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重症病人家庭決策者焦慮及睡眠障礙之相關因素探討

Exploration of Factors Related to Anxiety and Sleep Disorders in Primary Family Decision Makers of Critically Ill Patients

摘要


背景:加護病房所提供的密集照護,得以讓重症病人延續生命。當加護病房病人面臨死亡的威脅時,他們的家庭決策者也許正經歷身、心的煎熬。家庭決策者為了讓心愛的家人接受治療與否,往往盡力做出正確的抉擇,但通常也導致自身心理及生理的健康問題。大多數的家庭決策者在抉擇的過程中會經歷焦慮及睡眠障礙等壓力問題。目的:本研究在探討加護病房病人家庭決策者的背景與他們焦慮和睡眠障礙之間的關聯性並歸納出可能的預測因子。方法:運用相關性橫斷式研究設計,針對台灣南部某醫學中心13個加護病房之200位重症病人家庭決策者,藉由面對面訪談收案對象,完成「基本屬性」、「情境焦慮量表」、「匹茲堡睡眠品質指數量表」等三種量表。並使用統計套裝軟體「SPSS for Windows 19.0」,進行各項資料分析。 結果:研究發現66.5%重症病人家庭決策者呈現嚴重焦慮、33.5%有輕度到中度的焦慮,且87.5%出現睡眠障礙情形。家庭決策者的年齡與焦慮及睡眠障礙呈正相關。當家庭決策者的重症病人家屬具慢性疾病、本身為病人配偶、具較低教育及月收入較低之女性,其焦慮及睡眠障礙之發生率較高。家庭決策者之焦慮程度與睡 眠障礙呈正相關;收入為焦慮與睡眠障礙之顯著的預測因子,對焦慮的解釋力達26.2%、對睡眠障礙的解釋力達30.7%。結論/實務應用:本研究藉由描述重症病人家庭決策者焦慮及睡眠障礙之相關因素,其結果可提供醫療專業人員新的見解以預防家庭決策者焦慮及睡眠障礙,並藉此減少家庭決策者之身、心負擔,不但有助於家庭決策者與醫療專業人員建立更好的關係,並可協助家庭決策者做出最適當的決定。

並列摘要


Background: Intensive care unit (ICU) care helps critically ill patients survive life‐threatening diseases. ICU patients in high‐mortality risk categories can present huge mental and physical burdens for family decision makers (FDMs). Although FDMs do their best to make ”right” treatment decisions for beloved family member, FDMs often end up suffering psychological and physical health problems themselves. Most FDMs suffer anxiety, and sleep disorders during their decision‐making process. Purpose: This study investigated the association between ICU patient FDM characteristics and anxiety and sleep disturbance severity. This study also disclosed related predictors. Methods: This descriptive cross‐sectional study recruited 200 critically ill patient FDMs at 13 ICUs in a teaching medical center in southern Taiwan. We used face‐to‐face interviews with all participants to complete the demographic sheet questionnaire, which included the State Anxiety Inventory and Pittsburgh Sleep Quality Index. Data were analyzed using SPSS 19.0 to test our hypothesis. Results: Two‐thirds (66.5%) of FDMs interviewed had severe anxiety symptoms; 33.5% had mild to moderate anxiety symptoms; and most (87.5%) had sleep disorders. FDM age correlated positively with anxiety and sleep disorder severity. Care‐recipient comorbidities, female gender, care‐recipient being a spouse, having a relatively low education level, and having a relatively low monthly income were predictors of anxiety and sleep disorders in FDMs; anxiety correlated positively with sleep disorders; and FDM income was the most significant predictor of anxiety and sleep disorders which could explain 26.2% and 30.7% variances for anxiety and sleep disorder, respectively. Discussion and Conclusions: Our findings on factors significantly related to anxiety and sleep disorders in critically ill patient FDMs offer novel insight that can help healthcare professionals reduce FDM anxiety and sleep disorders. Improving FDM physical and psychological burdens can help build better rapport between FDMs and healthcare professionals and help FDMs make appropriate decisions for their family members.

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王靜慧(2015)。探討幼兒住院行為反應與主要照顧者焦慮程度之相關研究〔碩士論文,長榮大學〕。華藝線上圖書館。https://doi.org/10.6833%2fCJCU.2015.00123
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