主照顧者因照顧失智症引發需要之質性研究

A Qualitative Study on the Needs of the Primary Caregivers for Dementia Patients

王宣雅(wang hsuan ya)

指導教授 ： 葉玲玲

亞洲大學/健康學院/長期照護研究所/碩士(2008年)

摘要

針對失智症其病程所產生的特殊照顧及服務非常缺乏周延及長遠的完整照護模式。因此本研究將深入探討的是照顧者因為照顧老人所引發的需要，及其相關因素。其研究目的為探討失智症主照顧者需要以及影響因素。
研究方法：本研究是以紮根理論法針對彰化基督教醫院記憶門診之老人失智症病人及家屬，立意取樣各十二人，在取得其同意下以會談指引（內容從一般人口學資料、就醫史、老人失智症的需求、和主照顧者因照顧老人失智症所因發的需求等）進行錄音訪談收集資料後，進一步經教授指導進行資料分析、編碼，獲得研究結果。
研究發現：主照顧者有九人與失智症患者同住，有十人有人輪流照顧，有七人目前有職業，有十一人提供長時間的照顧，有75％女性主照顧者，有三名主照顧者再接手失智症照顧工作後得到憂鬱症，有一名主照顧者在照顧失智症後因照顧負荷大，自殺二次。主照顧者都是失智症家屬。以十二位主照顧者之照顧歷程支會談資料收集分析、編碼，獲得研究結果。包括主照顧者照顧歷程、主照顧者如何獲得外界協助、主照顧者自行發展照顧失智症患者技巧、主照顧者對失智症的了解、主照顧者因照顧失智症患者引發的需要。
　　研究結論與建議：主照顧者在失智症患者確立診斷前後需要不同。主照顧者在失智症患者確立診斷前需要為簡易普及化的失智症篩檢和一般性的失智症教育。協助一般民眾了解失智症、失智症疾病的預防、失智症患者能在早期被發現診斷。主照顧者在失智症患者確立診斷後需要依失智症患者疾病的情況而異，包括主照顧者在失智症患者穩定期的需要、主照顧者在失智症患者行為干擾時的需要、主照顧者在失智症患者末期的需要、主照顧者因照顧失智症患者引發之長期性需要。進而比較國內外主照顧者因照顧失智症患者引發的需要，國外因已有失智症的照護體系，國外主照顧者了解本身的權力，會主動尋求服務。國內無失智症照護體系，大多主照顧者不知道本身的權力，不懂得如何尋求幫助和服務，需要服務介紹課程。

關鍵字

主照顧者 ； 失智症 ； 需要

並列摘要

There has been a lack of a complete long-term caring and service programs for patients with dementia in Taiwan. Caregivers are unble to provide dementia patients with sustainable,overall service. The aim of this research is to investigate the needs and related factors needed by the caregivers to effect necessary routines whilst caring for dementia patients..
Method：This study is based on ground theory and collects pertinent data from the subjects who are dementia patients and their family members. The family members visit them in the Memory Outpatient Clinic in Changhua Christian Hospital. Twelve subjects were randomly selected from dementia patients and caregivers respectively and interviews were conducted for collecting relevant data, including demographic data, medical history, needs of dementia patients, needs of the primary caregivers, inclusively of caregivers and patients. Data were recorded ,analyzed and categorized from interview the raw data.
Result：From the interviews we found that seventy-five percent of the caregivers were female. Among these, three caregivers suffered from depression from their work with dementia patients. All of the twelve primary caregivers are family members of the dementia patients, and all of the interview data was collected by recording, translating verbatim, recording and analyzing all raw data simultaneously before categorizing them. translating verbatim and recording and analyzing all the raw data. included experences of caring dementia patient of primary caregiver、the primary caregiver knowhow to get help of caring dementia patient、the primary caregiver self-develeped care skills from caring demantia patient、knowledge about dementia disease of primary caregiver、the needs of the primary caregivers while caring dementia patient.
The conclusion and suggestion ：The finding of this research is that primary caregivers have different needs before and after the dementia patient is diagnosed. The needs of the primary caregiver before the diagnosis are developed an easy screen scale of determine dementia patient from people and an gerneral education about dementia disease. an gerneral education about dementia disease helping people to prevent and know how about dementia disease. The easy green scale would be used by people with a general education.not just for professional stuffs. This would help people to determine if there is enough deterioration in the patient’s faculties and responses or behavioural indications to get a complete early stage diagnosis.The needs of the caregivers after the dementia patient is diagnosed dependent to and proportional to the deterioration of dementia in the patient,including the needs of primary caregiver during the stable stage of the dementia patient、the needs of primary caregiver during the behavior problems happen on the dementia patient、the needs of primary caregiver during the terminal stage of the dementia patient、the needs of primary caregiver for long term careing dementia patient. more over the study make the comparsion between the needs of the primary caregivers while caring dementia patient in taiwan and other countries.and in other countries, some of which have well-developed dementia care system both in informal as well as formal care system. We have not established an adequate dementia care program in Taiwan.Most of the primary caregiver in taiwan do not know hot to get help,they needing a course of helpging resources. As populations around the world continue to age due to advancing treatment protocols that extend life, we will always have some people who fall through statistical cracks in the system. They are our loved ones, our family members, our dearly beloved friends and the people who cared for us when we could not have lived without their love, comfort and direct care. We have a clear responsibility here: they belong to us now. We must not fail them.

並列關鍵字

caregivers ； dementia ； need

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