The Self-Empowerment Process of Primary Caregivers: A Study of Caring for Elderly with Dementia

主要照顧者之自我充能歷程－以失智症為例

車慧蓮(Hui-Lian Che) ； 葉明理(Ming-Lee Yeh) ； 吳淑美(Shu-Mei Wu)

《The Journal of Nursing Research》 14卷3期 (2006/09) Pp. 209-218

摘要

本研究目的為建立失智症老人的主要照顧者自我充能過程的概念性理論。採茁根理論(grounded theory)研究法，理論性取樣九位居住於北部的主要照顧者參與研究。深入訪談後之錄音紀錄逐字轉譯為文字稿，並以持續比較分析原則，進行資料的編碼程序直至理論呈現。研究結果得到自我充能過程的六個要素分別是「孝道義務感」、「無助失控感」、「內在意識」、「照顧能力」、「心靈重整」和「生活的經營」。其中「孝道義務感」和「無助失控感」為前趨類組，用以激發照顧者的「內在意識」。內在意識啓動充能過程，並在不同階段幫助主要照顧者，促使其「照顧能力」、「心靈重整」和「生活的經營」三部分獲致成長。此三部分經時間催化，各發展出由淺到深的三階段，三階段間彼此又平行並互為助力或阻力。此外，充能過程也受到阻力和助力的影響，差別端賴主要照顧者如何運用，當助力大於阻力時，充能過程便能持續下去。整個架構蘊含著「力量」的流動。研究結果提供一個新的觀點看待失智老人主要照顧者的照顧過程，除對照顧者各階段心理更有感知外，更能導引其對照顧歷程產生正向感受。

關鍵字

主要照顧者 ； 自我充能 ； 失智症 ； 老人

並列摘要

The purpose of this qualitative research was to explore and develop the process of self-empowerment for primary caregivers responsible for caring for elderly with dementia. Nine primary caregivers who lived in northern Taiwan were interviewed through a theoretical sampling procedure. In-depth, face-to-face interviews were tape-recorded and transcribed verbatim. The grounded theory method was applied for analyzing data. The six main components that emerged in this model: ”filial piety”, ”feeling of out of control”, ”inner awareness”, ”care ability”, ”emotion reconstruction”, and ”life management”. This model starts from ”filial piety” and ”feeling of out of control,” then evokes caregivers' ”inner awareness”. The inner awareness powerfully influences caregivers' ”care ability”, ”emotion reconstruction” and ”life management,” which account for the three inner mechanism parts in their caregiving experience. Each part comprises three stages that are influenced by ”inner awareness”. The lower stage of each part supports the next higher stage. The same stages in all parts parallel one another, and influence each other by providing support or creating barriers. On the other side, competition between support and barriers from the outside environment determines the completion of this self-empowerment process. Results of this research extend the knowledge in understanding the psychological processes related to caring for elderly with dementia. The findings also provide readers a positive viewpoint on the caring experiences of primary caregivers of elderly with dementia.

並列關鍵字

primary caregiver ； self-empowerment ； dementia ； elderly

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