失智老人家庭主要照顧者施虐傾向相關因素之初探性研究

本研究欲瞭解失智症老人家庭主要照顧者的虐待傾向，探討失智老人家庭主要照顧者及老人的個人特質、正式資源、照顧負荷與照顧者的施虐傾向之影響，藉由研究結果提供政策發展之建議與有效減少家庭照顧者之施虐傾向。基於上述研究目的，本研究以多元理論歸因為研究架構，主要採量化研究方法，抽取南投縣76位照顧失智老人的家庭主要照顧者，以面訪方式進行問卷調查，且輔以質性訪談方式，訪問家庭主要照顧者4位，主要研究結果如下： 1. 照顧者施虐傾向的危險因子，包含失智老人個人特質，如對失智老人的問題困擾程度；正式照顧資源，如是否有使用精神門診；照顧者的照顧負荷等都和老人施虐傾向量表達到顯著相關，整體模式的解釋力為43.4%。 2. 從質性資料得知，失智症老人不同於一般失能老人的問題行為，將會影響到照顧照顧者的生理，如:失眠；心理及精神上的負荷；日常生活上的負荷，如:24小時看顧被照顧者、擔心被照顧者一個人在家；家庭關係負荷，如:因照顧工作致使照顧者與家庭關係緊張；經濟上的負荷:增加家庭經濟開銷。因此，所產生的照顧負荷是較照顧一般老人更重的，進而增加照顧者的施虐傾向。 3. 從質性資料中得知，照顧者在因應的過程中，確實會對失智症老人有言語虐待，如:會對照顧者大聲吼叫、言語上的恐嚇、甚至是限制被照顧者的行動，以減緩照顧者的照顧負荷。 4. 照顧者的施虐行為確實是存在於台灣社會中，考量照顧者施虐傾向發生的相關原因，需同時思考失智症老人的個人特質、照顧者的個人特質、正式資源、照顧者的照顧負荷以及被照顧的反饋行為因素交互影響之結果。未來將會有更多的照顧者面臨照顧失智症老人的情境，希望透過此研究可以讓政府正視到失智症老人家庭主要照顧者照顧負荷以及照顧者虐待傾向影響因素之重要性，期望有機會能夠作為政府訂定相關規範的參考，減少照顧者的照顧負荷，降低照顧者的施虐傾向，以利於提升失智老人的照顧品質，達到促進失智症老人的福祉。關鍵字:失智症、老人虐待、照顧者

關鍵字

失智症；老人虐待；照顧者

並列摘要

This study aimed to understand the potentially harmful behavior of dementia elderly caregivers in the family. This study investigated into the demographic characteristics of caregivers and the elderly, formal resources, and caregivers’ burden. The main research method is quantitative method by using face-to-face surveys to collect data. A total of 76 samples that care dementia elderly in the family completed this study in Nantou County. The researcher also combined qualitative research by using in-depth interview, including 4 dementia elderly caregivers. The main findings of this research are as following: 1. The risk factors for potentially harmful behavior are dementia elders’ characteristics, such as the distress degree of problem behaviors, formal resources, and caregiver’s burden. All of the variables accounted for 43.3% of the total variance of the dependent variable. 2. The problem behaviors of dementia elders are different from disabled elders. The problem behaviors impact on the caregivers' physical health, such as insomnia; psychological and spiritual well-being; daily life burden, such as caring for 24 hours a day, worrying about dementia elderly alone at home; family relations, such as the impacts of caregiving on family relations; and economic problems, such as increase the economic burden of the family. Therefore, the caregiving burden of dementia elders' is heavier than the care of disabled elderly, thus increasing the caregivers' potentially harmful behaviors. 3. From qualitative data, the caregiver of the demented did have verbal abuses to the elderly, including yelled the dementia elders, verbal threatening, even restriction are actions to relieve the caregivers' burden. 4. This study demonstrates that caregivers' abuse of the dementia elderly are common in Taiwan, four clusters of risk factors, including caregiver’s characteristics, formal resources, caregivers' burden, and dementia elders' negative feedback behavior have been interconnected. According to the findings and conclusions, this study has suggestions for policy, practice, and further research. Key word: dementia, elderly abuse, caregivers