提供社區式家庭支持方案能否減少機構式長期照護服務之使用意願？

Will Community-Based Family Supporting Programs Reduce the Use of Institutional-Based Long-Term Care?

徐慧娟(Hui-Chuan Hsu) ； 吳淑瓊(Shwu-Chong Wu)

《中華公共衛生雜誌》 17卷4期 (1998/08) Pp. 326-336

https://doi.org/10.6288/CJPH1998-17-04-06

摘要

本研究採取回溯性研究設計，希望了解安養中心院民家屬，當初在他們送功能障礙住進安養中心時，若提供社區式家庭支持方案，是否會延緩或不送院民至機構療養（即持續家庭照護），而減少機構式服務的使用。資料來源為台灣大學公共衛生研究所「1994年台北市安養中心調查」，於126家安養中心中訪視院民及家屬，選取回答家屬為院民過去的主要家庭照顧者為研究樣本，共得270人，包括院民的配偶、兒子、女兒、媳婦等。社區式家庭支持方案包含居家護理、社會服務、短期臨托、日間照護、金錢補助等五類。本研究並探索影響家屬意願的因素，以做為日後發展家庭支持方案的參考。
家庭照顧者表示若當初提供家庭支持方案的話，有28.5%的照顧者願意選擇居家照護替代機構照護；在其他的方案中，有27.0%願意選擇社會服務，24.8%顯選擇日間照護，21.1%願選擇短期臨托，23.3%願意選擇金錢補助，來替代機構照護的使用。媳婦相對於兒子願意選擇以居家照護替代機構照護的勝算比為2.9。其他願意採用家庭支持方案以替代機構照護的因素，包括家屬過去照顧時有照顧競爭、無次要照顧者、照顧時間安排負荷低、照顧財務負荷高、院民入院前無認知功能障礙者、曾使用社區照護者等。本研究結果顯示提供社區式家庭支持方案有替代部份機構照護的潛力。

關鍵字

長期照護 ； 社區式家庭支持方案 ； 機構式照護 ； 照顧者 ； 媳婦

並列摘要

The purpose of this retrospective study investigated whether family caregivers of nursing home residents would delay, or perhaps give up, the decision of placing their care recipients in institutions if community-based family supporting programs were available, including Home Health Care, Social Service, Day Care, Respite Care and Financial Support. Study subjects were 270 former primary family caregivers of residents at 126 nursing homes, including these residents' spouses, sons, daughters, daughters-in-law, and other relatives who participated in ”The 1994 Taipei City Nursing Home Survey”. Factors relating to the transition choice recommendations were also explored to provide information for future policy decision.
The results showed that if family supporting programs were available, approximately 28.5% former caregivers would choose Home Health Care instead of institutional care for their care recipients. The other preferences included 27.0% to Social Service, 24.8% to Day Care, 21.1% to Respite Care, and 23.3% to Financial Support. The daughters-in-law were 2.9 times more likely than sons to choose to provide Home Health Care. The caregivers with other care competition, lack of secondary caregivers, low time constraint, heavy financial burden, care recipient with no cognitive impairment prior to admission, and having experience in using community care, were also factors associated with the choice of family supporting programs. This implies that the community-based family supporting programs have the potential to replace the institutional care.

並列關鍵字

long-term care ； community-based family supporting programs ； institutional care ； care givers ； daughters-in-law