Family Caregivers' Burdens and Perceived Need for Home Care Services in the Taipei Metropolitan Area

大台北地區主要照顧者之工作負荷量及對居家照顧服務之需求程度的調查

屈蓮(Lian Chiu) ； 白璐(Lu Pai) ； 鄧光銳(Kwong-Yui Tang) ； 王修平(Shiou-Ping Wang)

《中華公共衛生雜誌》 15卷4期 (1996/08) Pp. 289-302

https://doi.org/10.6288/CJPH1996-15-04-02

摘要

本研究目的在藉著了解主要照顧病人的家屬，對居家照護服務項目的需要程度及照顧病人的工作負荷量，以此評估何種居家照顧服務模式較能滿足民眾的需求。工作負荷量乃指主要照顧者需花多少時間來照顧病人；在照顧病人時所面對的問題；和週間和週末是否有其它家庭成員協助照顧病人等。對服務項目的需要程度是以Likert five-point Method測量主要照顧者對57項服務項目之每一項的需要程度；由”5”（非常需要）到，”1”（完全不需要）共分為五個層級。
本研究對象為台北市及台北縣使用居家照顧服務之病人的主要照顧者，而主要照顧者是指直接地花最多時間照顧病人；並和居家照顧服務接觸最頻繁的家屬。本研究共取得152位名冊，扣除拒訪和主要照顧者為僱工等，實得110筆資料。
研究結果顯示，超過96%的主要照顧者每一星期7天和每天至少12小時在照顧病人。大約80%與70.9%的受訪者表示由於照顧病人所以社交活動受到限制；和即使身體不舒服，仍須要勉強地照顧病人。百分之五十的主要照顧者指出除了照顧病人外，他們仍需負擔其它的家事。而且多於50%的主要照顧者無論在週間或週末，均無法獲得其它家屬的協助。
多於三分之二的主要照顧者表示需要獲得由社會工作人員、醫療儀器維修人員、復健人員、醫師、護理人員和由居家照顧機構所訓練並能替主要照顧者暫時照顧病人之工作人員的服務。大約四分之三的受訪者指出病人住院時，是教導主要照顧者回家後照顧病人所需之技術與知識的好時間。
研究結果指出，主要照顧者肩負沉重的照顧工作；並且他們希望獲得一些居家照顧服務，使他們在家照顧病人的工作能夠持續。本研究建議：社會福利政策與健康保險的共同配合，居家照顧系統應與其它健康服務系統相互聯結，以增加服務項目，建立滿足身、心、社會需求的居家照顧服務模式。

關鍵字

居家照顧 ； 主要照顧者 ； 需求

並列摘要

This study was designed to evaluate the family caregivers' burdens and identify their perceived needs for home care services. The family caregiver was defined as the patient's family who spends most time to take care of the patient at home and frequently contacts with home care personnel. In total, 152 enrollment files of patients and care givers in the Taipei Metropolitan Area were obtained. Virtually, 110 family caregivers were interviewed at home.
Family caregivers' burdens referred to the amount of time family caregivers spent in caregiving, problems related to the confinement from caregiving experienced by the family care giver, and how much support form family members during weekdays and on the weekend. Using a five-point Likert scale, family caregivers checked their degree of need for each of 57 items of home care services. Their responses ranged from ”strongly desired” to ”not at all desired”.
More than 96.0% of the family care givers spent 7 days a week and at least 12 hours a day to take care of patients. About eighty per cent and 70.9% of the respondents suffered from limitations on social activities, and need to take care of the patients when they themselves are not well respectively. Fifty percent of family care givers needed to take on other housework and more than half of those interviewee had no assistance from family members during weekdays and over weekend.
Services from social workers, technicians for maintaining medical equipment, rehabilitation personnel, physicians, home care nurses and someone, who was trained by the home care agency to temporarily take care of patients for family caregivers, were needed by more than two-third of the interviewee. About three-quarters of respondents stated that a good time for teaching them the needed skills is when patients are hospitalized. Fifty-one per cent of the interviewed stated that patients ought to get the needed preventive services.
These findings indicated that the burden on family care givers were heavy; and they desired to receive some services to help them to continuously take care of patients in homes. According to results from this study, the combination of health insurance with social welfare to cover home care services; and better connection between home care system and other health care systems were recommended.

並列關鍵字

home care ； perceived need ； family caregiver