復健黃金期腦中風主要照顧者的需求與相關因素探討

背景:復健黃金期為病人恢復肢體或認知功能關鍵期，此期亦也是急性醫療照護銜接長期照護與家庭生活相當重要的轉接點。當疾病延伸出不同程度的後遺症，不管對病人或家屬在未來生活上必會造成衝擊，且每個階段所面臨的問題也會有所不同。因此於病人住院期間及早確立照護需求，依據不同階段著重的需求給予個別化措施及相關資訊，提供最正確方向與照護，使病人及照顧者能成功回歸家庭生活及提升生活品質目的：在探討復健黃金期腦中風病人主要照顧者需求及其相關因素。方法: 本研究採縱貫性研究設計，在中部某一地區醫院復健病房進行收案，共收集60位腦中風主要照顧者，分別於復健黃金期前3個月及後3個月兩階段使用「腦中風家屬需求量表」問卷收集資料，所得資料以SPSS/PC 22.0版進行描述性統計及推論性統計法進行資料分析。結果:腦中風復健黃金期前3個月期照顧者需求以健康訊息及專業支持之需求最高，而復健黃金後3個月則以專業支持之需求為最高。比較前期與後期兩階段之六大面向照護需求；在健康訊息、社區支持、專業支持、實質支持、參與照護病患需求等面向皆有達統計上之差異（p<0.05），而情感支持面向則無顯著差異（p>0.05）。主要照顧者關係是病人的子女及主要照顧者自覺健康狀態是腦中風復健黃金期照顧需求的主要影響因子。結論:腦中風主要照顧者照護需求於腦中風復健黃金期兩階段有所不同，臨床人員提供照護時因根據不同時期需求，提供所需的照護資訊。

關鍵字

復健黃金期；腦中風；主要照顧者；照顧需求

並列摘要

Background: Rehabilitation golden period is very important timing for the recovery of limb or cognitive function of patients and is also a key transfor point between acute medical care as well as long-term care and family life. When the disease extends to different degrees of sequelae, regardless of the patient or family in the future life will cause the impact, and each stage of the problems will be different, therefore early in the patient during hospitalization to establish care demands, according to the different demands of different stages to give individual measures and related information to provide the most correct direction and care, spend the least cost to maximize the benefits, that patients and caregivers can return to family life and improve the quality of life. Objecitve: To explore the demands of primary caregivers and related factors in patients with cerebral apoplexy during rehabilitation golden period. Methods: The longitudinal study subjects were primary caregivers of stroke patient in the rehabilitation ward of a hospital in central Taichung. A total of sixty primary caregivers for stroke patients were collected in the early stage of the rehabilitation golden period ( the first 3 months of stroke)and late stage (the 3 months). Two-stage used of the structural questionnaire Stroke Patient's Family Caregiver Demands Scale for data collection. The data analysed by SPSS/PC 22.0 version with descriptive statistics and inferential statistical methods. Results: The demands for the early stage of the rehabilitation golden period of cerebral apoplexy ( the 3 months) where health information and professional support, while professional support for the late stage of rehabilitation golden period (the3 months).Compared these two stage six major aspects of care Demands , health information, community networks, professional support, instrumental support, and involvement with patient care all showed statistically different, but emotional support not.Who were the patient's weather or not the caregivers was the child of patient's and caregiver's self-perceived health status were the predictive factors for the care demand in golden period of rehabilitation of stroke. Conclusion: Care demand stroke for the primary caregivers are different in the two stages of the brain stroke rehabilitation golden period. Clinical staff should provide the necessary care information according to the demands of different periods.