比較住院與居家之癌末安寧病人的主要照顧者生活品質差異

中國醫藥大學機構典藏 China Medical University Repository, Taiwan > 公共衛生學院 > 醫務管理學系暨碩士班 > 博碩士論文 > Item 310903500/54381

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题名:	比較住院與居家之癌末安寧病人的主要照顧者生活品質差異 Comparison of Caregiver's Quality of Life Between Caring Terminal Cancer Patients in the Hospital and At Home
作者:	林菁玉;Chin-Yu Lin
贡献者:	醫務管理學系碩士班
关键词:	住院;居家;安寧療護;主要照顧;生活品質;admission;home care;palliative care;main caregiver
日期:	2015-08-19
上传时间:	2015-11-04 17:07:24 (UTC+8)
出版者:	中國醫藥大學
摘要:	目標:台灣地區因癌症死亡之人數自1982年起即占死亡人口第一位，癌病死亡人數日益上升。病人忍受身心煎熬，其家人於照護過程需給予全力支持。然病人返家照顧時，醫療重擔將落在主要照顧者身上，進而造成主要照顧者的壓力而影響其生活品質。本研究針對中部某醫學中心安寧住院及居家二個族群的主要照顧者進行生活品質的調查，探討癌末安寧病人之主要照顧者的生活品質差異。方法:研究以台灣簡明版世界衛生組織生活品質問卷（WHOQOL-BREF）28題，收集主要照顧者之生活品質，以Excel 2007及SPSS 20版套裝軟體進行統計分析，以描述統計、卡方及單因子變異數分析、複迴歸分析進行資料分析。結果：研究安寧住院及居家之主要照顧者共126人，以統計t-test進行檢定，結果顯示住院及居家二組主要照顧者之生活品質於四個範疇「生理範疇」、「心理範疇」、「社會範疇」及「環境範疇」未達統計上差異(p> 0.05)，於此主要照顧者得分最低為社會範疇13.24(SD=2.535)，環境範疇得分最高25.17(SD=4.709)；然而居家安寧之主要照顧者病人人口學中「病人管路留置」、「病人年齡」、「病人慢性疾病」、「病人主診斷」，另外主要照顧者人口學於「照顧者工作狀況」及「輪替照顧病人」等相關因素，對主要照顧者生活品質有顯著差異(p< 0.05)，另於住院安寧之主要照顧者以「教育程度」有達顯著差異(p< 0.05)。結論：本研究主要了解主要照顧者住院及居家安寧照顧生活品質差異，顯示人口學相關因素會影響主要照顧者的生活品質，若醫護人員能關切主要照顧者並適時協助其負擔及壓力，及照顧歷程，必能提升主要照顧者之生活品質，對癌症末期病人的照護會更趨完善，方能與主要照顧者共同提升病人的照護品質。 Purpose:The cancer mortality rate is raising. Since 1982, cancer mortalities became the first place of all-cause mortality in Taiwan. The cancer patients suffered, and need support from family members. After discharged form hospital, the main caregiver of patients had to take care of them within home. It resulted in emotional distress of the main caregivers and influenced their quality of life. The study was designed to understand quality of life on the main caregiver of inpatient of hospice ward and outpatient received hospice home care in a medical center in Taichung. Method:The WHOQOL-BREF consists of 28 items to assess quality of life in the family caregiver of cancer patients. Data were evaluated by descriptive statistics, chi-square, one-way ANOVA and multiple repression, analyses by Excel 2007 and SPSS 20 software. Results:126 main caregivers of patients admitted to hospice ward and home care patients participated in the study. There was no significant difference in four domains, including physical domain, psychological domain, social do-main and environment domain of hospice admission group and home care group (p>0.05). The lowest score was in social domain, 13.24(SD=2.535), and the highest score is in environment domain 25.17(SD=4.709). However, several patient medical characteristics (invasive catheterizations, age, chronic disease, main diagnosis) are differed significantly in the home care group. Caregivers’ job and alternatively care the patient also had significant effect on caregivers’ quality of life (p<0.05). However, caregivers in the hospice admission group were more highly educated (p<0.05). Conclusions:The results suggest that the caregivers should be concerned and be supported to release their burden, and to increase their quality of life to benefit of the quality of cancer patient care.
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