家庭照顧者使用情緒支持服務之影響因素探討

據統計，在台灣生活無法自理的失能老人與身心障礙者，超過九成是以家庭為主要居住與照顧處所，而家庭照顧者則是提供照顧的主要來源，承擔了大部份的照顧責任。家庭照顧者滿足被照顧者的需求，但是照顧者的需求是否有被照顧到？在生命的轉折處，家庭照顧者經常面臨生活、照顧的雙重壓力，不友善的環境、缺乏經驗、缺少其他的選擇空間和機會及無力感等，如何為這些弱勢族群建構完善的社會支持網絡，特別是在情緒支持方面，因為各種類型的照顧壓力與負荷都會直接、間接影響到照顧者的情緒，惟有心、身健康、擁有正向能量的照顧者，才能在參予照顧的歷程中，以穩定的情緒提供被照顧者高品質的照顧服務，並能多方考量其需求，讓照顧關係存在於一種良性的循環中。為達上述目的，研究者採質性研究以深度訪談的方式，訪問七位資深的家庭照顧者，關於情緒困境的因應方式及使用情緒支持服務的感受及期待。研究發現家庭照顧者在承擔照顧角色的過程中，會隨著照顧歷程的演進而面臨各種不同的壓力；在其面臨照顧壓力時主要的因應方式首推宗教信仰，其次是離開照顧場域，運動與休閒也被多數照顧者採用。在漫長的照顧歷程中，家人、宗教信仰、朋友與病友家屬是支持照顧者持續照顧工作最主要的三股非正式支持的力量。而當非正式支持薄弱或有專業需求等因素會影響正式情緒支持的需求，因此，提供符合照顧者需求的差異化服務，將有利於照顧壓力的解除與情緒壓力的紓解。研究更發現「照顧也是要學習的」以及「照顧者也需要有自我成長的機會」，這些學習與成長主要依賴正式支持服務。但受限於非正式支持系統薄弱，大部份家庭照顧者只能在就自身的現實環境限制來使用服務可近性較高的服務，而非自己最需要或最想要的服務。因此，照顧壓力的跳脫或許可由臨短托、居服員及志工等的公部門的資源支持；而充足的支持系統使照顧者得以從容自在的選擇各項服務，讓照顧者也受到照顧，感受到自我的價值與意義。

關鍵字

家庭照顧者；照顧壓力；社會支持；情緒支持；因應方式

並列摘要

According to the statistics,people live in Taiwan who are handicapped and elderly-disabled, more than ninety percent of them take their "home" as the main residence and care premises. Family caregivers play a vital role in supporting resources and bearing responsibility for those in need. Family caregivers always try their best to meet the needs of their nursed families, however,if the needs of caregivers have been satisfied? In the turning point of life,caregivers constantly have to face the dual pressures of how to take care of the life of their nursed family and their own. ? These pressures may be caused by some reasons like unfriendly environment,lack of experience,without other choice or opportunity and the sense of despair ...etc. ? How to construct a sound social support network for these disadvantaged groups especially in terms of emotional support is worthy to discuss.Because all types of pressures which the nursed people may bring about and the load will directly or indirectly affect the caregiver's emotional. It is the caregivers live in a optimistic way with healthy physical and mental that they can treat their nursed family with steady emotion supporting them a high quality service and considering what they real need during the process of participating care.All we try to improve is making the relationship between caregiver and nursed people into a virtuous cycle. ? To achieve the above object, researchers collected qualitative research with in-depth interview approach,visiting seven experienced family caregivers about the way they dealt with emotional distress and the feelings they used emotional support services. ? The study found that caregivers will face different pressures during the time they play a role in "Nurse", and this kind of pressure will also evolve with time. When they face these pressures, (A)taking religion as solutions is their first priority. (B)Secondly,leaving the care field can make them feel better temporarily, (C)furthermore,sports& recreation is also be chosen by caregivers. There are three informal supporting forces which support caregivers to continuetheir care work constantly: (a)family(b)friends (c)religion Nevertheless,if the informal support is gradually weak or caregivers need professional advices,both of these two reasons will affect the demand for formal emotional support.Thus,providing differentiated services to caregivers will help them release overwhelmed pressure. Research also found that: ? "Taking care is also to be learned" and "Caregivers also need the opportunity of self-growth". ? These learning and growth depend on formal support services,however,limited informal support systems are weak,most part of caregivers can only choose unsuitable service because of the environmental restrictions instead of the service they really desired. As a result,caregivers can escape from pressure for the time being by the help of volunteers, temporary short-care resources and other public sector.Adequate support system not only help caregivers choose the services at leisure,but also make them find their own self-worth and meaning.