居家服務的介入對於失能者之家庭照顧者的照顧壓力及生活品質成效探討-以新竹市為例

ASIA unversity > 醫學暨健康學院 > 健康產業管理學系 > 長期照護組 > 博碩士論文 > Item 310904400/117025

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题名:	居家服務的介入對於失能者之家庭照顧者的照顧壓力及生活品質成效探討-以新竹市為例
其它题名:	The effect of intervention of home care service on the care burden and quality of life in family caregivers of the elderly with disabilities: Take the Hsinchu city as an example
作者:	林良安 LIN, LIANG-AN
贡献者:	李雅珍 LEE, YA-CHEN 健康產業管理學系長期照護組碩士在職專班
关键词:	生活品質;照護壓力;照顧者;居家服務;新竹市;失能者 caregiver stress;caregiver;home-based care service;Hsinchu City;people with disability;quality of life
日期:	2023
上传时间:	2023-11-22 02:01:29 (UTC+0)
摘要:	前言：鑒於臺灣整體人口快速老化，加上家庭功能日益消失，提供服務的照顧者日益減少，而需要的被照顧者日益增加，在長照 2.0 中居家服務的使用率最高。目前我國對於照顧者缺乏全國性完整照顧者法案，而目前國內尚無本土性實證闡述居家服務與家庭照顧者壓力之關係。因此，本研究目的為探討居家服務介入後對於失能者之家庭照顧者照顧壓力與生活品質之效益，並探討居家服務介入後對於失能者之家庭照顧者照顧壓力與生活品質間之關聯性。研究方法：本研究採單組前後測追蹤研究，前測時，個案之主要照顧者將填寫：人口學特性資料表、照顧者壓力自我測驗量表及台灣簡明版世界衛生組織生活品質問卷(台灣簡明版 WHOQOL-BREF)。三個月後之後測，個案須填寫：照顧者壓力自我測驗量表、台灣簡明版 WHOQOL-BREF 及居家服務使用者滿意度調查表。本研究採問卷面訪的方式收集資料。以描述性統計分析家庭主要照顧者人口學變項等資料之次數分配、百分比與平均數。以t檢定或ANOVA：分析家庭照顧者之人口學變項、居家服務的介入前後在其家庭主要照顧者的照顧壓力和生活品質之差異。以皮爾遜相關係數(Pearson Correlation Coefficient, r)分析家庭主要照顧者之照顧壓力與生活品質兩者間之關聯性。研究結果：本研究共收集 30 份個案問卷，家庭的主要照顧者性別以「女性」為主，年齡在「55-64 歲」，婚姻以「已婚」為主。照顧者壓力自我測驗量表總分與其分量表情緒、心理社會及社交經濟四個因素分數達統計顯著差異。不同的經濟狀況對於生理因素方面，有顯著差異(p=0.046)。居家服務的介入前後於照顧壓力，無顯著差異(p=0.661)。生活品質方面，有顯著差異(p=0.027)。居家服務的介入前後於生活品質整體品質無顯著差異。整體而言照顧壓力與生活品質呈現負相關。討論與結論：本研究結果顯示，居家服務介入前後經過成對樣本t檢定分析，分析顯示生活品質方面有達到提升的效果，但照顧壓力方面經過居家服務的介入並未達到減輕的效果。照顧壓力量表各層面及生活品質量表各層面透過皮爾遜相關係數分析，分析結果顯示照顧壓力與生活品質呈現負相關，表示家庭主要照顧者在照顧期間感受到壓力情況越大時，生活品質方面呈現下降。綜合上述所獲得之結論，本研究將針對家庭主要照顧者「年齡」、「經濟方面」及「居家服務」介入的時間點等三個面向提出討論，希望能夠降低家庭主要照顧者的照顧壓力及提高其生活品質。 Introduction: As Taiwan's population rapidly ages and traditional family functions decline, the number of available caregivers is decreasing while the number of individuals in need of care is increasing. As a result, the usage-rate of home-based care services is the highest among the services provided in the Long-Term Care 2.0 Plan. At present, Taiwan lacks a comprehensive national act for caregivers, and there is no local empirical research on the relationship between home-based services and caregiver stress among family caregivers. The objective of this study was to investigate the benefits of such services for disabled family caregivers with respect to reducing caregiver stress and enhancing quality of life, as well as to examine the correlation between caregiver stress and quality of life among caregivers of disabled families who have received home-based care services.Methods:This study used a one-group pretest-posttest design. During the pre-test,the primary caregiver of each case completed a demographic data form, TheCaregiver Burden Interview Scale, and a Taiwan brief version of the World HealthOrganization Quality of Life questionnaire (WHOQOL-BREF). The data for thisstudy were collected through face-to-face questionnaires. Descriptive statisticswere used to analyze the frequency distribution, percentage, and mean ofdemographic variables for the primary family caregiver. T-tests or ANOVA wereemployed to analyze the differences in demographic variables, caregiver stress,and quality of life for primary family caregivers before and after the engagement of home-based care services. In addition, the Pearson correlation coefficient was utilized to analyze the correlation between caregiver stress and quality of life for primary family caregivers.Results: This study collected a total of 30 case questionnaires. The gender of the primary caregiver in the family was mostly female, and the age was in the range 55 to 64 years old. The majority of the caregivers were married. There was a significant difference in the physical dimension based on different economicconditions. There was no significant difference in caregiving stress before and after the intervention of home care services, but there was a significant difference in quality of life. The total score of the Caregiver Burden Interview Scale was significantly different from the four subtests of the Caregiver Burden Interview Scale (including physical, emotional, psychological, and social economic). No significant diffidence found between the scores of the Caregiver Burden Interview Scale and WHOQOL-BREF. The total score of the Caregiver Burden Interview Scale was negatively correlated with WHOQOL-BREF.Discussion and Conclusion:The paired-sample t-tests that were conducted beforeand after the intervention of home care services showed that while there was nosignificant reduction in caregiver stress, there was a significant improvement in quality of life. The results of correlation revealed a negative correlation between caregiver stress and quality of life, indicating that primary caregivers experience a decline in their quality of life as their perceived stress increases. This study has addressed three factors: age, economic status of primary family caregiver,and timing of home care service intervention. The findings of this were expecting to alleviate caregiver burden and enhance the quality of life for caregivers.
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