失智症家庭照顧者轉化學習歷程模式之建構：邁向正向經驗

The Construction of Transformative Learning Patterns among Family Caregivers with Dementia: Towards Positive Experiences

嚴嘉明(Chia-Ming Yen)

指導教授 ： 胡夢鯨

國立中正大學/教育學院/成人及繼續教育學系/博士(2014年)

摘要

有鑑於台灣社會高齡人口增長快速，近年來，失智症人口有逐年攀高的趨勢。失智症迄今仍為一不可逆轉且不同階段伴隨不同的問題行為症狀的病症。相關研究調查顯示，許多失智症患者仍由家人照料，家庭照顧者所面臨的挑戰，家庭照顧者所衍生出的相關問題及其影響的層面不可言喻。有別於過去類似主題的研究強調家庭照顧者飽受身體、心理及財務上的壓力，本研究主要探討失智症家庭照顧者如何從負面經驗中轉化邁向正向的照顧經驗。因此，本研究首先探索家庭照顧者的負向及正向經驗。其次，探討影響失智症家庭照顧者改變的因素有哪些？又這些因素如何促使其正向經驗的改變？第三，參與教育課程及家屬支持團體的受訪者與從未參與的受訪者，其邁向正向經驗的歷程是否有所異同，研究者也將一併討論之。最後，研究者欲了解照顧者的負向與正向經驗的關係。
本研究為一質性研究，以深入訪談的方式，總共訪問了來自台中及高雄三個不同機構的18位失智症家庭主要照顧受訪者。其中女性12位，男性6位。另訪問了與失智症患者有所熟識的主治醫師、社工及家庭訪問員等7位。根據訪談內容及結果，研究者將訪談資料以主題式及次主題的方式進行歸類、詮釋與分析。最後，綜合及歸納本研究結果，共有下列六種因素：分別是照顧者的個性、照顧者與被照顧者之間的關係、照顧者因應問題的能力與技巧、從困境中恢復的能力、靈性在照顧歷程中扮演正向經驗角色的影響及照顧資源等。研究者就上述六項成因進行深入分析與討論，建構出五種邁向正向經驗之失智症家庭照顧者轉化學習歷程模式。並提出相關建議，供其他失智症家庭照顧者、政府政策制定者、學界及實務工作者之參考。

關鍵字

轉化學習歷程模式 ； 正向經驗 ； 失智症家庭照顧者

並列摘要

Recently, more and more studies show a family caregiver could achieve positive meaning and personal growth through the process of caring for a family with dementia, while previously this situation was generally reported as being a physical, psychological and financial burden. This study first explores both negative and positive experiences of caregivers among families with dementia. Second, it moves to look at the changes how and in what ways dementia family caregivers are changed. Significant triggers are explored and examined. Third, participants and non participants of educational programmes and family support groups are compared in terms of the approaches for bringing about a positive caring experience. Lastly, it is followed by an elaboration of the relationship between negative and positive experiences.
A qualitative method is adopted in this study. Eighteen family caregivers were recruited via three local organisations in Taichung and Kaohsiung. An in-depth interview is undertaken with each caregiver and each interview was audio-recorded. A third party of interviewees are adopted. A list of open-ended interview questions is used to explore the experiences from the process of care giving among dementia family caregivers. Data are transcribed verbatim. The stories are returned to participants for verification. Data analysis is a thematic interpretation to analyse the themes and sub-themes in relation to the significant transformative factors. In the end, six triggers are found include: characteristics of the caregiver, relationship between caregiver and care recipient, the abilities to cope, and the abilities to resile, the positive role of spirituality in the process of care giving, and caring resources, including educational programmes and family support groups. Thereafter five types of transformative learning patterns are constructed in terms of leading to create positive caring experience. It is hoped these patterns are able to provide the types of information and guidance to other dementia family caregivers, government policy-makers, academics and dementia caring distributers in Taiwan.

並列關鍵字

transformative learning patterns ； positive experiences ； dementia family caregiver

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