護理之家照顧提供者與家屬之壓力與自覺健康狀況相關性之研究

A Study of the Relationship between Job Stress and Perceptive Health Status for Care Provider and Family in Nursing Home

吳東昇(Tung-Sheng Wu) ； 陳韋良(Wei-Liang Chen) ； 林易申(I-Shen Lin) ； 江昇達(Sheng-Ta Chiang) ； 王映權(Ying-Chuan Wang) ； 高東煒(Tung-Wei Kao) ； 王鐘慶(Chung-Ching Wang)

《中華職業醫學雜誌》 21卷2期 (2014/04) Pp. 81-90

摘要

目的：探討長期照護機構之照顧員及家屬的壓力與健康生活品質狀況之間關連性。方法：除參考台灣地區的相關文獻，以99年12月1日至101年1月31日，居住於北部某社區護理之家的住民之照顧者及家屬為對象，以結構式問卷，調查居家護理主要照顧者的工作壓力與健康生活品質的危險因子。結果：照顧提供者及家屬的壓力（PSTR量表），發現建議尋求醫療協助的人有13.7%（n=14）；在生活品質構面中，照顧提供者及家屬只有在生理功能層面之自評分數平均值在80以上，其餘則均小於80，尤以活力狀況最低，與台灣常模有顯著差異。同時照顧者的受教育年數愈高，及有“管路更換”和“鼻胃管更換”的需求，則壓力的分數較高。機構人員在生理功能、一般健康、活力狀況和心理健康等均比非機構人員高，且有統計上差異，但在整體生理面向和整體心理面向則無。本國籍、未婚或其他婚姻狀況照顧提供者及家屬的心理健康則較差。結論：本研究結果發現照顧提供者的壓力愈大，健康品質愈差。以住民是否有管路為最主要之壓力源，其次非機構人員、在受教育年數愈長者，壓力較大。機構人員部分生理和心理功能均較非機構人員健康。已婚者的心理健康則較未婚或其他婚姻狀況者為高。增加非機構照顧提供者紓壓方法以增進身心健康，給予適當的社會支持，尤其是家庭支持系不全或教育年數較長的照顧提供者，提升他們（尤其是非機構人員）的身心健康，增進照顧品質。

關鍵字

護理之家 ； 工作壓力 ； 自覺健康狀況 ； 照顧提供者

並列摘要

Purpose: Nursing home is one of the important parts of long-term care in Taiwan, and their caregivers and their families directly affect the quality of patient care. The purposes of our study to explore the correlation between the work stress of caregivers and quality of life.Method: The survey adopts prospective study design and purposive sampling by using a structured self-administered questionnaire to collect information. The study is conducted in a nursing home of the medical center in the northern city in Taiwan from January 1, 2011 to December 31, 2011.Results: Our study includes a total of 102 participants. The main nationality of caregivers is Taiwanese (97%). Most caregivers compose of females (94.1%), with mean age 41.61 ± 9.57 years. The main composition of residents is females (63.2%), with mean age 78.40± 13.04 years. 53.3 % of the residents in the nursing home have one implanted tube, especially nasogastric tube (40.2%).There were 36.3% of residents with one comorbid disease, 32.4% of residents with two comorbid disease and 31.4% of residents with three comorbid disease. Functional status of most nursing home resident is poor. (the score of barthel index 0~20 is 52.2%). In the PSTR score and eight dimensions of health-related quality of life for caregivers, the mean scores of PSTR is 54.02 and the score of SF-36 for caregiver is significantly lower than the healthy population in Taiwan.

並列關鍵字

home nursing care ； job stress ； perceptive health status ； care provider