精神分裂病患者主要照顧者照顧負荷之探討： 以某醫學中心復健及門診個案為例

The Study of Different Primary Caregiver Burdens in Schizophrenic Patients Between Rehabilitation Group and Outpatient Service in a Medical Center.

張秀桃(Hsiu-Tao Chang)

指導教授 ： 陳正宗

高雄醫學大學/健康科學院/行為科學研究所/碩士(2004年)

摘要

本研究主要探討日間復健與門診治療之精神分裂病患主要照顧者照顧負荷程度。採立意取樣，以結構式問卷進行訪談，研究樣本依研究條件分為復健組（36人）與門診組（45人），共訪談81位研究對象，個案平均年齡35.9±10.8歲，男佔59.3％，女佔40.7％。主要照顧者平均年齡58.5±10.5，女（66.7％）多於男（33.3％），研究結果顯示：
1.復健組主要照顧者照顧負荷低於門診組，兩組達統計學上顯著差異。
2.整體之照顧負荷落到輕到中度負荷（24.8分）。次量表以「照顧者緊張感」、「案主依賴」的負荷程度最高。復健組照顧負荷次量表以照顧者緊張感排序第一，門診組以案主依賴得分最高。
3.整體個案之社會功能介於尚可到中度功能（50.5±15.3）；次量表得分排序以獨立/能力功能最佳，人際溝通第二，獨立/表現第三；復健組與門診組在社會功能次量表均以獨立/能力排序第一位，社會性得分最低。
4.復健組和門診組個案之社會功能和主要照顧者身心健康未達顯著差異。
5.影響照顧負荷因素為照顧者身心健康、個案職業/就業功能等變項。
根據上述研究結果，建議廣設及宣導社區復健設施，提供家屬心理教育支持方案，降低照顧者照顧負荷。

關鍵字

精神分裂病 ； 主要照顧者 ； 照顧負荷 ； 社會功能 ； 身心健康

並列摘要

This research aims are to compare the degree of primary caregiver burdens in schizophrenic patients between rehabilitation program and outpatient service. Eight-one cases by purpose sampling are divided into rehabilitation group (36 cases) and outpatient service group (45 cases),and are interviewed with structured questionnaires . The mean age of the 81 patients was 35.9±10.8 years old, with 59.3％male , and 40.7％female . The mean age of primary caregivers are 58.5±10.5 years old, the female (66.7%) is much more than the male (33.3%). Results from this research indicates that:

1. Caregiver burdens of rehabilitation group is statistically significant less than outpatient service group .
2. Total primary caregiver burden is in moderate degree（ranged 21-32points, case mean=24.8 points) using the Caregiver Burden Scale. The first two factors related to caregiver burdens are “caregiver strain” and “client dependency”. The highest score of caregiver burden subscale in rehabilitation group is“ caregiver strain”. The highest score of caregiver burden subscale in outpatient group is “client dependency”.
3. Total social functioning of cases are in acceptable range to average range degree（ranged 34-51 points, case mean=50.5±15.13 points) using the Social Functioning Scale. The score of subscale are independence/ competence functioning, interpersonal communication, and independency/performance subsequently. The highest score of social functioning subscale in both groups is independency/ competence functioning, The lowest score of social function subscale is sociality in both groups.
4. Social function of cases and health condition of primary caregivers of both groups do not defer statistically.
5. Influentence factors of caregiver burdens are health condition of primary caregivers and occupations/employment functioning of social functioning subscale of patients.
According to research results above, researcher suggests that extensively establishing and promoting rehabilitation facilities in the communities and offering supporting programs of psycho-educational programs to families may lead to lessening caregiver burdens.

並列關鍵字

social function ； care burden ； primary caregiver ； schizophrenic patient ； mental health

參考文獻

參考文獻

一.中文部分

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

余漢儀（2002）精障者社區復健模式探討------以台灣地區的四個康復之友為例. 中華心理衛生學刊 第十五卷 第二期 1-24

宋麗玉（1998）精神病患社區照顧省思----社區化或機構化，選擇或困局？中華心理衛生學刊 第11卷 第四期73-102