失能老人家庭尋找平衡點的照顧過程及相關因素探討

A Correlational Study of "Finding a Balance Point" in Family Caregiving Process for Frail Elders

王玉女(Yu-Nu Wang) ； 徐亞瑛 (Yea-Ing Shyu) ； 姚開屏(Kai-Ping Yao) ； 吳淑瓊(Shwu-Chong Wu)

《護理研究》 6卷6期 (1998/12) Pp. 489-500

https://doi.org/10.7081/NR.199812.0489

摘要

本研究之目的旨在探討失能老人家庭「尋找平衡點」的照顧過程及相關因素。採立意取樣方式，以具可接受信、效度之結構性問卷訪談失能老人及其家庭主要照顧者，共得有效問卷97份。結果顯示：失能老人家庭照顧者在照顧過程中將面臨許多互相競爭需求，如「要適應病人的時問，但同時也要考慮自己的時間」等。大多數照顧者在面臨互相競爭需求時均能夠事先「察覺互相競爭需求的存在」，且常採用的權衡輕重方式為「原則導向權衡」或「模擬式權街」。照顧者常用之尋找平衡點策略包括「活動時間表安排」、「照顧小組徵召」、「照顧小組經營」、「照顧技巧創新」、「治療處理」、「自我照顧」及「行為情緒處理」。經由階級迴歸分析，「照顧時間」、「照顧工作有人輪替」、「照顧資源」及「照顧者的自我要求」等自變項對「尋找平衡點：需求兼顧程度」之解釋量為30.9％。研究結果可供居家護理人員以不同的角度看失能老人家庭照顧過程，且從多方面考量造成照顧者在照顧過程中無法找到平衡點的原因。研究限制包括立意取樣，結果無法推論所有失能老人家庭照顧過程，及橫斷性研究，缺乏長期變化資料。

關鍵字

失能老人 ； 家庭照顧過程 ； 尋找平衡點 ； 互相競爭需求

並列摘要

The purpose of this study was to investigate the process of family caregiving to frail elders, ”Finding a Balance Point”, and to explore related factors. Ninety-seven frail elders and their primary caregivers each received a single contact interview. Statistical analysis of results obtained demonstrated the reliability and validity of measures used in data collection. Findings revealed that in the care- giving process caregivers faced many competing needs. Most of the caregivers were able to recognize competing needs in advance and used ”principle weighing” or ”simulation weighing” to set their priorities. Balancing strategies frequently used by caregivers were ”altering the schedule/activity” ”recruiting an additional member to the work team”, ”running the work team”, ”innovating care tasks” , ”managing treatment”, ”engaging self-care activities” and ”managing behavior/emotion problems”. Results indicated that caregivers with long periods of caregiving, other caregivers to take turns, good caregiving resources, and realistic caregiving principles were more able to find a balance point between competing needs. The variance of ”finding a balance point” explained by these variables was 30.9%. Based on these findings, home care nurses will be able to develop appropriate nursing interventions to facilitate the caregivers to find a balance point more easily. Measures developed in this study may also be used in clinical assessment by home care nurses. The factors limiting the scope of this study could be overcome in future studies by utilizing random sampling and more longitudinal approaches to data collection and analysis.

並列關鍵字

frail elder ； family caregiving process ； finding a balance point ； competing needs