家戶有需長期照顧者之家庭成員與主要照顧者生活品質影響因素探討

Factors Influencing the Quality of Life of Family Members and Primary Caregivers of Long-term Care Demanders

王瀅筑(Ying-Chu Wang)

指導教授 ： 朱僑麗

亞洲大學/健康學院/長期照護研究所/碩士(2009年)

摘要

背景：台灣有90%需要長期照顧者是在家中接受家屬的照護，而過去研究著重於探討主要照顧者生活品質的影響因素，較少探討家庭成員生活品質的部分。
目的：本研究目的為探討家中有長期照顧需求者，其家庭成員與主要照顧者生活品質之影響因素。
研究方法：本研究資料來源為2001年「國民健康訪問調查」資料庫。在其中找出有需長期照顧者之家戶4126人(833戶)後，篩選出853位(315戶)家中有1位被照顧者、 18歲以上與SF-36生活品質量表能夠計算的家庭成員，此853位樣本為架構一之研究對象。再將架構一的家庭成員生活品質之分析樣本中，表示為主要照顧者的樣本分離出來，成為架構二主要照顧者生活品質的分析樣本，分析樣本共144位(144戶) 。本研究依變項為SF-36生活品質量表，分數介於0-100分，分數越高代表生活品質越佳。家庭成員生活品質自變項包含家庭成員基本特性、有無罹患疾病、經濟狀況、照顧方式、家庭成員人數、照顧需求、被照顧者情形、家戶經濟與居住地。於主要照顧者生活品質中加入被照顧者基本特性、有無罹患疾病、活動受限情形，並將照顧方式改為有無利用政府服務。
結果：家庭成員生活品質在SF-36生理健康層面平均得分為68.28，心理健康層面平均得分為67.47。經多元迴歸分析，結果顯示女性、年齡越高、教育程度低、有罹患疾病、無工作、家庭成員人數2人以上者生理健康層面較差；心理健康層面則以女性、有罹患疾病、被照顧者為智能不足或唐氏症與居住在都會區者心理健康層面較差。主要照顧者在生理健康層面平均得分為49.80，心理健康層面平均得分為44.79，經多元迴歸分析後，主要照顧者教育程度低、有宗教信仰、有罹患疾病、無工作與個人經濟高，其主要照顧者生活品質生理健康層面較差，而被照顧者年齡於30~59歲，主要照顧者生活品質生理健康層面較佳；被照顧者有罹患疾病，主要照顧者生活品質心理健康層面較佳。
結論與建議：研究發現，當被照顧者為智能不足或唐氏症者，其家庭成員與主要照顧者生活品質受到負向影響，但被照顧者有罹患疾病者與被照顧者年齡於30~59歲，家庭成員與主要照顧者生活品質較佳。建議政府為家庭成員與主要照顧者提供較多社會服務，以利家庭成員與照顧者得到較佳的生活品質。

關鍵字

生活品質 ； 家庭成員 ； 主要照顧者 ； 長期照顧

並列摘要

Background: About 90% long-term care demanders was received care form their family members in Taiwan. Most of previous studies focused on the quality of life influence factor of primary caregivers, and there is little study focus on quality of life of family members.

Purpose: This study was to explore the factors affecting quality of life of family members and primary caregivers with demanders of long-term care in family.

Methods: In this study, data of National Health Interview Survey in 2001 was used and analyzed. Among 4126 persons (833 families) with demanders of long-term care in family, we selected 853 persons (315 families) who have one care recipient, over 18 years old and could be calculated by SF-36 Life of Quality Scale as the subjects of the first analysis model. In addition, 144 primary caregivers (144 families) from the participants of first model were also selected to be the subjects of the second analysis model for understanding the quality of life for primary caregivers. Dependent variable was SF-36 Quality of Life Scale, and could be scored from 0 to 100. Higher scores equaled to better quality of life. Independent variables for the life quality of family members included characteristics of family members, illness, financial status, ways of care-taking, number of family members, care demand, conditions of care recipient, household income and residential region. In the part of examining quality of primary caregivers, characteristics of care recipients, conditions of health and conditions of motional restrictions of care recipient were added. Also, ways of care was changed to know if government services were used.

Results: Family members’ quality of life averagely scored 68.28 on SF-36 physical component summary, and 67.47 on SF-36 mental component summary. After multiple regression analysis, female, higher age, lower education level, with illness, jobless, and over two family members were worse on physical component summary. Female, with illness, care recipients with mental retardation or with Down syndrome, and living in urban were worse on mental component summary. Primary caregivers averagely scored 49.80 on SF-36 physical health summary, and 44.79 on SF-36 mental component summary. After multiple regression analysis, low education of primary caregivers, with religion, with illness, jobless, and high individual economy were worse on physical component summary, and age from 30 to 59 of care recipients was better. And the care recipients with illness were better on mental component summary.

Conclusion and suggestion: According to the findings. When care recipients were of mental retardation or had Down syndrome, their family members and primary caregivers were usually negatively affected. When care recipients were with illness and age from 30 to 59, their family members and primary caregivers were usually positive affected. Government should provide necessary services on social welfare resources, benefit family members and primary caregivers with better quality of life.

並列關鍵字

quality of life ； family members ； primary caregivers ； long-term care

參考文獻

吳淑瓊、林惠生(1999)。台灣功能障礙老人家庭照護者的全國概況頗析。中華衛誌，18(1)，44-53。

陳貞吟、陳楚杰、蔡明足、沈玉卿、周歆凱、翁林仲(2008)。影響居家長期照護病患主要照顧者生活品質因素之研究。長期照護雜誌，12(3)，267-283。

呂如分(2005)。中風病患主要照顧者生活品質及其相關因素之探討。長期照護雜誌，9(2)，152-170。

邢占軍(2005)。對主觀幸福感測量的反思。本土心理研究，(24)，301-323。

孫嘉玲、黃美瑜、宋梅生、陳施妮、李綉彩、王秀香(2005)。中風病患主要照顧者的生活品質與社會支持。台灣醫學，9(3)，303-311。