家庭韌力、家庭界限模糊與失智病人其主要照顧者之希望感的相關性探討

Relationship Between Family Resilience, Family Boundary Ambiguity, and the Hope Felt by Family Caregivers for Dementia Patients

郭紡瑄(Fang-Xuan Kuo) ； 穆佩芬(Pei-Fan Mu) ； 王培寧(Pei-Ning Wang)

《榮總護理》 38卷2期 (2021/06) Pp. 175-183

https://doi.org/10.6142/VGHN.202106_38(2).0008

摘要

照顧罹患失智症病人為家庭須長期抗戰的危機，家庭韌力是家庭調適資源，可協助失智症家庭順利調適並產生希望感。主要照顧者常困擾於與失智病人相處模式改變，出現家庭界限模糊的現象。因此，了解主要照顧者的家庭界限模糊程度與其家庭韌力對希望感的影響至關重要。本研究為描述相關性橫斷式研究設計，研究目的為了解失智家庭之家庭韌力、家庭界限模糊與主要照顧者之希望感的相關性。共收集133位由主要照顧者填寫之基本資料表、家庭韌力量表、家庭界限模糊量表、中文版赫氏希望量表資料。研究結果發現：一、家庭韌力與希望感得分呈正相關（r= .463, p＜ .01）；二、家庭界限模糊與希望感得分呈負相關（r=-.269, p＜ .01）；三、家庭韌力能預測主要照顧者之希望感，可解釋20.9%變異量，表示強化家庭韌力有助於提升其希望感。此結果可做為發展提升失智症主要照顧者希望感的介入措施的基礎。

關鍵字

失智 ； 主要照顧者 ； 希望感 ； 家庭韌力 ； 家庭界限模糊

並列摘要

Aim: During the long-term process of caring for patients diagnosed with dementia, family boundary ambiguity arises when family caregivers find the changed nature of interactions with family members with dementia to be challenging. Extending the duration of home care for people diagnosed as having dementia instead of sending such individuals to care facilities has been the main problem in the long-term care system. By exploring the relationship between family resilience, family boundary ambiguity, and the hope felt by family caregivers of patients with dementia, we sought to provide caregivers with family-centered, evidence-based, and positive care interventions to meet the psychological demands of caregivers. The findings are expected to improve the quality of long-term care administered to patients. Methods: A cross-sectional correlational design was used. The sample comprised 133 family caregivers recruited from a neurology outpatient department in Taiwan. We used the following research instruments: the Herth Hope Index, family resilience scale, and family boundary ambiguity scale. Results: Family resilience and hope were positively correlated (r= .463, p＜ .01), family boundary ambiguity and hope were negatively correlated (r= -.269, p＜ .01), and family resilience was a predictor of sense of hope among family caregivers (R^2=20.9%). Conclusion: Family resilience had a positive correlation with hope and predicted sense of hope among family caregivers. Thus, we recommend for medical personnel to evaluate the degree of family resilience among families caring for people with dementia and use evidence-based interventions to create positive care experiences and environments.

並列關鍵字

dementia ； caregivers ； hope ； family resilience ； family boundary ambiguity

參考文獻

林蕙君、鄭淑子、曾秀雲(2017)．正念減壓方案對失智症家庭照顧者身心健康之研究．長期照護雜誌，21(2)，133-148。

張玉蘭、游守正、張景媛(2014)．希望感融入國小五年級視覺藝術課程對學生希望感影響之研究．慈濟大學教育研究學刊，11，113-143。

陳韋良、張耀文、高東煒(2017)．失智症之診斷與治療．源遠護理，11(2)，12-17。

蔡甫昌、許毓仁、黃宗正、陳晶瑩、邱銘章(2015)．失智症患者治療與照護之倫理議題．台灣醫學，19(5)，499-507。

穆佩芬、楊寶圜(2009)．由家庭韌力觀點促進罕見疾病病童家庭健康．源遠護理，3(2)，15-22。