影響安寧癌末住院病患主要照顧者照顧評價之因素及相關性探討; Factors associated with caregiving appraisal by primary caregivers of terminal ill cancer patients in hospice

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 310903500/763

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题名:	影響安寧癌末住院病患主要照顧者照顧評價之因素及相關性探討;Factors associated with caregiving appraisal by primary caregivers of terminal ill cancer patients in hospice
作者:	楊曉雯;Hsiao-Wen Yang
贡献者:	醫務管理學研究所
关键词:	主要照顧者;照顧評價;安寧緩和療護;primary caregiver;caregiving appraisal;palliative care
日期:	2008-06-16
上传时间:	2009-08-12 16:22:04 (UTC+8)
摘要:	目的：由於癌末病患逐年增加，目前鮮少研究探討癌末住院病患主要照顧者之負荷，過去研究雖多探討照顧工作所產生的主觀負荷，但並未對照顧工作的掌控能力、提供照顧的滿足程度及對照顧工作的思想模式等方面之測量，故本研究以照顧評價衡量主要照顧者對照顧工作之感受，研究目的期望了解安寧癌末住院病患主要照顧者之照顧評價，並探討影響主要照顧者照顧評價之因素。方法：本研究為橫斷式研究，採立意取樣方式，選擇某醫學中心緩和安寧病房病患之主要照顧者為研究對象，以翻譯Lawton(1989)照顧評價(caregiver appraisal)問卷進行面對面訪談，於民國96年11月至97年6月期間收案，最後有效問卷共72份，統計方法包括描述性統計、t檢定、變異數分析、逐步複迴歸分析等。結果：癌末病患主要照顧者之照顧評價中較認同「給予照護的滿足程度構面」及「給予照護的掌控程度構面」兩構面，而對於「給予照護的影響構面」及「主觀照護的負荷構面」兩構面認同感較低，表示照顧者之照顧評價是正向照顧感受多於負向照顧感受，另外逐步複迴歸分析結果，歸納在病患特性方面，疲倦、腹瀉、水腫症狀及病患身體功能狀態(KPS)之變項為照顧評價之影響因素，而照顧者特性方面，教育程度、現在與病患的關係、是否因照顧病患而換過職業、是否有罹患其他疾病之變項為照顧評價之影響因素。結論與建議：研究結果將提供臨床護理人員在協助癌症病患之照顧者的實證基礎，以供未來制定本土化安寧療護模式的參考依據，讓醫護人員除能與家屬共同提升病患的生活品質，更維持照顧者的生活品質。 Objectives：Although the number of terminal cancer patients increases year by year, few researchers have discussed caregivers’ burden in dealing with terminal cancer patients in palliative hospitals. Much research has discussed the subjective of caregiving subjective burden, but hasn’t measured the impact of caregiving, the levels of caregiving mastery, and satisfaction during caregiving. The purpose of this study was to measure caregiving appraisal and to find important factors in those who cared for terminal cancer patients in palliative hospitals. Methods：A cross-sectional survey was used to collect data by face to face interview from a convenience sampling of 72 caregivers who cared for terminal cancer patients in palliative hospitals. Questionnaires was interpreted from Lawton, published in 1989. The data was gathered from November 2007 to June 2008. The statistical analysis methods included descriptive statistics, independent t test, one way ANOVA, and stepwise multiple regression analysis. Results：Caregivers who cared for terminal cancer patients were agreeable to “caregiving satisfaction” and “caregiving mastery” than “subjective caregiving burden” and “impact of caregiving” for each domain of caregiving appraisal. The results found that it was higher scroes in positive caregiving experiences than in negative caregiving experiences for caregiving appraisal of caregivers. A stepwise multiple regression analysis indicated that predict variables included fatigue, diarrhea, edema, and Karnofsky Performance Scale(KPS) in patient’s characteristic aspect. In caregiver’s characteristic predict variables included education, relationship with patient, changing occupation, and other diseases. Conclusions：The findings of this study provide clinical nurses with an evidence basis while helping primary caregivers of cancer patients to make referrals of Taiwan’s palliative care models in the future. The results help multidisciplinary teams promote and maintain caregivers’ quality of life.
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