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  • 學位論文

呼吸器居家照護病人家屬照顧者之照護經驗

The home care experiences of Family Caregivers for Ventilator-Dependent Patients.

指導教授 : 曾月霞

摘要


由於呼吸器依賴的病人長期滯留於醫療院所急性病床或加護病房,健保局於民國89年試辦「全民健保呼吸器依賴病患整合照護」計劃,推動呼吸器依賴病人在家接受呼吸器居家照護。然而當家屬將病人安置在家中照顧時,是否有後續照顧上的困難或問題,則很少被注意。因此本研究的目的是探討呼吸器依賴病人返家接受呼吸器居家照護,其家屬照顧者之照護經驗。 本研究採質性研究,以深度訪談法進行資料收集。研究來源為中部地區呼吸器居家照護病人的家屬,採立意取樣,共訪談15位家屬,訪談後依據訪談錄音文稿做質性資料分析。資料分析後呈現呼吸器居家照護病人主要照顧者之照護經驗共有八個類別,包含(1)對親情的不捨而決定返家,(2)準備迎接新生活,(3)發展減少照顧工作負荷的策略,(4)經歷各種突發狀況,(5)自行執行醫療處置,(6)承受沉重身心社會負荷,(7)持續照護的「美」中「不足」,及(8)對呼吸器的愛恨情結。本研究的結果有助於護理人員對家屬在居家照護期間照護經驗的了解,可作為未來進行呼吸器居家照護出院準備服務之參考,以規劃更符合病人及家屬需求的呼吸器長期安置方案,使病人家屬得到持續性的服務。家屬的居家照護經驗也可提供給其他呼吸器依賴病人之家屬進行安置決策時的意見。另外,本研究結果也提供給健保局作為修改呼吸器居家照護政策之參考。

並列摘要


Due to the ventilator-dependent patients occupied hospital acute-care or intensive care beds, Bureau of National Health Insurance (NIH) has carried out the ‘Integrated Delivery System’ plan since year 2000 to facilitate ventilator-dependent home care. However, it was little noted about difficulties or problems that home-care patients and their families met. The purpose of this study was to illuminate lived experience of caregivers caring for ventilator-dependent patients at home. A qualitative research design was used. Data were collected by in-depth interview. Fifteen family caregivers who had the ventilator-dependent care experience were invited to participate in this study by purposive sampling. The interviews were tape-recorded and then transcribed word by word. Content analysis was used to analyze the data. The result of the study emerged 8 categories of the experience of caregivers: (1) Deciding to care at home because of the intimacy relationship. (2) Preparing for a new life. (3) Developing strategies to reduce care loadings. (4) Experiencing various sudden/emergent events. (5) Performing medical treatments without medical orders. (6) Having heavy burdens on physical, mental, and social aspects. (7) Insufficiency in the fair of home care. (8) Contradictory feelings to the ventilator. The results of this study could be used to refine discharge plan for home care of ventilator-dependent patients and their caregivers. The experience of the caregivers could be used by other families to make decision for home care. Moreover, the results may provide information for NIH policy reform about ventilator-dependent home care.

參考文獻


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簡雅芬、吳淑瓊(1999)•影響子女照顧失能父母意願之因子•中華衛誌,18(3),189-198。
胡幼慧、郭淑珍、王孝仙(1996)•老人長期病患照顧者對取代方案之考量:潛在需求與困境分析•中華衛誌,15(4),275-288。
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被引用紀錄


吳倩宜(2014)。探討慢性阻塞性肺病病人之罹病經驗〔碩士論文,長榮大學〕。華藝線上圖書館。https://doi.org/10.6833%2fCJCU.2014.00174

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