長期照顧機構住民住院對家屬之壓力與因應行為研究

研究目的：老年人口急速上升，機構式照顧成為長者照顧上另一項選擇。彰化縣長期照顧機構近十年來數量倍增，更多的家庭選擇將長者送至機構照顧，但每當長者住院時，照顧的重擔又回到家庭成員身上，故本研究旨在了解長期照顧機構住民住院對家屬壓力與因應行為，並找出影響及預測主要照顧者壓力與因應行為相關因子。研究方法：本研究採量性、橫斷式調查，以立意取樣方式，選取臺灣中部某區域教學醫院住院之長期照顧機構住民家屬為收案對象，共收案162位主要照顧者。研究工具為基本屬性資料表、壓力感受量表及因應行為量表，資料回收後以SPSS 22版統計套裝軟體進行描述性及推論性統計。研究結果：主要照顧者壓力感受總得分標準化後平均得分為57.03分，壓力感受為中等壓力，壓力感受四大構面得分由高至低依序為生理構面、生活構面、心理構面和經濟構面，主要照顧者之因應行為以問題導向為主。此外，基本資料之家庭收入、工作狀況及與住民關係好壞三變項，以及壓力之生理、心理和經濟三構面對其採取問題導向因應行為具有顯著預測力，具有59.6％的解釋力；而壓力之生活構面、主要照顧者性別、婚姻狀況及住民半年內的住院次數則對情緒導向因應行為具有顯著預測力，具有19.0％的解釋力。研究結論：主要照顧者對住民住院的壓力感受度高，特別是生理壓力，且以年紀小於39歲、無輪替家屬者之壓力感受總得分較高，而主要照顧者之因應行為以問題導向為主，本研究結果可作為臨床或長期照護機構護理人員提供或發展機構住民之主要照顧者有效及個別化的服務的參考。

關鍵字

長期照顧機構；家屬；壓力與因應行為

並列摘要

Objective: The increase in the elderly population, institution-based care has become another option for elder people. In Changhua, the number of long-term institutions has doubled in the past decade, and more families choose to send their elders to institutions for care. However, the stress of care the elders come back to the family members when the elders in hospitalization. Therefore, this study aimed to understand the stress and coping behavior of family members for long-term care facility residents in hospitalization, and to identify relevant factors that affect and predict the stress and coping behavior of the family members. Research method: In this study, a quantitative and cross-sectional survey was conducted, using a convenient sampling method, selecting applicants for family members of long-term care facility residents in hospitalization in a regional hospital in central Taiwan as the research objects, and total of 162 family members were admitted. The data were collected in the form of questionnaires, including: the basic information, stress and coping behavior of the family members. Data were collected and coded using SPSS 22.0 perform descriptive and inferential statistical analysis. Results: The standard average score for family members of total stress was 57.03 points, which was moderate level. The four perception of family members of stress were in order of physiological, life, psychological and economic. Besides, family income, work status and relationship between residents of the family members and physiological, psychological, economic, had predictive power for their problem-oriented coping behavaiors, with a explanatory power of 56.9%. The life aspects, gender, marital status and the number of hospitalizations in half year had a siginificant predictive power for their emotion-oriented coping behavaiors, with explanatory power of 19.0%. Conclusion: The family members were highly on stress. Especially the physical stress, and the total score of stress perception is higher for those who are younger than 39 years old and have no rotating family members, and the coping behavior of the main caregiver is mainly problem-oriented. The results of this study may serve as a reference for nursing staff in clinical or long-term care facilities to provide or develop effective and individualized services for family members of facility residents.