探討下肢手術後病患的主要照顧者照顧負荷及其相關因素

病患接受下肢手術會對主要照顧者產生負荷，本研究目的在探討下肢手術後病患的主要照顧者照顧負荷及其相關因素。本研究採橫斷式研究設計，下肢手術後病患的主要照顧者為研究對象，研究過程採結構式問卷和方便取樣進行資料收集，收案地點在嘉義某地區醫院，招募105名下肢手術後病患的主要照顧者進行研究，收案期間2018年4月至2020年1月。問卷內容包含下肢手術後病患及其主要照顧者的基本資料、日常生活活動量表、照顧負荷量表，研究數據以SPSS 19.0進行資料分析，並以描述性統計、獨立t檢定、單因子變異數分析與事後比較進行各變項分析，再以複迴歸進行研究分析。研究發現:(1)主要照顧者女性佔多數、小於65歲、已婚、沒有慢性病。(2)下肢手術後病患的疼痛屬於中度程度。(3)主要照顧者整體照顧負荷屬於輕度負荷，接受全髖關節置換術病患其主要照顧者的照顧負荷程度屬於重度負荷，照顧負荷各層面負荷程度由高到低依序為社會負荷、心理負荷、身體負荷及經濟負荷。(4)下肢手術後病患的疼痛指數愈高和日常生活活動能力愈差者其主要照顧者的整體照顧負荷愈大;病患接受全髖關節置換術者其主要照顧者的整體照顧負荷高於清創手術的病患。主要照顧者婚姻狀況分居、離婚、喪偶者則整體照顧負荷高於已婚及未婚的主要照顧者;主要照顧者因照顧須請假或離職者則整體照顧負荷高於有工作無請假的主要照顧者。(5)主要照顧者的婚姻狀況和工作狀況、病患的疼痛指數、病患的日常生活活動能力及病患的手術方式等可解釋主要照顧者的整體照顧負荷共30%的變異量。主要照顧者的整體照顧負荷的預測因子為下肢手術後病患的疼痛指數以及主要照顧者的婚姻狀況為分居/離婚/喪偶-未婚對比組。基於本研究結果，期望醫護人員能重視下肢手術後病患的主要照顧者其照顧負荷。

關鍵字

下肢手術；主要照顧者；負荷

並列摘要

Lower limb Surgeries cause burden to caregivers. The aim of this study is to examine burden of care in primary caregivers of patients after lower limb surgery and relevant factors. A cross-sectional study design was employed and primary caregivers of patients who underwent lower limb surgery were recruited as study subjects. Structured questionnaires were employed for data collection. 105 primary caregivers were recruited as subjects from a district hospital in Chiayi County from April 2018 to January 2020. The questionnaire content includes basic information of patients who underwent lower limb surgery and their primary caregiver, activities of daily living scale, and burden of care scale. SPSS 19.0 was used for analysis of data and descriptive statistics, Independent t-test, one-way ANOVA, and post-hoc comparison, and multiple regression analysis were employed. The study found that: (1) Demographic characteristics of primary caregivers: Most primary caregivers are females, younger than 65 years old, married, and did not have chronic disease. (2) Moderate pain was experienced by patients after lower limb surgery. (3)The burden of care of primary caregivers after lower limb surgery is mild, and the level of burden in descending order are social, psychological, physical, and lastly economic burden. (4) As the pain index increased and activities of daily living decreased, the overall burden increased. In addition, for patients who underwent total hip replacement, the overall burden was higher than that for those who underwent debridement. For patients who were separated, divorced, or widowed, the overall burden was higher than that for unmarried patients. Furthermore, for patients who took leave or resigned from work due to caregiving, the overall burden was higher than that for patients who worked without taking leave.(5)Caregiver’s marital and employment status and pain index, activities of daily living, and surgical procedures of patients account for 30% of the variance in overall care burden. Predictors of overall care burden include the pain index of patients after lower limb surgery and caregiver’s marital status, i.e., We parated/divorved/widowed vs. single. We hope that medical staff will pay attention to burden of care in primary caregivers of patients after lower limb surgery based on the results of this study.