照顧負荷對老人家庭主要照顧者施虐傾向影響之研究

The Impact of Caregiving Burden on Potentially Harmful Behavior of Elderly Caregivers

林潔萍(Chieh-Ping Lin)

指導教授 ： 黃志忠

國立暨南國際大學/人文學院/社會政策與社會工作學系/碩士(2017年)

摘要

本研究欲瞭解照顧負荷對老人家庭主要照顧者施虐傾向的影響，探討老人家庭主要照顧者及老人的個人特質、照顧互動情境、照顧負荷對照顧者施虐傾向之影響，基於上述研究目的，本研究以生態系統理論為研究架構，主要採取量化研究方法，選取中部地區48位老人家庭照顧者，以面訪方式進行問卷調查，並輔以質性訪談方式，訪問家庭者主要照顧者6位，主要研究結果如下：
1. 影響照顧者照顧負荷因素，包含老人個人特質，例如老人的失能與失智程度；主要照顧者特質包含家庭經濟狀況，在照顧情境中，家庭互動關係、老人干擾行為及社會支持，皆對照顧負荷來顯著影響。
2. 照顧者施虐傾向因素危險因子，包含老人個人特質如性別與失智程度；主要照顧者個人特質包含婚姻狀況、和老人同住與否，在照顧情境中，則包含家庭互動關係、老人的干擾行為、社會支持及照顧負荷，都和照顧者施虐傾向達顯著相關，整體模型解釋力為54.4%。
3. 從質性資料中得知，居家服務介入帶來的效益，包含減少體力耗費、增加照顧者活用自己的時間、減少照顧擔憂、增加社會支持、減少老人干擾行為且成為老人情緒抒發管道。
4. 照顧者的施虐傾向因居家服務的介入減少照顧負荷、提升照顧者的社會支持，以減緩家庭照顧者獨自面對照顧困難處境，因照顧帶來負面效益亦隨之降低。
未來將有更多照顧者面對老人照顧議題，希望透過此研究能讓政府重視老人家庭者議照顧者照顧負荷及施虐傾向影響因素，期望作為政府訂定相關規範之參考，透過服務減少照顧者照顧負荷，降低照顧者施虐傾向，以提升老人照顧品質，促進老人與家庭照顧者生活福祉。

關鍵字

老人虐待 ； 照顧負荷 ； 照顧者

並列摘要

This study aimed to understand how the caregiving burden affects potentially harmful behavior of elderly caregivers. This study investigated into the demographic characteristics of caregivers and the elderly, caregiving context between the elder and caregiver and the caregiving burden affect such tendencies. For the aforementioned purpose, this study mainly followed a quantitative research method and selected 48 family caregivers for older people in Central Taiwan for an interview survey in addition to subsequent qualitative interviews with 6 of the caregivers. The main findings are outlined below:
1. Factors that affect the caregiving burden for the caregivers include personal characteristics of the elderly, such as degree of disability and dementia, characteristics of the main caregivers, including the family’s financial situation, interactive relationships in the family, disruptive behaviors in the elderly and social support all have significant effects on the caregiving burden.
2. Risk factors leading to abusive tendencies in the caregivers include personal characteristics of the elderly, such as gender and degree of dementia, personal characteristics of the main caregivers, including marital status and living with their older family members or not and caregiving scenarios, including interactive relationships in the family, disruptive behaviors in the elderly, social support and burden of care, all have significant correlations with abusive tendencies in the caregivers. All of variables accounted for 54.4%.
3. Qualitative data show that the benefits brought by intervention through home care services include less physical exertion, more time for the caregivers, fewer concerns with caregiving, more social support, fewer disruptive behaviors in the elderly, and provision of emotional outlets for the elderly.
4. Potentially harmful behavior of elderly caregivers are prevented because the intervention through home care services has lessen the caregiving burden and increased social support for the caregivers that help reduce the difficulties faced by them while giving care alone and negative effects associated with such caregiving.

There were more issues faced by caregivers in the future while looking after their older family members. It is hoped that this study can draw the government’s attention to factors that affect burden of care and abusive tendencies in family caregivers for the elderly and serve as a reference for the government in establishing related regulations as well as improving the quality of elderly care and wellbeing for the elderly and their family caregivers in everyday life by providing services that reduce burden of care for caregivers and in turn prevent abusive tendencies in them.

並列關鍵字

elder abuse ； caregivers ； caregiving burden

參考文獻

一、中文部分

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呂寶靜(2001)。老人照顧:老人、家庭、正式服務。台北：五南。

呂寶靜(2005)。支持家庭照顧者的長期照護政策之構思。國家政策季刊，4卷4期，25-40。

呂寶靜(2012)。老人福利服務。台北：五南。