長期呼吸器依賴病患之主要照顧者負荷與需求探討－以南區呼吸照護病房與居家照護為例

Needs and Burdens Assessment among Primary Caregiver on Long-Term Ventilator-Dependent Patients-A Case Study in Respiratory Wards and Home Care in Southern Taiwan

王淑珍(Shu-Jane Wang) ； 劉瑞芳(Jui-Fang Liu) ； 王淑慧(Shu-Hui Wang) ； 王金洲(Chin-Chou Wang) ； 李英俊(Ying-Chun Li)

《呼吸治療》 12卷2期 (2013/07) Pp. 1-15

https://doi.org/10.6269/JRT.2013.12.2.01

摘要

目前接受居家呼吸照護個案佔整體呼吸器依賴患者數的0.08%，大多數的家屬都選擇呼吸照護病房的照護模式，由於呼吸器依賴患者對家庭的衝擊既深且遠，主要照顧者在照顧的過程中扮演著重要的角色，亦背負著極大的責任與壓力。但臨床上針對照顧者負荷與需求之探討並不多。因此本研究主要以長期呼吸器依賴病患主要照顧者為對象，探討其負荷與需求之程度。研究採橫斷式研究設計，擇定南台灣區2010年6月至2010年10月間因長期呼吸器依賴住入呼吸照護病房或居家照護病患之主要照顧者為對象，以結構式問卷進行調查，內容包括呼吸器依賴個案基本資料、主要照顧者負荷量表及需求量表。研究結果發現：（1）居家照護相較於呼吸照護病房的病患年齡較輕，使用呼吸器總月數較長（平均30.9個月），意識清醒者較多，氣切比率較高。（2）居家照護與呼吸照護病房的主要照顧者平均年齡50～52歲、大多為已婚女性、與病患的關係以子女居多、大部分沒有接受社會補助。（3）在負荷方面主要照顧者的經濟來源、目前健康狀況、與照顧病患前比較，主要照顧者感到照顧病患後自覺健康狀況、家庭年總收入，呈現顯著差異。（4）居家照護的主要照顧者「生理負荷」和「生理需求」都大於呼吸照護病房的主要照顧者。希望本研究結果能提供政府制訂長期照護保險時參考之依據，針對不同需求的照顧者，給予不同的服務，減低呼吸器依賴病患主要照顧者的負荷。

關鍵字

呼吸器依賴 ； 主要照顧者 ； 負荷 ； 需求

並列摘要

0.08% of the long-term ventilator-dependent patients receiving home care patterns. Ventilator-dependent patients have a great and far-reaching impact on families, and the primary caregiver plays an important role during the caring process, however scarce studies have investigated the needs and burdens assessment among the primary caregivers. The purpose of this study is to explore the burdens and needs of the primary caregiver on long-term ventilator-dependent patients. A cross sectional study was used to select the primary caregiver on Long-term Ventilator-dependent Patients in respiratory ward and home care in southern Taiwan from June 2010 to October 2010. The questionnaire gathered the patients' basic information and the needs and burdens assessment among the primary caregivers. The results showed as follows: (1) Patients from home care are normally younger in comparison with the patients from respiratory wards; their average use of ventilator is more than 30.9 months; they tend to have better consciousness and higher rate of tracheotomy. (2) The average age of primary caregivers is 50~52; most of them are female and married; most of the caregivers are the patients' children and have no social welfare subsidy. (3) The burden showed significant differences in self rate health condition and the annual household income of primary caregivers after they take care of the patients. (4) Home care caregivers have greater ”physiological burdens” and ”physiological needs” than the caregivers in respiratory ward. Evidence based results are provided for different types of caregiver from the study as a reference for the establishment of long-term-care insurance system in Taiwan.

並列關鍵字

ventilator dependent ； primary caregiver ； burden ； need