鬱症患者主要照顧者照顧負荷相關因素之探討

鬱症是常見的情感性精神疾病，患者常需依賴別人照顧，對主要照顧者會產生身心方面的負荷。本研究目的為探討:(1)鬱症患者社會人口學特性與主要照顧者照顧負荷之關係；(2)主要照顧者社會人口學特性與其照顧負荷之關係；(3)主要照顧者自覺健康狀況與其照顧負荷之關係；(4)主要照顧者憂鬱程度與其照顧負荷之關係；(5)影響主要照顧者照顧負荷之重要解釋因子。以鬱症患者主要照顧者為研究對象，自 2019 年 09 月 01 日至 2020 年 01 月 30 日於高雄市某區域教學醫院精神科門診進行收案，採用結構性問卷調查收集鬱症患者社會人口學資料、主要照顧者社會人口學資料、自覺健康狀況、憂鬱程度及照顧負荷等，共收案 150 人，以描述性統計、獨立樣本 t 檢定、皮爾森積差相關性分析及階層複迴歸分析進行資料分析。研究結果發現(1)主要照顧者照顧總負荷程度屬於輕度至中度負荷；(2)主要照顧者照顧負荷次向度以照顧者緊張感最高，其次為案主依賴；(3)主要照顧者教育程度及憂鬱程度為主要照顧者照顧總負荷之重要解釋因子；(4)鬱症患者婚姻狀況，主要照顧者平均月收入及憂鬱程度為主要照顧者家庭干擾照顧負荷次向度之重要解釋因子；(5)主要照顧者教育程度、與患者關係、自覺健康狀況及憂鬱程度為主要照顧者烙印照顧負荷次向度重要解釋因子；(6)主要照顧者 II 憂鬱程度為主要照顧者愧疚、緊張感及案主依賴照顧負荷次向度之重要解釋因子。關鍵字:鬱症、主要照顧者、照顧負荷、自覺健康狀況、憂鬱

關鍵字

鬱症；主要照顧者；照顧負荷；自覺健康狀況；憂鬱

並列摘要

Major depressive disorder (MDD) is a relatively common emotional mental illness, where patients generally rely on others to take care of them, which may cause physical and mental burden on the primary caregivers. This study aims to explore the factors and relationships regarding the primary caregivers of MDD patients: (1) the association between social-demographic characteristic of the MDD patients and caregiver burden; (2) the association between sociodemographic characteristics of the primary caregivers and caregiver burden; (3) the association between self-perceived health condition of the primary caregivers and caregiver burden; (4) the association between depression level of the primary caregivers and caregiver burden; and (5) the important explanatory factors associating with caregiver burden. A total of 150 participants were recruited from a Psychiatric Clinic Department at a regional teaching hospital in Kaohsiung since September 1, 2019 to January 30, 2020. Structured questionnaire survey were used to collect social-demographic characteristics of MDD patients and the primary caregiver, the self-perceived health condition, depression level, and caregiver burden of the primary caregivers. Data were analyzed with descriptive statistics procedure, independent samples t-test, Pearson’s correlation coefficient, and hierarchical multiple regression analysis. Findings based on the result of the current study are as below: (1) The overall caregiver burden of primary caregivers was at low to middle level; (2) among the IV subdimensions of the primary caregiver’s caregiver burden, nervousness appeared to be the strongest, followed by patient dependency caregiver burden; (3) the educational level and depression level of the primary caregivers were important explanatory factors of the overall caregiver burden; (4) marriage status of MDD patients, average monthly income and the depression level of the primary caregivers were important explanatory factors of the “family interference” subdimension in caregiver burden; (5) the primary caregivers’ educational level, relationship with the patients, self-perceived health condition and depression level were important explanatory factors for the “impressionistic” subdimension in caregiver burden; (6) depression level of primary caregivers was an important explanatory factor for the “guilt”, “nervousness” and “patient dependency” subdimensions in caregiver burden of the primary caregivers. Keywords: major depressive disorder, primary caregiver, caregiver burden, selfperceived health condition, depression