Caregiver Burden Structural Equation Modeling

照顧者負荷－以結構公式模式探討

周桂如(Kuei-Ru Cho)

《護理研究》 6卷5期 (1998/10) Pp. 358-371

https://doi.org/10.7081/NR.199810.0358

摘要

家屬在照顧失智老人的附和問題在台灣越來越重要，故暸解影響照顧者負荷之導因及其相互之間的關係乃越顯得重要，本研究目的即在測試ㄧ照顧者負荷之理論，希望藉此能瞭解照顧者的需求、義務感、照顧之自我實現能力、調適方法以及照顧之參與程度對照顧者負荷之影響。這是一橫斷切面式研究，從三所醫院之門診收及符合條件之收案對象，在個案家中以結構是問卷進行訪談。所收集到之樣本資料並不符合原來之理論模式，在經過些微的修正後呈現適合之照顧者負荷之理論模式，其X^(2)值與自由度之比為2.1；良好適合度指標為.89；相較適合度指標為.93。研究結果呈現：「照顧者的需求」及「照顧者的義務感」直接正向的影響到照顧者的參與度；「照顧者的參與度」及「以情緒調節為主的調適方法」直接正向的影響到照顧者的負荷；「照顧者之義務感」、「自我實現能力」及「以問題為主之調適方法」對照顧者負荷有直接反向之影響。研究中七項假說中有六項被支持，使我們更清楚地瞭解在台灣影響照顧者負荷之導因，進一步藉由融合中外相關研究文獻，來拓展我們對照顧者負荷此一概念之認識。

關鍵字

負荷 ； 失智老人 ； 結構公式模式

並列摘要

The burden produced by caring for relatives with dementia is an increasing problem in Taiwan necessitating a better understanding of the interrelationships of the factors that influence burden. The purpose of this study was to test a theoretical model specifying how the demands of care, filial oblige- tion, caregiving self-efficacy, coping strategies, and caregiving involvement affect caregiver burden. A descriptive cross-sectional design with a convenience sample of 150 caregivers and care-reveiver dyads from outpatient dinics of three hospitals in Taiwan was used. The original model did not fit the data well but monor re-specifications produced a good model as avidenced by an X^(2)/df ratio of 2.1, a goodness-of-fit index of .89, and a comparative fit index of .93. Demands of care on the caregiver and filial obligation had direct positive effects on caregiving involvement. Caregiving involvement and emotion-focused coping had direct positive effects on caregiving burdn. Filial obligation, caregiving self-efficacy, and problem-focused coping had direct negative iffects on caregiving burden. Six of the seven original hypothesized structural relationships were confirmed in the final model. The Burden Model tested in this study corroborates findings from other burden studies and extends our knowledge of caregiver burden. Filial obligation, self-efficacy, demands of care involvement in care, and coping were shown to predict burden in this sample of Taiwanese caregivers.

並列關鍵字

burden ； elders with dementia ； structural equation modeling