精神分裂病患者生活品質及主要照顧者負荷之探討

Quality of Life of the People with Schizophrenic Disorder and the Burden among their Caregivers

侯淑英(Shu-Ying Hou)

指導教授 ： 龍佛衛

高雄醫學大學/健康科學院/行為科學研究所/碩士(2004年)

摘要

本研究旨在了解精神分裂病患生活品質及主要照顧者負荷之影響因素，並意圖探討病患生活品質與照顧者負荷之因果關係，以作為精神醫療照護計劃之參考。

此為橫斷式調查研究，採立意取樣方法，以南部某區域教學醫院及某醫學中心急性病房與日間病房之精神分裂病患者與主要照顧者為研究對象。以結構式問卷調查收集資料，收案期間自91年4月至10月底，共收案126名（男性79名，女性47名）。研究工具包括：病患個人屬性、簡短精神症狀量表及世界衛生組織生活品質問卷-台灣簡明版；照顧者個人屬性、華人健康問卷及照顧者負荷量表。

研究結果發現：(1).精神病患生活品質以環境範疇最滿意，其次為生理健康，社會關係最差；「病房組」與「日間組」兩組生活品質滿意程度，未達顯著差異。(2).自覺健康狀況、精神症狀與藥物副作用是整體生活品質的重要預測因子。(3).照顧者的負荷為中程度的感知；其中以緊張感之負荷量最高，其次為案主依賴，烙印感負荷量較輕。「病房組」之照顧者緊張感及家庭干擾較「日間組」高，且達統計上顯著差異。(4).照顧者整體負荷程度之預測因子是：病患對醫療人員支持滿意程度、照顧者心理健康、精神症狀及病患年齡。(5).病患對社會關係的滿意程度越高，照顧者烙印感越輕；病患在環境層面越滿意，照顧者的烙印感、家庭干擾與整體負荷程度越輕。(6).病患的生活品質滿意度與照顧者負荷程度兩者之間無因果關係存在。

根據以上研究結果，精神醫療人員應重視且主動關心病患主觀健康狀況，以「人」為中心來了解其個人對生活的感受，提供病患所需之治療、教育與訓練，對家庭、社會提供整體性的介入與照護，將能提升病患生活品質，減輕照顧者負荷程度。

關鍵字

精神分裂病 ； 生活品質 ； 照顧負荷

並列摘要

The purpose of this study was to find out the effect of quality of life (QOL) of schizophrenics and the burden amount for caregivers, and investigate the correlation both between of QOL of schizophrenics and the burden amount for caregivers, to intent to help the policy of the mental health care.

The study of this cross-sectional, by convenience sampling, subjects of this study were selected the schizophrenics and the caregivers, either admitted at daycare center or acute ward, from two medical hospital at Southern Taiwan. The study period from April 2002 to October, include 126 schizophrenics patient (79 males, 47 females), by structural questionnaire was utilized by face to face interview. Measurement instruments were as follows: (1) Brief Psychiatric Rating Scale, (2) World Health Organization Quality of Life-Brief (TW), (3) Care Burden Questionnaire-Brief, (4) Chinese Health Questionnaire.

The results revealed that: (1) the environment field was the most satisfied part on QOL of schizophrenics, secondly was the physical health, the social relations was the most dissatisfied part; the QOL were less than different between the group of acute ward and daycare center. (2) The most important index to whole QOL is self-assessed score in health condition, patient's psychiatric symptoms and the medicine side effect, (3) The burden amount for caregivers is middling degree; feeling being tense was the most burden part, client dependence was the secondly, brand feeling not the important in the burden. The nervous feeling and family trouble was serious to acute ward compare with daycare center, (4) revolution analysis result the complete burden amount index was: Patient satisfy for the assist of medical personnel, the caregiver's mental health, client's psychology condition and how old of client, that could explain the 14% variable, and the assist of medical personal, was the best part of index of variable. (5) Satisfying to the relationship of society of the schizophrenics the burden amount for the caregivers is comparatively light. (6) However, there was no evidence of relationship between QOL of the patients and burden amount for their caregivers.

In conclusion, findings will be informative reference for future designation of community mental health service program in Taiwan’s society.

Key ward：schizophrenia; quality of life; burden of care

並列關鍵字

schizophrenia ； quality of life ； burden of care

參考文獻

毛家舲（1986）.家屬對精神疾病的反應—文獻查證.護理雜誌,33(4),13-23。

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