慢性思覺失調症病患家屬面臨病患出院時之焦慮與影響因子探討

Anxiety and Associated factors of family members of patients with chronic schizophrenia when they are discharged from hospital

陳信志(Hsin-Chi Chen)

指導教授 ： 顏文娟

中山醫學大學/醫學院/護理學系/碩士(2020年)

https://doi.org/10.6834/csmu202000264

摘要

背景：思覺失調症病患因疾病症狀反覆，往返於社區及醫院之間，病患住院使得家屬獲得短暫的壓力紓解。但面臨病患即將出院時，情緒將隨之而起伏，家屬的情緒若未能獲得解決勢必影響病患出院後之照顧。
研究目的：了解思覺失調症病患家屬在面臨病患即將出院時之焦慮程度及其預測因子。
研究設計與方法：本研究為橫斷式研究設計，量表採用自評焦慮量表SAS(Self－Rating Anxiety Scale)、自覺社會支持量表(Scale of Perceived Social Support)、正性及負性症狀嚴重度評量表、照顧者評價量表(Caregiver Appraisal Scale)。描述性統計以次數分配、百分比、 平均值、標準差進行分析，推論性統計以t檢定，ANOVA及相關、迴歸統計分析。
結果：92%的家屬焦慮程度界於無症狀及輕度症狀間，病患自殺意念、暴力行為、家屬的自覺社會支持、家屬學歷、照顧者評價等與焦慮程度有顯著差異。病人正性、負性症狀與家屬的焦慮具有正相關；自覺支持程度及照顧者評價與家屬的焦慮呈負相關。家屬焦慮的預測因子為病患負性症狀及家屬的照顧者評價對於家屬的焦慮。
結論:本研究結果可提供臨床專業人員未來在提供慢性思覺失調症患者照護時也能協助家屬降低家屬焦慮程度以維持健康的身、心、靈狀態。

關鍵字

思覺失調症 ； 焦慮 ； 家屬 ； 照顧者評價 ； 社會支持

並列摘要

Background: Schizophrenia patients travel back and forth between the community and the hospital due to the repeated symptoms of the disease. The patient's hospitalization allows the family members to get a short-term stress relief. However, when the patient is about to be discharged from the hospital, the emotions will be aroused and affect the care of the patient after discharge.
Research objective: Understand the level of anxiety and the predictors of schizophrenic patients’ family members when they are about to be discharged from the hospital.
Research design and methods: This study is a cross-sectional research design. The scales of Self-Rating Anxiety Scale (SAS), the Scale of Perceived Social Support, and the severity of positive and negative symptoms, Caregiver Appraisal Scale (Caregiver Appraisal Scale) were used. Descriptive data were analyzed by are analyzed by frequency, percentage, mean, and standard deviation. t test, ANOVA, correlation, and multiple regression were adopted for inferential data analysis.
Results: The anxiety level of 92% of family members was between no and mild anxiety. Suicidal idea and violent behavior of patients, self-perceived social support, education, and caregiving appraisal of family members, etc. were significantly associated with anxiety. The patient's positive and negative symptoms are positively correlated with family anxiety; perceived social support and caregiving appraisal are negatively correlated with family anxiety. The patient's negative symptoms and the caregiving appraisal were the two predictors of family anxiety.
Conclusion: The results of this study can provide clinical professionals in the future when providing care for chronic schizophrenic patients; meanwhile, they can also help family members to reduce their anxiety to maintain a healthy body, mind, and spirit.

並列關鍵字

schizophrenia ； anxiety ； family members ； caregiving appraisal ； social support