探討失智症患者使用日間照顧中心與瑞智互助家庭模式下之家庭照顧者多元評估

Comprehensive Assessment of Family Caregivers with Dementia in Adult Day Care and Wisdom of Family

張鈺勤(Yu-Chin Chang)

指導教授 ： 陳雅美

國立臺灣大學/公共衛生學院/健康政策與管理研究所/碩士(2015年)

https://doi.org/10.6342/NTU.2015.00510

摘要

研究背景：全球失智症人數逐年攀升，失智症患者由家庭照顧者所提供照護有增加的趨勢，家庭照顧者因照顧而產生的影響需被了解，因會影響到照顧者及失智症患者身理及心理，進而影響照護結果。選擇使用不同的長期照護模式，會對家庭照顧者產生不同的正負向影響。由此推測，失智症患者及家庭照顧者選擇使用日間照顧中心模式及瑞智互助家庭模式，會對家庭照顧者產生不同的正負向影響，目前國內研究大多針對單一正向或是負向影響進行研究，但未探討家庭照顧者對使用不同模式的正負向照顧影響。
研究目的：探討失智症患者使用日間照顧中心模式及瑞智互助家庭模式，對家庭照顧者多元評估之影響。
研究方法：本研究在五家日間照顧中心及瑞智互助家庭進行問卷調查。研究對象為經醫師確診為失智症患者且已經使用服務模式達三個月失智症患者之主要照顧者，且為主要提供失智症患者照顧服務之家庭照顧者。研究以複迴歸(Multiple Regression)控制家庭照顧者及患者人口學特質，探討使用日間照顧服務模式及瑞智互助家庭模式下，家庭照顧者之正負向影響。
研究結果：本研究共納入93人。照顧者多元評估量表兩組服務模式無顯著差異，其三個構面「照顧者壓力指數」、「照顧的滿足感」、「照顧的熟練能力」對兩組服務模式皆無顯著差異。照顧者就業狀況是否改變對多元評估及照顧者壓力指數為正相關，與照顧的滿足感為負相關；每日照顧平均時間對多元評估為正相關；照顧者年齡對照顧的熟練能力為負相關。
研究討論：兩者服務模式在照顧者壓力指數、照顧的滿足感及照顧的熟練能力無顯著差異，代表兩種服務對家庭照顧者其實都有很好的支持。建議未來發展多元長照家庭支持照顧服務時，也可提供瑞智家庭給之失智長輩的家庭做參考。研究結果建議對於家庭照顧者，在未來應給予照顧者社會支持及照顧技巧的訓練，來降低照顧的壓力，增加照顧的滿足感及熟練能力。

關鍵字

日間照顧中心 ； 瑞智互助家庭 ； 家庭照顧者 ； 照顧者多元評估

並列摘要

Background：As global aging, more dementia patient are cared by family caregivers., family caregivingmay have great impact onboth physical and mental health of the caregiver and the dementia older adults they are caring for. Evaluating family cargivers' experiences, which may included both positive and negative experiences, are important for future program and policy development. People with dementia and their family caregivers may use adult day care model or wisdom of family model in Taiwan.
Objective：The purpose of this study was to explore and compare comprehensive assessment of family caregiver with dementia using adult day care and wisdom of family.
Method：This study administer a comprehensive questionnaire in five adult day care centers and one wisdom of family. The comprehensive Questionnaire incldued three subscale. There were caregiving satisfaction, caregiving mastery and modified caregiver strain index. Participants of this study is the caregiver who attended the dementia patient, patient used the service already three months and is the mainly caregiver. The study used multiple regression to analyze and compare the differences in comprehensive assessment between families using adult day care and wisdom of family. Dementia cases and their family caregivers' characteristics were controlled.
Result：93 family caregiver were surveyed. There were no significant differences in comprehensive assessment scores between caregiver using adult day care and wisdom of family. For subscales, caregiver strain index, caregiving mastery and caregiving satisfaction, there were no significant differences found between family caregivers using adult day care and wisdom of family. As for the total score of comprehensive assessment scores, employment status change of caregiver was positively associated with caregiver comprehensive assessment scale and caregiver strain index, and negatively associated with caregiving satisfaction. The average care time of a day is positively associated with caregiver comprehensive assessment scale. Caregiver age was negatively associated with caregiving mastery.
Disscussion：There were no significant differences in the scores for conprehensive assessment, caregiver strain index, caregiving satisfaction and caregiving mastery between family careivvers using adult day care and wisdom of family. This indicated both services are equally supported family caregivers with demented older adutls. Findings suggested both services can be recommended to family careivgvers with different service preference. In the future, we suggest service agency to give caregivers’ social support and skills of care to declined caregiving stress and increase caregiving satisfaction and mastery.

並列關鍵字

adult day care ； wisdom of family ； family caregiver ； comprehensive assessment of caregiver

參考文獻

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