親密感,是一種與生俱來的能力與感受,是一種最簡單亦是最困難述說的感覺,需要長時間的累積與培養才會形成。然而「久病床前無孝子」、「夫妻大難來時各自飛」道盡子女與夫妻面臨重大危機時,情感再怎麼強韌,也不堪疾病的折磨。本研究旨在研究失智症照顧者對於親密感與照顧任務的看法,及照顧者與患者的親密感於罹病前後與病程演進中動態歷程之變化,並探究不同照顧場域對於照顧者與患者親密感的影響。研究者以半結構式深度訪談法訪問十位失智症照顧者,研究發現如下: 一、失智症照顧者對於親密感的定義可分為情感、認知、生理、信 任、心靈上的親密。夫妻關係的照顧任務立基於婚姻承諾的責 任;親子關係的照顧任務則是孝道反哺與責任回饋。 二、罹病前後失智症照顧者與患者親密感的變化有日復一日型、親密 到疏離型、由怨轉愛型,與更上層樓型;隨著病程演進,影響雙 方親密感的原因有照顧者對疾病的認識、有無接受支持服務,與 患者問題行為多寡。 三、照顧者選擇照顧場域的轉換,多取決於病程演進;照顧場域的確 影響照顧者與患者的親密感。當患者被送進機構後,減緩照顧者 與患者的負向互動,反而讓雙方的親密感增加。 四、照顧者多數認為照顧歷程中的親密感非常重要,也是支持他們繼 續照顧與陪伴下去的動力;回顧照顧歷程,多數照顧者認為失智 症帶來的正向影響多於負向影響。
This purpose of this study was to explore (1)the dementia caregiver’s perspective on his/her care-taking task, (2)the dynamic changing process of intimacy between the caregiver and the patient in the disease course, and (3)the impact of caring fields on the intimacy between the caregiver and the patient. The researcher adopted the semi-structured interview strategy to conduct the research. Ten dementia caregivers were interviewed. The research findings were as follows: 1.The definition of intimacy for dementia caregivers can be divided into five types: emotional, cognitive, physiological, trust, and spiritual intimacy. The relationship with conjugal on the responsibility of marriage and commitment; the blood relationship for caring tasks is based on the feedback of filial piety. 2.The types of intimacy between dementia caregivers and patients before and after the disease are as follows: “no change”, “gradually alienated”, “gradually closer”, and “better than before”. The impact on intimacy between dementia caregivers and patients during the disease course are depend on the understanding of disease, acceptance of supportive services, and problem behaviors of the patient. 3.Patients are transferred to different caring field depending on the evolution of disease course. The caring fields do have impact on the intimacy between caregivers and patients. When the patient is transferred to an agency, reducing the negative interaction between caregivers and patients and increasing the intimacy of both sides. 4.Most caregivers believe that intimacy is very important in the caring process. It also supports them to go on and accompany; while reviewing the caring process, most caregivers agree that dementia bring more positive than negative impact to them.