南部某醫學中心家屬照顧者對精神科居家照顧滿意度及其相關因素探討

The satisfaction and its related factors of family caregivers in psychiatric home care at a medical center in southern Taiwan

黃文慧(Wen-Hui Huang)

指導教授 ： 鍾信心

高雄醫學大學/護理學院/護理學系研究所/碩士(2009年)

https://doi.org/10.6832/KMU.2009.00021

摘要

本研究目的在探討南部某醫學中心精神病患之家屬照顧者對精神科居家照顧的滿意情形及相關因素。為一項相關性研究，以立意取樣，在南部某醫學中心精神科收集精神科居家照顧病患之家屬照顧者共101位。研究工具利用結構性問卷包括「家屬照顧者對精神科居家照顧服務滿意度量表」、「精神疾病患者及其家屬照顧者背景資料」及病歷回顧方式查詢收案之精神病患醫療情形。
研究結果發現：ㄧ、精神科居家照顧滿意度量表，經由因素分析可歸納為「精神居家照顧核心能力」、「服務態度」、「有效性」、「方便性」、「資源可利用性」；最高得分項目為護理師服務態度，最低為增加將來安置的機會與資源。滿意度分數平均為4.69±0.41分，以各分項滿意度平均值佔滿意度總分之百分比計算，整體滿意度為92％，超過九成的滿意度屬於滿意，顯示家屬照顧者對精神科居家照顧的滿意度是較高的。
二、滿意度相關因素：（一）家屬照顧者性別與滿意度的關係得分有差異，女性滿意度較高於男性。（二）主要照顧者和精神病患是否同住與滿意度有差異，同住者滿意度情形高於未同住者。（三）照顧者教育程度與滿意度的關係有差異，專科學歷之家屬滿意度低於高中/職者、國小以下及國初/中。（四）醫學診斷與滿意度的關係得分有差異，精神分裂症其滿意度較高於其他醫學診斷的家屬照顧者。
本研究對於精神科居家照顧滿意度及醫療服務品質上，可提供實證資料，建議精神科居家照顧提供者可以維持及提升相關知能，期使此項服務可以建立精神科居家護理師制度，使精神病患及其家屬可以在社區獲得更佳服務品質。

關鍵字

精神科居家照顧 ； 滿意度 ； 家屬照顧者 ； 精神病患

並列摘要

The purpose of this study was to explore the satisfaction and its related factors of family caregivers in psychiatric home care at a medical center in southern Taiwan.
The study was a correlative research, and a purposive sampling was adopted, using structured questionnaires and anamnesis review. Purposive samples were 101 of family caregivers in psychiatric home care from a medical center in southern Taiwan. Questionnaires used in the study included: 1.Psychiatric home care service satisfaction scale.2.The demographic data of the mentally ill patients and family caregivers. 3. The medical treatment of the mentally ill patients. Collected sample were descriptively and inferentially analyzed using SPSS 12.0 statistical program.
The results of this study were obtained as follow; Factor analysis indicated that Psychiatric home care service satisfaction scale could be induced in five factors: competencies of psychiatric home care service, service attitude, efficacy, convenience and utilizable resources. The highest score is “the service attitude”, and the lowest score is “the opportunity and resources for the increase of placement in the future”. The overall satisfaction of family caregivers was higher than 90%, since the mean of each item was 4.69, full score was 5.00.
The related factors of satisfaction were: 1. The family caregivers of gender of satisfaction has higher than the male. 2. Family caregivers who live with patient has more satisfaction. 3. Family caregivers educational level show the difference, the satisfaction of the graduate of associate degree program has lower than the graduate of senior high school, elementary school and junior high school. 4. The family of patient with diagnosis of schizophrenia, the satisfaction has higher than others.
This study expect to provide more information to nurses for understand the satisfaction and its related factors for family caregivers in psychiatric home care, and expect to set up the institution of psychiatric home care nurse, in the future for the mentally ill patients and there family caregivers to improve the quality of service.

並列關鍵字

psychiatric home care ； satisfaction ； family caregivers ； mentally ill patient

參考文獻

中文文獻

王祥章（2005）．結合居家治療與新一代抗精神病藥物長效針劑-慢性精神分裂症病患之治療模式．慈濟醫學，17(12），53-56。

行政院衛生署（1997）．衛生白皮書－跨世紀衛生建設。

沈淑華、沈秀娟、張達人、顏妙芬（2005）．社區慢性精神病患主要照顧者心理衛生教育需求之探討．健康促進衛生教育雜誌，25，89-108。

林進嘉、殷建智、李添誠、謝秀幸（2001）．日間留院及居家治療之精神分裂症患者生活品質之比較．臺灣精神醫學，15（3），60-70。