家屬陪伴失智症患者門診就醫之生活經驗

The Lived Experience of Family Accompanying Persons with Dementia to Clinic Visit

石又敏(Yu-Min Shin) ； 陳玉敏(Yuh-Min Chen) ； 曾月霞(Yueh-Hsia Tseng)

《長期照護雜誌》 14卷1期 (2010/04) Pp. 43-57

https://doi.org/10.6317/LTC.201004_14(1).0005

摘要

台灣地區65歲以上老年人口比例明顯增加，失智症又是老人常見疾病，因此，失智症健康照護需求顯得迫切需要。然而，醫療環境之吵雜、就醫路線及流程複雜、醫護人員對失智症患者的行為認識不夠，對家屬協助患者門診就醫時產生影響，這些經驗在文獻中很少被描述。因此，本研究採質性研究深入訪談方法，探討失智症患者之主要家屬照顧者陪伴就醫之生活經驗。使用立意取樣(purposive sampling)，邀請16位失智症家屬照顧者參與本研究，以臨床失智量表(Clinical Dementia Rating, CDR)及躁動行為量表(Brief Agitation Rating Scale, BARS)收集失智症患者的日常生活與認知功能和問題行為；歸納出六個生活經驗，包括：(1)摸索出陪同就醫的工作方式，(2)令人措手不及與困窘，(3)漫長、枯燥與不安的等待，(4)就醫環境的不友善，(5)診療之時效性不足，(6)缺少失智症專科化醫療照護。研究結果有助於醫護人員瞭解家屬就醫困難並提供協助，例如專科化門診、獨立失智症門診區、男女合用的廁所等，提升失智症患者醫療照護品質。

關鍵字

失智症 ； 就醫 ； 生活經驗 ； 質性研究

並列摘要

Dementia is a common disease in older persons. The population of older persons is increasing in Taiwan which makes health care for dementia become important. However, when persons with dementia come to out-patient department (OPD), noisy environment in hospitals, complicated OPD routes and process, and insufficient knowledge about dementia in medical staff may make family who accompany demented persons to OPD encounter problems. The problems or experience are little described in the existed literature. Therefore, the purpose of the study was to explore the experience of family caregivers accompanying demented persons to OPD. Qualitative research design was used and 16 family caregivers were invited to participate in the study by purposive sampling. In-depth interview was used to collect the experience. The finding of the study revealed six lived experience: (1) Groping ways for accompanying demented persons to OPD, (2) Too abrupt to respond and embarrassment, (3)Endless, boring, and restless waiting, (4)Unfriendly medical environment, (5)Untimely medical treatment, and (6)Lack of specialized medical care for dementia. The findings of the study could provide information to health professionals to understand problems for OPD visit. Health professionals would provide assistance to solve the problems, for example, specialized dementia OPD, separated dementia OPD unit, and family restrooms.

並列關鍵字

dementia ； out-patient department ； lived experience ； qualitative research