sampling was used with a total of 52 participants. The research instrument was a family‐caregiver overload in hospice‐shared care recording sheet. A generalized estimating equation was used to analyze the change in severity level of family‐care overload. Results: According to the data on hospice‐shared care involvement, the overload severity of family caregivers improved significantly and continuously between the recent intervention 48hrs and the following 12 days (p ＜ .05). Conclusions: The hospice shared‐care model assists oncology care teams to improve care overload for family-caregivers.

並列關鍵字

hospice shared‐care ； primary family‐caregiver ； care overload

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