精神分裂症患者需要狀況之生活品質與主要照顧者負荷之探討研究

Exploring Different Needs Met the States of Schizophrenic Patient and the Burden among their caregivers in Central Taiwan

余姿瑩(Tzu-Ying Yu)

指導教授 ： 葉玲玲

亞洲大學/健康學院/長期照護研究所/碩士(2006年)

摘要

理想的精神健康照護體系應讓精神分裂症患者獲得妥善的照顧，維持一定的生活品質與將照顧者負荷減至最低，過去研究考量的患者疾病狀況對生活品質的影響，但現在逐漸重視患者自身需要對其生活品質與照顧者負荷的影響。因而本研究主要想瞭解精神分裂症患者的需要狀況、生活品質與照顧者負荷，及需要狀況不同其生活品質與照顧者負荷的差異情形，作為精神健康照護體系服務計畫之參考。
研究方法：採橫斷性研究，研究對象為中部某區域精神專科教學醫院急性病房出院一年內之精神分裂症患者，面訪各100位患者與其照顧者。研究工具包括（一）個案基本資料表、（二）主要照顧者基本資料、（三）精神患者的CAN中文版量表、（四）世界衛生組織生活品質問卷台灣簡明版、（五）精神患者照顧者負荷量表簡短版，採用 T-TEST、ANOVA與多元回歸的統計分析。
研究結果：(1)社交聯繫、白天活動與心理上的痛苦的未滿足需要項為精神衛生體系可優先努力滿足之處。(2)精神分裂症患者生活品質以心理範疇最低，可見在心理層次可提供的實質性服務需加強。(3)患者有打理家務、心理上痛苦、社交聯繫、福利金等需要者生活品質較低且需要未滿足者生活品質最低。因此，當國內精神健康照護體系想提昇精神分裂症患者的生活品質時可優先解決此四個需要項目。(4)患者有打理家務、照顧子女、基本教育、金錢、性生活、使用電話等需要之照顧者負荷高。當國內精神健康照護體系想減輕照顧者負荷時可優先解決此六個需要項目。此外，患者需要未滿足並不代表照顧者負荷高，須特別注意患者需要項被滿足的來源。
結論：由於本研究僅收集100位患者與照顧者資料，在分析有需要者之生活品質與照顧者負荷影響因素時因而受限，因此建議未來研究可收集較多患者與照顧者資料。沒有需要之精神分裂症患者生活品質高，且需要未滿足患者生活品質最低；沒有需要的精神分裂症患者之照顧者負荷低，但需要未滿足患者其照顧者負荷不一定高。影響患者生活品質的因素有患者需要狀況，影響照顧者負荷的因素有患者需要狀況、照顧者的健康狀況、與患者關係、患者婚姻狀況。

關鍵字

精神分裂症患者 ； 需要 ； 生活品質 ； 負荷

並列摘要

An ideal psychal health care system should let the schizophrenia patient get appropriate treatment, maintained certain quality of life and minimise the caregiver burden,. In the past, the impact on quality of the life of patient’s disease was considered. Now we pay attention to patients themselves and can influence quality of life and caregiver burden. Therefore the objective of this study was to identify need states, different situations and ameliorate quality of life and lessen the caregiver burden, as well as serve to follow the reference to the psychal health care system plan.
Methods : The study was designed to be a cross-sectional study. The subjects were discharged in the middle part of the year of the study from the acute care ward of a local psychiatric teaching hospital. A researcher would conduct one-on-one interviews with the patients and with their caregivers. The interviews were done with the following research tools: (1) Basic materials to desribe the case (2) Basic information from the caregiver. (3) The Camberwell Assessment of Need(CAN) scale(4)WHO Quality of Life Measure-abbreviated version-taiwan (5) An "Burden scaled abbreviated version. T-TEST , ANOVA and multiple regression analysis were used in the analysis.
Result : (1) Psychal health care system could priority to met for unmet needs of company, daytime activities, psychological distress (2)Schizophrenia patient's quality of life is the lowest with the psychological category, it is obvious that the substantive service that can be offered strengthened psychological needs.(3)Quality of life of patient who had look after home, psychological distress , company, benefits needs is low and the lowest quality of life of patient had unmet need.So, the psychal health care system wants to promote the schizophrenia patient's quality of life could have priority to solve this four needs. (4)Caregiver burden of patient had look after home, child care, education, money, sexual expression, telephone need is high.Psychal health care system wants to promote caregiver burden of schizophrenia patient could have priority to solve this six needs.In addition, patients who had unmet needs has not represented the persons's caregiver burden must been high, must pay special attention to source of met need.
conclusion: Because the research was collected 100 patient and caregiver materials and caregiver materials only. Patient of schizophrenia who had no needs quality of the life is high, caregivers of patient who had unmet needs had lowest burden, caregivers of patient had no needs had low burden,but caregiver buren of Patient who have unmet need may not be high. Quality of life was predicted by Need status, and caregiver burden was predicted by need status, caregiver's healh status with patient relationship, patient's marital status.

並列關鍵字

schizophrenia ； need ； quality of life ； caregiver burden

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