୯ҥᆵεᏢϦӅፁғᏢଣ଼நࡹᆶᆅࣴز܌
ᅺγፕЎ
Institute of Health Policy and Management College of Public Health
National Taiwan University Master Thesis
Ѩඵੱޣ٬ҔВ໔ྣ៝ύЈᆶྷඵϕշৎኳԄΠ ϐৎྣ៝ޣӭϡຑ
Comprehensive Assessment of Family Caregivers with Dementia in Adult Day Care and Wisdom of Family
✎༇
Yu Chin, Chang
ࡰᏤ௲Ǻഋऍ റγ
BewjtpsǺZb.Nfj!Difo-!Qi/E/!
ύ҇୯104ԃ12Д
December, 2015
ठ ठᖴ
ࡐ໒ЈಖܭֹԋᅺγፕЎǴஒाᗌӛΓғޑΠ໘ࢤǶᗨฅ೭ࢤၸำǴӭ
Α٤ਔ໔ǴനࡕಖܭճޑֹԋΑǶ
२ӃǴाགᖴךޑࡰᏤԴৣ-ഋऍԴৣǴߚதᖴᖴԴৣޑ௲ᏤǴό๏ϒך ᏢೌޑࡌǴΨ௲ᏤךࣴزޑᄊࡋǴᎦךᐱҥࡘԵૈΚǴӧࣴزޑၸำύǴ
٬ךڙؼӭǶΨߚதགᖴѨඵੱڐޑ෯ҏઝਜߏǴаϷࢬႣ܌ޑำԴ
ৣǴࡐᄪ۩ёаᗎፎգॺᏼҺךޑα၂ہǴ๏ϒךፕЎࡐӭᝊޑཀـǴ٬ך ޑፕЎ׳уޑֹ๓Ƕ
ӆٰाགᖴǴךॺࣴز࠻ޑӳუՔॺǴᖴᖴ᐀༾ᏢۊǵޱࣦᏢۊϷᏢߏǴ Ꮲߏۆॺόսᆶךϩ٦ᡍǴΨૈਔޑ๏ϒךࡌǶᗋԖӕᏢࠧ᱒ǵॕຬǴ གᖴգॺӧࣴزޑၸำύǴᆶךଆᏢಞǵϕ࣬ןᆶႴᓰǶΨࡐགᖴࠔϡᏢǵ
⍌ޱᏢۂǴӧፕޑਔংΨૈ๏ϒؼӳޑࡌǴ࣬ϕᏢಞǶ
ԶӧךԏਢޑၸำύǴགᖴᅰЈڐշךԏਢޑВ໔ྣ៝ύЈϷྷඵϕշৎǴ ᗋԖӚൂՏޑᖄ๎ืαǴߚதᖴᖴරఘ࿎Ꮴǵᎄӵ࿎ᏤǵఘमЬҺǵᐽཀ
൛ޗπৣǵ৪ᇞ౺ޗπৣǵڬޗπৣǵഋ୯۸ǴऩࢂؒԖգॺǴךόёૈٗ
ሶճޑֹԋԏਢǴགᖴգॺӧၸำύǴ๏ϒךࡐεޑᔅԆϷڐշǶ
നࡕǴाགᖴךޑৎΓǴգॺࢂךനமεޑࡕ࣯Ǵᡣךӧװ᠐ᅺγය໔ϣǴ คࡕ៝ϐኁǴЈᏢಞǶ
Ў҃ǴךाठךനుޑགᖴǴߚதགᖴ೭ၡᔅշךޑգॺǶ
✎༇ ᙣठ
ύ
ύЎᄔा
ࣴزङඳǺӄౚѨඵੱΓኧԃᚹϲǴѨඵੱޣҗৎྣ៝ޣ܌ගٮྣៈԖ ቚуޑᖿ༈Ǵৎྣ៝ޣӢྣ៝ԶౢғޑቹៜሡΑှǴӢቹៜډྣ៝ޣϷ ѨඵੱޣيϷЈǴԶቹៜྣៈ่݀Ƕᒧ٬ҔόӕޑߏයྣៈኳԄǴ
ჹৎྣ៝ޣౢғόӕޑ҅ॄӛቹៜǶҗԜෳǴѨඵੱޣϷৎྣ៝ޣ ᒧ٬ҔВ໔ྣ៝ύЈኳԄϷྷඵϕշৎኳԄǴჹৎྣ៝ޣౢғόӕޑ
҅ॄӛቹៜǴҞ୯ϣࣴزεӭଞჹൂ҅ӛ܈ࢂॄӛቹៜՉࣴزǴՠ҂
ৎྣ៝ޣჹ٬ҔόӕኳԄޑ҅ॄӛྣ៝ቹៜǶ
ࣴزҞޑǺѨඵੱޣ٬ҔВ໔ྣ៝ύЈኳԄϷྷඵϕշৎኳԄǴჹৎ
ྣ៝ޣӭϡຑϐቹៜǶ
ࣴزБݤǺҁࣴزӧϖৎВ໔ྣ៝ύЈϷྷඵϕշৎՉୢڔፓǶࣴزჹ ຝࣁᙴৣዴບࣁѨඵੱޣЪς٬Ҕ୍ܺኳԄၲΟঁДѨඵੱޣϐЬा
ྣ៝ޣǴЪࣁЬाගٮѨඵੱޣྣ୍៝ܺϐৎྣ៝ޣǶࣴزаፄᘜ (Multiple Regression)ڋৎྣ៝ޣϷޣΓαᏢ፦Ǵ٬ҔВ໔ྣ៝ܺ
୍ኳԄϷྷඵϕշৎኳԄΠǴৎྣ៝ޣϐ҅ॄӛቹៜǶ
ࣴز่݀ǺҁࣴزӅયΕ93ΓǶྣ៝ޣӭϡຑໆ߄ٿಔ୍ܺኳԄคᡉৡ ౦ǴځΟঁᄬय़Ȩྣ៝ޣᓸΚࡰኧȩǵȨྣ៝ޑᅈىགȩǵȨྣ៝ޑዕግૈ
Κȩჹٿಔ୍ܺኳԄࣣคᡉৡ౦Ƕྣ៝ޣ൩ރݩࢂցׯᡂჹӭϡຑϷྣ
៝ޣᓸΚࡰኧࣁ҅࣬ᜢǴᆶྣ៝ޑᅈىགࣁॄ࣬ᜢǹВྣ៝ѳ֡ਔ໔ჹӭϡ ຑࣁ҅࣬ᜢǹྣ៝ޣԃសჹྣ៝ޑዕግૈΚࣁॄ࣬ᜢǶ!
ࣴزፕǺٿޣ୍ܺኳԄӧྣ៝ޣᓸΚࡰኧǵྣ៝ޑᅈىགϷྣ៝ޑዕግૈΚ คᡉৡ౦Ǵж߄ٿᅿ୍ܺჹৎྣ៝ޣځჴԖࡐӳޑЍǶࡌ҂ٰว
ӭϡߏྣৎЍྣ୍៝ܺਔǴΨёගٮྷඵৎ๏ϐѨඵߏ፸ޑৎୖ
ԵǶࣴز่݀ࡌჹܭৎྣ៝ޣǴӧ҂ٰᔈ๏ϒྣ៝ޣޗЍϷྣ៝מѯ ޑ૽ግǴٰफ़եྣ៝ޑᓸΚǴቚуྣ៝ޑᅈىགϷዕግૈΚǶ!
ᜢᗖӷǺВ໔ྣ៝ύЈǵྷඵϕշৎǵৎྣ៝ޣǵྣ៝ޣӭϡຑ
Abstract
BackgroundǺAs global aging, more dementia patient are cared by family caregivers., family caregivingmay have great impact onboth physical and mental health of the caregiver and the dementia older adults they are caring for. Evaluating family cargivers' experiences, which may included both positive and negative experiences, are important for future program and policy development. People with dementia and their family caregivers may use adult day care model or wisdom of family model in Taiwan.
ObjectiveǺThe purpose of this study was to explore and compare comprehensive assessment of family caregiver with dementia using adult day care and wisdom of family.
MethodǺThis study administer a comprehensive questionnaire in five adult day care centers and one wisdom of family. The comprehensive Questionnaire incldued three subscale. There were caregiving satisfaction, caregiving mastery and modified caregiver strain index. Participants of this study is the caregiver who attended the dementia patient, patient used the service already three months and is the mainly caregiver. The study used multiple regression to analyze and compare the differences in comprehensive assessment between families using adult day care and wisdom of family. Dementia cases and their family caregivers' characteristics were controlled.
ResultǺ93 family caregiver were surveyed. There were no significant differences in comprehensive assessment scores between caregiver using adult day care and wisdom of family. For subscales, caregiver strain index, caregiving mastery and caregiving satisfaction, there were no significant differences found between family caregivers using adult day care and wisdom of family. As for the total score of comprehensive assessment scores, employment status change of caregiver was positively associated with caregiver comprehensive assessment scale and caregiver strain index, and negatively associated with caregiving satisfaction. The average care time of a day is
positively associated with caregiver comprehensive assessment scale. Caregiver age was negatively associated with caregiving mastery.
DisscussionǺThere were no significant differences in the scores for conprehensive assessment, caregiver strain index, caregiving satisfaction and caregiving mastery between family careivvers using adult day care and wisdom of family. This indicated both services are equally supported family caregivers with demented older adutls.
Findings suggested both services can be recommended to family careivgvers with different service preference. In the future, we suggest service agency to give caregivers’
social support and skills of care to declined caregiving stress and increase caregiving satisfaction and mastery.
KeywordsǺ adult day care, wisdom of family, family caregiver, comprehensive assessment of caregiver
Ҟ Ҟᒵ
ठᖴ...i
ύЎᄔा...ii
Abstract...iv
Ҟᒵ...vi
߄Ҟᒵ... viii
კҞᒵ...x
ಃക! ᆣፕ...1
ಃ! ࣴزङඳ... 1
ಃΒ! ࣴزᐒ... 5
ಃΟ! ࣴزҞޑ... 5
ಃΒക! Ўӣ៝...6
ಃ! Ѩඵੱ... 6
ಃΒ! Ѩඵੱৎྣ៝ޣӭϡຑᆶቹៜ... 16
ಃΟ! ѠѨඵੱྣ୍៝ܺ... 24
ಃѤ! ຑπڀӣ៝... 31
ಃΟക! ࣴزБݤᆶी...34
ಃ! ࣴزࢎᄬ... 34
ಃΒ! ࣴزჹຝ... 35
ಃΟ! ࣴزၸำ... 35
ಃѤ! ࣴزπڀ... 36
ಃϖ! ୢڔਏࡋᆶߞࡋෳ၂... 44
ಃϤ! ीБݤ... 46
ಃѤക! ࣴز่݀...48
ಃ! ୢڔӣԏ... 48
ಃΒ! ୢڔߞਏࡋϩ... 49
ಃΟ! ኬҁቻᆶӚᡂϩѲ... 58
ಃѤ! В໔ྣ៝ᆶྷඵϕշৎჹྣ៝ޣӭϡຑޑเᚒϩ... 69
ಃϖ! ӭϡຑໆ߄ϐྣ៝ޣϷྣ៝ޣ୷ҁ፦Кၨ... 77
ಃϤ! В໔ྣ៝Ϸྷඵϕշৎ୍ܺϐӭϡຑӭᡂϩ... 84
ಃΎ! ྣ៝ޣᆶྣ៝ޣϐ፦ჹᒧ٬ҔВ໔ྣ៝Ϸྷඵϕշৎܺ ୍ӭᡂϩ... 89
ಃΖ! ྣ៝ޣᆶྣ៝ޣޑ୷ҁ፦ϐӭϡຑӭᡂϩ... 90
ಃ ಃϖക! ፕ...95
ಃ! ࣴزၗࠔ፦... 96
ಃΒ! В໔ྣ៝ᆶྷඵϕշৎჹӭϡຑໆ߄ϐፕ... 99
ಃΟ! ྣ៝ޣϷྣ៝ޣ፦ჹ୍ܺᒧϐፕ... 103
ಃѤ! ྣ៝ޣϷྣ៝ޣ፦ჹӭϡຑϐፕ... 104
ಃϖ! ࣴزज़ڋ... 107
ಃϤക! ่ፕᆶࡌ...108
ಃ! ่ፕ... 108
ಃΒ! ࡌ... 109
ୖԵЎ... 111
ߕᒵ...120
ߕᒵ! ࣴزউቩਡёܴ... 120
ߕᒵΒ! ࣴزୢڔ... 122
߄ ߄Ҟᒵ
߄1-1-1! 2010 ԃӄౚ 60 ྃаѨඵੱΓαՉ ... 2
߄1-1-2! Ѡ 2013 ԃۭ 65 ྃаѨඵੱՉ( 5 ྃࣁൂՏ) ... 3
߄2-1-1! ѨඵੱΜεૻ ... 11
߄2-1-2! ѠѨඵੱՉ(2014 ԃԿ 2061 ԃ) ... 13
߄2-1-3! ѠߓੇᓨੱޣੱރᆶՉࣁϐՉ ... 14
߄2-3-1! Ѡ 2013 ԃۭВ໔ྣ៝ύЈৎኧ ... 26
߄3-4-1! Ծᡂᏹբࠠۓက ... 38
߄3-4-2! ৎྣ៝ޣӭϡຑໆ߄ୢڔᄬय़Ϸᚒϣ ... 38
߄3-4-3! ৎྣ៝ޣӭϡຑໆ߄ᏹբࠠۓက ... 39
߄3-4-4! ྣ៝ޣ୷ҁၗᏹբࠠۓက ... 40
߄3-4-5! ྣ៝ޣ୷ҁၗᏹբࠠۓက ... 42
߄4-2-1! ӭϡຑໆ߄ϐ KMO ᆶ Bartlett ᔠۓ... 53
߄4-2-2! ӭϡຑໆ߄ϐ܄Ӣનϩ ... 54
߄4-2-3! ኳࠠଛ߄ ... 55
߄4-2-4! ӭϡຑໆ߄ϐᡍ܄Ӣનϩ-ኳԄ ... 56
߄4-2-5! ӭϡຑໆ߄Ӛᄬय़໔ϐᒣਏࡋ-ኳԄ ... 57
߄4-2-6! ӭϡຑໆ߄Ӛᄬय़໔ϐᒣਏࡋ-ኳԄΒ ... 57
߄4-2-7! ӭϡຑໆ߄ӚኳԄߞࡋ ... 57
߄4-3-1! ྣ៝ޣ୷ҁၗϐඔॊ܄ϩ ... 61
߄4-3-2! ྣ៝ޣ୷ҁၗϐඔॊ܄ϩ ... 66
߄4-4-1! ӭϡຑໆ߄ϐඔॊ܄ϩ ... 72
߄4-4-2! ӭϡຑໆ߄ϐᐱҥኬҁ t ᔠۓ ... 74
߄4-4-3! ӭϡຑໆ߄ϐᄬय़ளϩ ... 76
߄4-4-4! ӭϡຑໆ߄ϐᄬय़ନаᚒኧϐளϩ ... 76
߄4-5-1! ӭϡຑໆ߄ϐྣ៝ޣᜪձᡂ୷ҁ፦Кၨ ... 78
߄4-5-2! ӭϡຑໆ߄ϐྣ៝ޣᜪձᡂ୷ҁ፦Кၨ ... 81
߄4-5-3! ӭϡຑໆ߄ϐྣ៝ޣϷྣ៝ޣೱុᡂ୷ҁ፦Кၨ ... 83
߄4-6-1! ٬ҔВ໔ྣ៝܈ྷඵϕշৎჹӭϡຑໆ߄ᕴϩޑቹៜ ... 85
߄4-6-2! ٬ҔВ໔ྣ៝܈ྷඵϕշৎჹྣ៝ޣᓸΚࡰኧᕴϩޑቹៜ ... 86
߄4-6-3! ٬ҔВ໔ྣ៝܈ྷඵϕշৎჹྣ៝ޑᅈىགᕴϩϐቹៜ ... 87
߄4-6-4! ٬ҔВ໔ྣ៝܈ྷඵϕշৎჹྣ៝ޑዕግૈΚᕴϩϐቹៜ ... 88
߄4-7-1! ྣ៝ޣᆶྣ៝ޣ፦ჹܭ٬ҔВ໔ྣ៝Ϸྷඵϕշৎ୍ܺϐቹៜ ... 89
߄4-8-1! ྣ៝ޣᆶྣ៝ޣޑ୷ҁ፦ჹӭϡຑໆ߄ᕴϩޑቹៜ ... 91
߄4-8-2! ྣ៝ޣᆶྣ៝ޣޑ୷ҁ፦ჹྣ៝ޣᓸΚࡰኧᕴϩޑቹៜ ... 92
߄4-8-3! ྣ៝ޣᆶྣ៝ޣޑ୷ҁ፦ჹྣ៝ޑᅈىགᕴϩϐቹៜ ... 93
߄4-8-4! ྣ៝ޣᆶྣ៝ޣޑ୷ҁ፦ჹྣ៝ޑዕግૈΚᕴϩϐቹៜ ... 94
߄5-2-1! ٬Ҕ࣬ӕ୍ܺΠǴྣ៝ޣϷྣ៝ޣ፦ჹྣ่៝݀ቹៜ ... 102
߄5-2-2! ྣ៝ޣϷྣ៝ޣ፦ჹྣ่៝݀ቹៜ ... 102
߄5-4-1! ಔϣྣ៝ޣ܄ձჹӭϡຑޑቹៜ ... 104
კ კҞᒵ
კ2-2-1! ߓੇᓨྣ៝ޣᓸΚኳԄ ... 17 კ3-1-1! ࣴزࢎᄬ ... 34 კ4-2-1! ଥڵკ ... 53
ಃ
ಃക! ᆣፕ
ಃ! ࣴزङඳ
ӧ2012ԃࡰрӄౚѨඵੱൔ(World Alzheimer Report, 2012)ࡰрǴӧ2010ԃ
ीǴӄౚஒԖεऊ3,600ΓບᘐࣁѨඵੱޣǴѨඵੱΓαஒזೲቚуǴႣ
ीӧ2030ԃஒၲډ6,600ΓǴ2050ԃஒၲډ11,500ΓǴԶΟϩϐΒޑΓαஒՏ ܭύեԏΕޑ୯ৎǶӧ2010ԃ൩Ԗ58%ޑѨඵੱΓαࢂวғӧύեԏΕޑ୯ৎǴ Ⴃӧ2030ԃஒၲ63%Ǵ2050ԃၲډ71%(Prince et al., 2013)ǶШࣚፁғಔᙃ(World Health Organization,WHO)ӧ2012ϦթޑѨඵੱൔύǴࡰрӧ2010ԃԖ770Ӝ ཥບᘐࣁѨඵੱޑঁਢǴ࣬ܭ4ࣾ൩рՏѨඵੱޣǶӄౚѨඵੱΓα
ԃቚуǴ߄1-1-1ࣁ2010ԃӄౚ60ྃаΓαѨඵੱՉǴӄౚѨඵੱѳ֡
Չࣁ4.7%Ǵځύऍࢪଯၲ6.5%ǴՠࢂӧѨඵੱԴԃΓαኧ߾а٥ࢪۚ߷ǴԶځ ύаܿ٥Ϸࠄ٥ޑѨඵੱՉനଯǶ
ߓੇᓨੱ(Alzheimer’s disease, AD)ӧ21Шइჹܭ଼நǵޗаϷᔮࢂ
ঁࡐεޑࡷᏯǶ2010ԃऍ୯ஒ߈Ԗ1500ޑߚ҅Ԅྣ៝ޣǴගٮߓੇᓨੱޣ ऊ170ሹঁλਔޑྣ៝ਔኧǴ܌ଅޑሽॶຬၸ2020ሹऍϡǶऍ୯Ԗ520Γບ ᘐࣁߓੇᓨੱ(Alzheimer’s disease, AD)ǴځύऊԖ20Γλܭ65ྃǴӧᓻٽዊ ޑቹៜΠǴӧ҂ٰΜԃǴႣीஒӆቚу100ޑߓੇᓨੱޣǶ(W Thies &
Bleiler, 2011; William Thies & Bleiler, 2013)Ƕ2010ԃीǴӄౚԖ6,040ሹӧѨ ඵੱय़Ǵ70%ӧՋኻϷчऍӦǶځύଯԏΕ୯ৎǴӧᙴᕍ܌ޑԋҁᇻ եܭӧߚ҅Ԅྣ៝ϷޗᜢᚶޑޔௗԋҁǶԶӧեԏΕ୯ৎύǴځޗᜢᚶԋҁ
ࢂཱུϿޑ(Wimo, Jönsson, Bond, Prince, & Winblad, 2013)Ƕ
߄ 1-1-1! 2010 ԃӄౚ 60 ྃаѨඵੱΓαՉ
ୱ 60ྃаΓα (ԭΓ, 2010)
ಉՉ
(%, 2010)
ѨඵੱΓα (ԭΓ, 2010)
٥ࢪ 406.55 3.9 15.94
ᐞεճ٥ 4.82 6.4 0.31
٥ϼ 46.63 6.1 2.83
εࢩࢪ 0.49 4.0 0.02
ύ٥ 7.16 4.6 0.33
ܿ٥ 171.61 3.2 5.49
ࠄ٥ 124.61 3.6 4.48
ܿࠄ٥ 51.22 4.8 2.48
ኻࢪ 160.18 6.2 9.95
ऍԀ 120.74 6.5 7.82
ߚࢪ 71.07 2.6 1.86
ӄౚ 758.54 4.7 35.56
ၗٰྍǺPrince et al, 2013
ѠԴԃΓαזೲԋߏǴӧ1993ԃ65ྃаԴԃΓαэᕴΓαኧၲډ7%а
ǴਥᏵᖄӝ୯ШࣚፁғಔᙃۓကǴ65ྃаԴԃΓαэᕴΓαኧၲډ7%Ǵᆀࣁ ଯសϯޗ(Aging society)ǹၲ14%ࣁଯសޗ(Aged society)ǹၲ20%аࣁຬଯ សޗ(Hyper-aged society)Ƕ2014ԃ6ДۭѠԴԃΓαςၲډ11.75%Ǵ୯ৎว
ہޑѠΓαी2014ԃԿ2061ԃൔࡰрǴԴԃΓαӧ2018ԃஒᗌ ΕଯសޗǴ2025ԃΕຬଯសޗǴ2061ԃஒၲډ41%ǴןԴКၲ1.1Ǵ߄Ң1.1
ঁԃᇸΓሡןᎦঁԴΓǶЪ65-74ྃԃᇸԴΓǴஒҗ2014ԃ55.7%ǴΠफ़Կ2061 ԃ38.8%Ǵ85ྃаຬଯសԴΓǴ߾җ2014ԃ11.5%ǴϲԿ2061ԃ25.6%Ǵ࣬
ܭ4ঁԴԃΓύ൩ԖՏ85ྃаຬଯសԴΓǶ
ѠѨඵੱՉਥᏵ2004ԃՉࡹଣፁғہૼѠѨඵੱڐޑȨѠѨ ඵੱᐒᄬྣ៝ሡϐፓ-ߏයྣៈᐒᄬѨඵੱޣϐՉፓȩǴൔ
2016ԃޗ65ྃаѨඵΓαऊ18ΓǴ՞ᕴΓαКٯࣁ0.7%Ǵӧ2060ԃޗ65
ྃаѨඵΓαஒၲ73ΓǴ՞ᕴΓαКٯ4.2%Ǵ҂ٰޑѨඵΓαஒε൯ቚуǶ
߈ԃፁғᅽճӧ2013ԃہૼѠࢂඵੱڐჹѠѨඵੱΓαࢬՉੰᏢ ӆፓǶ٩ϣࡹϦѲၗǴ2013ԃۭӄѠ65ྃаԴΓΓαၲ2,690,000ΓǴ ځύԖᇸࡋᇡޕምᛖޣၲ50ΓǴऊ՞65ྃаԴԃΓα18.7%ǴԶዴບࣁѨඵ
ੱޣၲ217ίӭΓǴऊ՞65ྃаԴԃΓα8.1%Ƕፓ่݀ӵ߄1-1-2Ǵ65ྃ-69
ྃՉࣁ3.40%Ǵ70ྃ-74ྃՉࣁ3.46%Ǵ75ྃ-79ྃՉࣁ7.19%Ǵ80ྃ- 84ྃՉࣁ13.03%Ǵ85ྃ-89ྃՉࣁ21.92%Ǵ90ྃаՉࣁ36.88%Ƕ
߄ 1-1-2! Ѡ 2013 ԃۭ 65 ྃаѨඵੱՉ( 5 ྃࣁൂՏ)
ԃស(ྃ) 65-69 70-74 75-79 80-84 85-89 90ྃа
Չ(%) 3.40% 3.46% 7.19% 13.03% 21.92% 36.88%
ၗٰྍǺѠѨඵੱڐ(2013)
ਥᏵШࣚፁғಔᙃۓကѨඵੱࢂᅿတੱংဂǴჹޣޑᏫǵࡘԵǵ БӛགǵှΚǵीᆉǵᏢಞૈΚǵᇟقکղᘐΚԋቹៜǶѨඵੱޣޑՉࣁ όჹޣғࢲࠔ፦ԋቹៜǴΨჹྣ៝ޣౢғॄǴԋғǵЈޑቹៜ (Fauth, Zarit, Femia, Hofer, & Stephens, 2006; Herrmann et al., 2006; K. Eagar et al., 2006)ǶғॄԖᅵምᛖǵيᡏ଼நǵЈՈᆅ੯ੰϷཥഋжᖴୢᚒ(Mills et al., 2009; Martin Pinquart & Sörensen, 2005, 2006)ǹЈॄԖኁᢠǵขቾǵྣ៝ॄ
(Mohamed, Rosenheck, Lyketsos, & Schneider, 2010; Zarit, Anthony, & Boutselis, 1987)Ƕ೭٤ёૈԋৎྣ៝ޣيᡏ଼நрૻǴࣗԿ໒ۈ٬Ҕᙴᕍၗྍ
(Beinart, Weinman, Wade, & Brady, 2012)ǶԖ׳ӳޑྣ៝ৎྣ៝ޣࢂШࣚӚ୯ޑ ख़ाޑߏྣࡹ(Keefe, Guberman, Fancey, Barylak, & Nahmiash, 2008; Seddon &
Robinson, 2001)ǶѠ2015ԃΨຫٰຫख़ຎৎྣ៝ޣޑᚒ(ߋ௴ዎ, ల௵, &
ֆలӵ, 2003)ǶԶຑЍৎྣ៝ޣޑ٬Ҕ୍ܺޑᡍҭࢂҞѠख़ाޑࡷ
ᏯǶځύВ໔ྣ៝ឦܭޗԄޑഹ৲୍ܺǴჹܭྣ៝ޣ๏ϒኩਔྣ៝ޑڐշǴ٬
ྣ៝ޣૈԖቸ܄ၮҔޑਔ໔Ǵ٬ځёаᆢ໘ࢤ൩ރᄊ(ֈᝊᓉ, ٫Ꮒ,
& ᇳ᐀ޱ, 2014)ǴྷඵϕշৎኳԄࣁᅿᜪ՟ޗԄޑഹ৲୍ܺǴྣ៝ޣϷ
ྣ៝ޣၸᆶځд࣬ӕᡍޑဂΓௗΠǴᕇளགޑЍϷྣ៝מѯޑҬࢬ (෯ҏ, ֆ؊ᒹ, ࣔ, & ࢫЈѳ, 2013)Ƕ
୍ܺჹৎྣ៝ޣޑԋਏຑᔈࢂӄय़܄Ǵҗܭόӕޑߏྣ୍ܺჹৎྣ៝
ޣ ࢂ Ԗ ό ӕ ޑ ቹ ៜ (Chen, Hedrick, & Young, 2010; Diehl-Schmid et al., 2013;
Jennings et al., 2015; Mossello et al., 2008; ഋ൛ & ߋ௴ዎ, 2015; ௵ስ, ৪٥
ྻ, ླྀ࣑, & ယࣂம, 2004)Ƕৎྣ៝ޣӢྣ៝πբǴౢғޑྣ៝ᡍԖ҅
ॄӛᡍǴՠࢂԖѠҞၨӭޑຑࣁॄӛᡍ(ߋ௴ዎ, ల௵, & ֆᛏᅈ, 2002; ᑉᐇ, ቅЎؼ, & ᅩྷᑫ, 2014; ഋࢅӜ, 2013; මഓስ, 2014)Ǵଞჹӭय़ ӛຑޑࣴز׳ࢂલЮ(Цഓ, 2005; ד۸, 2013)Ƕ
ᆕӝॊǴҁࣴزགྷΑှӧόӕޑྣ៝ኳԄΠǴྣ៝ޣޑ҅ӛᡍϷॄӛ
ᡍ໔Ǵჹৎྣ៝ޣځྣ่៝݀ޑቹៜǴࡺҁࣴزஒଞჹѨඵੱৎྣ៝ޣǴ
Չྣ៝ޣӭϡຑǶ
ಃ
ಃΒ! ࣴزᐒ
ӧВ໔ྣ៝ᆶྷඵϕշৎٿᅿ࣬՟ޑ୍ܺኳԄΠǴྣ៝ޣॄࢂցӢࣁ
٬Ҕόӕ୍ܺኳԄԖ܌όӕǶҗܭྷඵϕշৎኳԄۘ҂х֖ӧߏයྣៈ୍ܺύǴ
В໔ྣ៝ϷྷඵϕշৎኳԄჹѨඵੱޣৎឦޑྣ៝҅ॄӛቹៜǴ׆ఈᙖ җࣴزჹЬाྣ៝ޣޑቹៜǴ҂ٰቶᆶࡹڋुޑୖԵǴ٬ߏයྣៈܺ
୍ჹѨඵੱޣޑྣៈӧޗૈԖ׳ӭϡޑᒧǶ
ಃΟ! ࣴزҞޑ
ၸѐଞჹৎྣ៝ޣ܌ޑຑǴεӭѝଞჹൂय़ӛǴջॄӛޑቹៜՉ
Ǵ҅ӛϷॄӛޑቹៜࣣჹৎྣ៝ޣکྣ៝ޣౢғόӕޑቹៜǶࡺҁࣴ
زޑҞޑགྷ٬ҔВ໔ྣ୍៝ܺኳԄϷྷඵϕշৎ୍ܺόӕኳԄΠǴѨඵੱ
ৎྣ៝ޣޑӭϡຑቹៜࢂցόӕǶ
ҁࣴزҞԖаΠΟᗺǺ
1. ٬ҔВ໔ྣ៝ᆶྷඵϕշৎᆶྣ៝ޣӭϡຑޑᜢ߯Ƕ
2. ྣ៝ޣϷྣ៝ޣόӕޑΓαᏢ܄ᆶ٬ҔόӕҔ୍ܺኳԄޑᜢ߯Ƕ 3. ྣ៝ޣϷྣ៝ޣόӕޑΓαᏢ܄ᆶྣ៝ޣӭϡຑޑᜢ߯Ƕ
ಃ
ಃΒക! Ўӣ៝
ҁകϩࣁѤঁλǴಃѨඵੱǹಃΒѨඵੱྣ៝ޣӭϡຑᆶቹៜǹ
ಃΟѠѨඵੱྣ୍៝ܺǹಃѤຑπڀӣ៝Ƕ
ಃ! Ѩඵੱ
Ѩඵੱࢂߚ҅தԴϯϐຝǴѨඵੱޣԖᇡޕфૈޑምᛖǴᝄख़ำ ࡋቹៜډВதғࢲϷᙍϐфૈǶ҅தԴϯຝٰᇥԴԃΓޑᏫΚ
КԃᇸΓৡǴՠЬाৡ౦ࢂࡰȨᏫೲࡋȩϷȨᏫໆȩǶᖐٯٰᇥǴ҅தԴ ϯޣёૈँฅבԾρ҅ाѐࢌ٤٣Ǵՠࢂϐࡕགྷଆখωाޑ٣
ǹԶѨඵੱޣόבԾρाޑ٣ǴЪֹӄགྷόଆٰǶаΠଞჹѨඵ
ੱޑۓကᆶੱރբϟಏǺ
ǵѨඵੱۓက
ਥᏵШࣚፁғಔᙃۓကѨඵੱࢂᅿတੱংဂǴჹޣޑᏫǵࡘԵǵ БӛགǵှΚǵीᆉǵᏢಞૈΚǵᇟقکղᘐΚԋቹៜǶཀόڙډቹៜǶ ՠࢂᇡޕфૈምᛖ೯தՔᒿᆣڋǵޗՉࣁϷᐒޑൾϯǴԶԖਔং߾ว ғᇡޕфૈምᛖޑׯᡂǶ
ΒǵѨඵੱᅿᜪ
Ѩඵੱޑᅿᜪ٩ྣੰӢёϩࣁѤεᜪǴϩձࢂଏϯ܄Ѩඵੱ(Degenerative Dementia)ǵՈᆅ܄Ѩඵੱ(Vascular Dementia)ǵషӝࠠѨඵੱ(Mixed Dementia)Ϸ ځ д Ӣ ન ܌ Ꮴ ठ ޑ Ѩ ඵ ੱ Ƕ ଏ ϯ ܄ Ѩ ඵ ੱ Ь ा த ـ ޑ ᜪ ࠠ Ԗ ߓ ੇ ᓨ ੱ (Alzheimer`s Disease)ǵᚐ㙠ယࠠѨඵੱ(Frontotemporal lobe degeneration)Ϸၡܰ
МᡏѨඵੱ(Dementia with Lewy Bodies)ᜪࠠǴځύаߓੇᓨੱനࣁதـ
(American Psychiatric Association, 2013; ߋሎക & ෯ҏ, 2006; ఉৎݒ, ำ
, & ഋΓᇬ, 2014)ǶӚᜪѨඵੱඔॊӵΠǶ
ଏϯ܄ѨඵੱதـޑᜪࠠԖߓੇᓨੱ(Alzheimer’s Disease)ǵၡܰМᡏѨඵ
ੱ (Dementia with Lewy Bodies) Ϸ ᚐ 㙠 ယ ࠠ Ѩ ඵ ੱ (Frontotemporal lobe degeneration)(National Institutes of Health, 2013a, 2013b, 2014)ǴаΠϩձϟಏ೭Ο ᅿଏϯ܄ѨඵੱǶځǴߓੇᓨੱЬाౢғᏫΚϷᏢಞΚᅌ૰ଏǴЪӧ Γނǵਔ໔ǵӦᗺޑᒣᇡр֚ᜤǶӧတޑੰቻЬाࣁߟҍੇଭǴаϷတ
ܴᡉޑᕭǴੰᡂϯ߾хࡴ౦தԴԃඬ(amy loidplaques)Ϸઓᠼᆢޟ
่(neurofibrillary tangles)ޑǶځΒǴၡܰМᡏѨඵੱԐයޣёૈౢғي ᡏሼฯǵЋםکຳॹޑǶՔᒿౢғᇡޕфૈምᛖ(ٯӵǴᇟقǵຎޜ໔ղᘐ
)ǴதวғӰགྷޑǴΨܴᡉޑЄຝวғ(ٯӵǴౢғຎЄ܈᠋Є)Ƕ ၡܰМᡏѨඵੱࣁಃΒதـޑଏϯ܄ѨඵੱǶޣတಒझ֖Ԗα-Synucleinೈқ ޑᆫǴԶԋȨၡܰМᡏȩǴԶޣԝࡕޑတှওΨวઓݹඬǴՠࢂ
ੰᡂϯޑϩǴวғઓᠼᆢޟ่ޑ߾ၨϿǶځΟǴᚐ㙠ယࠠѨඵੱޣ
ౢғΓᡂϯǴՉࣁᖐЗΨวғׯᡂ(ٯӵǴᅃǵքᅉǵڰ܈ՉࣁѨѐ
ڋૈΚ)ǴᇟقૈΚҭౢғምᛖ(ٯӵǴނࠔӜᆀคݤᇥрǵפӷ֚ᜤ܈คݤ
ှӷက)ǶတޑੰቻԖֽޑҜ፦ᕭǴЬाаߟҍϩᚐယϷ㙠ယ
БࣁЬǴԖ٤Ԗtauೈқޟ่ޑݩǴ࣬ၨॊٿᅿᜪࠠޑѨඵੱǴတલཞ٠ ߚӢࣁځдઓسރݩ܌ౢғǶ
Ոᆅ܄ѨඵੱࢂԋѨඵੱޑಃΒεচӢǴऊ՞ԴΓѨඵੱޣޑ15%Կ 20%(Duthie Jr & Glatt, 1988)Ǵӧύ୯ϷߚࢪӦ߾ଯၲ30%Ϸ26%(George-Carey et al., 2012; Zhang et al., 2012)ǶՈᆅ܄ѨඵੱࡰޑࢂӢՈᆅ੯ੰ(х֖Ǵӭख़܄တ ύ॥ǵӭว܄တఒ༞)܌ԋޑѨඵੱǶတύ॥ԋတՈనൻᕉόؼǴᏤठတ ಒझԝΫԋඵΚ෧ଏǴԐයதрբᄌǵϸᔈᒨǵᄊምᛖᆶᆒઓੱރǴ ԶՈᆅ܄ѨඵੱޑޣǴ೯தᆶတύ॥ޑวғԖᜢǶՈᆅ܄ѨඵੱЬाԖٿᜪϩ
ձ ࣁ ύ ॥ ࡕ Ո ᆅ ܄ Ѩ ඵ ੱ (post-stroke vascular dementia) Ϸ λ Ո ᆅ ܄ Ѩ ඵ ੱ (dementia with small vessel diseases)ǶதـޑቻރౢғᆣᡂϯǵኁᢠǵֿѨǵ ຳॹǵտᚮ֚ᜤݩǶ
షӝࠠѨඵੱࣁଏϯ܄ѨඵੱϷՈᆅ܄ѨඵੱޑషӝᜪࠠǶόឦܭаΟε ᜪੰӢޑѨඵੱᜪࠠޣǴஒځϩᜪࣁځдӢન܌ᏤठޑѨඵੱǴёૈӢགࢉǵ ੯ੰǵѦӢનٰᏤठѨඵੱǴٯӵǺ(1)Ѧ܄တǹ(2)ނ፦܈ᙴᛰޑ٬Ҕ(ٯ ӵǴଚᆒǵᙼۓᏊ)ǹ(3)ΓᜪխࣝલЮੰࢥགࢉ(HIV Infection)ǹ(4)දճܳੰ(Prion Disease)ǹ(5)ЃߎහМੱ(Parkinson’s Disease)ǹ(6)ՎႥੰ(Huntington’s Disease)ǹ (7)ځдيᡏੰݩ(ٯӵǴӭว܄ฯϯੱ)ǹ(8)ߚۓੰӢ(ٯӵǴޗҬǵᙍ܈ځд ख़ाሦୱфૈ෧ཞ)Ƕ
ΟǵѨඵੱੰำϷᖏੱރ
όӕᜪࠠѨඵੱບᘐྗࢂਥᏵᇡޕጄᛑ(Cognitive Domains)ٰۓကǴᇡޕ ጄᛑх֖Ϥ ঁϩǴࣁፄᚇݙཀΚ(Complex attention)ǵՉфૈ(Executive function)ǵ Ꮲ ಞ ک Ꮻ (Learning and memory) ǵ ᇟ ق (Language) ǵ ޕ բ (Perceptual-motor)Ϸޗᇡޕ(Social cognition)(ѠᆒઓᙴᏢ, 2014)Ƕ
ፄᚇݙཀΚх֖ុ܄ݙཀΚ(Sustained attention)ǵᚈӛݙཀΚ(Divided attention)ǵᒧ܄ݙཀΚ(Selective attention)Ϸೀೲࡋ(Processing speed)Ǵޣ ӧӭख़ڈᐟޑᕉნύ(ٯӵǴႝຎǵፋ၉)ݙࡋफ़եǴЪܰӢᕉნύځд٣ނ ቹៜǶុݙཀΚࣁߏਔ໔ޑᆢݙཀΚǶᚈӛݙཀΚࣁӕਔݙٿ٣ނǶᒧ
܄ݙཀΚࣁόڙډځдѦٰڈᐟ܈ࢂ٬ϩЈޑ٣ނቹៜޑݙཀΚǶೀೲࡋࣁ ஒՉ٣ނ܌ޑਔ໔ໆϯǶ
Չфૈх֖ीฝ(Planning)ǵ،(Decision making)ǵπբᏫ(Working memory)ǵӣ㎸/ᒱᇤঅ҅(Responding to feedback/Error correction)ǵঐᎯܭಞᄍ/
ڋ(Overriding habits/inhibition)ϷЈቸ܄(Mental flexibility)ǴޣคݤയҺፄᚇ ޑीჄǴԛѝૈݙܭҹ٣ނǶीฝࡰޑࢂှញೱᕉკฝ܈ࢂނᡏ௨ӈޑ
ૈΚǴٯӵวрαޑૈΚǶ،ࡰޑࢂჹܭᝡݾᒧޑ،ۓၸำǴٯӵኳ ᔕ።റǶπբᏫࡰޑࢂอኩޑߥӸૻ৲Ъڋૻ৲ޑૈΚǴٯӵॹ௶ॊࢤ ኧӷǶӣ㎸/ᒱᇤঅ҅ࡰޑࢂёаவᒱᇤύᏢಞ܈ࢂவӣ㎸ύᕇǴፕ рှ،ୢᚒޑૈΚǶঐᎯܭಞᄍ/ڋࡰޑࢂ׳ፄᚇϷ׳ࠂޑᒧ҅ዴเਢޑ
ૈΚǴٯӵᇥрӷޑᚑՅԶߚӷޑཀࡘǶЈቸ܄ࡰޑࢂӧٿᅿཷۺǵπբ܈ࢂ
ϸᔈೕ߾ϐ໔ᙯඤޑૈΚǴٯӵኧӷޑуᕴډኧӷޑ௨ׇǶ
ᏢಞکᏫх֖ҥջᏫ(Immediate memory)ǵ߈යᏫ(Recent memory)ǵ ߏΦᏫ(Long term memory)Ǵޣதӧӕࢤჹ၉ύǴख़ፄޑ߄ၲӕҹ٣Ƕ ҥջᏫࡰӆԛਟᇝࢤЎӷ܈ኧӷޑૈΚǶ߈යᏫࡰჹܭཥޑၗૻጓዸޑૈ
ΚǴຑޑБԄх֖ԾҗӣᏫ(Free recall)ǵԖጕӣᏫ(Cued recall)ϷᒤᇡᏫ (Recognition memory)ǶߏΦᏫࡰߏਔ໔ޑᏫǴຑБԄԖᇟཀᏫ(Semantic)ǵ ԾԄᏫ(Autobiographic)ϷϣᗦᏢಞ(Implicit memory)Ƕ
ᇟقх֖߄ၲ܄ᇟقϷௗڙ܄ᇟق(Receptive language)Ǵޣคݤӧ߄ၲ܄
ᇟقϷௗڙ܄ᇟق҅ዴ߄ၲǶ߄ၲ܄ᇟقх֖ڮӜ(Confrontational naming)ǵפӷ
ૈΚ(Word finding)ǵࢬᄣࡋ(Fluency)ǵЎݤϷᇟݤ(Grammer and Syntax)Ƕௗڙ܄
ᇟقࢂෳᡍޣޑှૈΚǶ
ޕբх֖ຎޕ(Visual perception)ǵຎࡌᄬ(Visuocon-struction)ǵޕ
բ(Perceptual-motor)ǵ٬Ҕ(Praxis)Ϸᒣ(Gnosis)ǴޣჹӃዕޑ٣ނ(ٯ ӵ໒ً)ՉԖ֚ᜤǴ܈ჹܭӀጕޑׯᡂቹៜޕགڙǶຎޕཀࡰό֖
բޑޕ(ٯӵᖍޑᒣ)ǶຎࡌᄬཀࡰЋڐፓٰࡌᄬ٣ނǴٯӵฝკǵಔး
ᑈЕǶޕբཀࡰӝޕϷҞޑ܄ޑբǴߚ٬ҔຎղᘐጕǴٯӵஒ ଝηזೲܫΕԖϾޑЕ݈ϐύǶ٬ҔཀࡰஒᏢಞٰޑբ߄рٰǴٯӵኳү
բǵ༈ޑૈΚǶᒣཀࡰӆᒣᇡ܈ჸޑޕӝૈΚǴٯӵᒣрΓᖍ܈ᚑ ՅǶ
ޗᇡޕх֖ᆣᒣᇡ(Recognition of emotion)ϷЈඵፕ(Theory of mind)Ǵ
ޣޑՉࣁܴᡉၴङޗૈௗڙޑጄൎǴჹܭӝޑऀ܈ፋ၉ϣಥᚆޗ
ྗǶᆣᒣᇡࡰҗᖍ߄ٰᒣ܌߄ၲᆣǴ఼ᇂӭኬ܄ޑ҅य़Ϸॄय़
ᆣǶЈඵፕࡰࢂցૈԵቾдΓޑЈඵރᄊ(ٯӵǴࡘԵǵኅఈǵཀკ)Ƕ
ѨඵੱନΑჹޣԋᇡޕфૈޑཞ্ǴΨՔᒿୢᚒՉࣁϷᆒઓੱ
ރޑౢғǴԶѨඵੱޣதـޑՉࣁϷᆒઓੱރ(Behavioral and Psychological Symptoms of Dementia, BPSD)Ԗኁᢠ(depression)ǵขቾ(anxiety)ǵӰགྷ(delusions)ǵ Є(hallucinations)ǵᅃ(apathy)ϷՉࣁምᛖǶځύǴӰགྷΞёϩࣁୂӰགྷǵ
্ӰགྷϷג֪ӰགྷǹՉࣁምᛖх֖װᔐՉࣁǵᅵምᛖǵၡǵख़ፄຝǵᅐ ၯǵ१ׯᡂǵੰᄊԏϷܶੱংဂ(Aalten et al., 2007; ҅ѳ, 2006)ǶԶѠ
ѨඵੱޣதـޑՉࣁϷᆒઓੱރԖኁᢠǵขቾǵӰགྷǵЄǵᅵምᛖǵߟ
ౣՉࣁǵចǵᅃ(J. Fuh, 2006)Ƕ
ѨඵੱำࡋёаϩࣁΟᜪǴࣁᇸǵύǵख़ࡋǴаΠϩձඔॊόӕයำѨඵੱ
ำࡋ܌ౢғޑՉࣁϷੱރ(National Institutes of Health, 2013a; ߋሎക & ෯ҏ, 2006; ఉৎݒ et al., 2014)Ƕ
() ᇸࡋѨඵੱ
ੱރ೯தόܴᡉǴܰ౧۹Զۯᇤ൩ᙴǶޣჹܭϐԖᑫ፪ޑ٣ނǴᡂ ளόགᑫ፪ǴܰבܿՋܫޑӦБǵᆶдΓޑऊ܈ᇥၸޑ٣Ƕрߐډа
όதѐޑӦБਔǴܰၡǴ٬ளᅌᅌ໒ۈό഻ѦрǶԶ߈යวғޑ٣
ܰבǴᏢಞཥ٣ނౢғ֚ᜤ(National Institutes of Health, 2013a; ߋሎക & ෯
ҏ, 2006; ఉৎݒ et al., 2014) Ƕ
(Β) ύࡋѨඵੱ
ᏫΚଏϯຫٰຫܴᡉǴԾρрߐᖼނ܈མ४Ҭ೯πڀౢғ֚ᜤǴӧዕ
ޑӦБوѨǶӧৎѝૈՉᙁൂޑৎ٣ǴӭਔংሡाдΓޑᅱ࿎ǶᆣଆҷεǴ
ܰғǵวǴ໒ۈрЄǶӧᇟقૈΚϷ᎙᠐ૈΚΨᅌᅌрୢᚒǴ ᇥ၉ӷѡ෧ϿǴፋ၉ϣόೱೣǴલЮᡄᒠ(National Institutes of Health, 2013a; ߋ ሎക & ෯ҏ, 2006; ఉৎݒ et al., 2014) Ƕ
(Ο) ख़ࡋѨඵੱ
ᏫΚᝄख़ଏϯǴѨѐғࢲԾૈΚǴคݤᐱΚֹԋৎ٣܈ှ،ୢᚒǴيᡏ фૈΠफ़ǴֹӄคݤԾՉрߐǶਔதวғόޑՉࣁǴႽࢂעܿՋܫӧόჹ ޑӦБ(ٯӵǴᇿᏔܫӧӇጃ္)ǴჹܭελߡคݤڋǴᏤठѨวғǶЪᅌ ᅌԖտᚮӢᜤǴᝄख़ਔѝૈ٩ᒘሷगᆅ(National Institutes of Health, 2013a; ߋ ሎക & ෯ҏ, 2006; ఉৎݒ et al., 2014)ǶѨඵੱคݤ౫ᘰǴᗨฅёаၸܺ
Ҕᛰނ෧ѨඵੱޑੰำϷफ़եӢ੯ੰ܌ౢғޑੱރǴՠࢂჹܭတޑཞ্ࢂค ݤݯᘰǶѨඵੱޣੰำऊࣁ8Կ10ԃǶΓখ໒ۈрᇡޕфૈԖୢ
ᚒਔǴ೯தࡐᜤวǴதᇤаࣁѝࢂ҅தԴϯޑຝǴԶۯᇤݯᕍޑਔᐒǴऍ ୯Ѩඵੱڐ(Alzheimer's Association)ჹѨඵੱ߃ය๏ϒΑΜεૻ(߄2-1-1)Ǵ යఈѨඵੱૈԐයวԐයݯᕍǴωૈۯѨඵੱޑำǶ
߄ 2-1-1! ѨඵੱΜεૻ
1. ᏫΚ૰ଏǴԶቹៜډВதғࢲǶ 2. ഼Ѩीฝ܈ှ،ୢᚒޑૈΚǶ
3. চҁዕޑ٣ނคݤയҺǶ 4. ഼Ѩਔ໔ᆶӦᗺޑཷۺǶ
5. ຎϷޜ໔ᜢ߯ղᘐр֚ᜤǶ 6. قᇟ߄ၲр֚ᜤǶ
7. ނࠔᘍܫᒱǶ
8. લЮղᘐૈΚ܈܄फ़եǶ 9. ঁ܄ׯᡂǶ
10. ᆣᆶՉࣁׯᡂǶ
ၗٰྍǺAlzheimer's Association, 2009
ѤǵѨඵੱᆶѨඵੱՉࣁϷᆒઓੱރϐՉ
ӄౚԴԃΓαቚуǴѨඵੱΓαΨᒿϐቚуǴѨඵੱޑวғᒿԃសޑቚ уԶቚу(C.-s. Lee, Chang, Su, Chen, & Chen, 1997)Ƕ65ྃԴԃΓαǴቚу5ྃǴ ᑡѨඵੱޑ॥ᓀ൩ቚуǶ٩ᖄӝ୯ШࣚፁғಔᙃۓကǴ65ྃаΓα՞ᕴΓ α7%Ǵᆀࣁଯសϯޗ(Aging society)Ǵၲډ14%ࣁଯសޗ(Aged society)Ǵၲډ 20%аࣁຬଯសޗ(Hyper-aged society)ǴѠӧ1993ԃԴԃΓαКςၲ7%Ǵ
ΕଯសϯޗǶਥᏵ୯ৎวہȨύ҇୯Γαी(2014ԃԿ2061ԃ)ȩ ൔࡰрǴך୯2014ԃ6ДԴԃΓαςၲډ11.57ǴѠԴԃΓαஒӧ2018ԃ
ၲډ14%ǴΕଯសޗǴӧ2025ԃၲډ20%ǴΕຬଯសޗǶ2014ԃԿ2061 ԃԴԃΓαэᕴΓαКǴஒҗ12%ቚуԿ41%ǶԶ2014ԃԿ2061ԃ80ྃаΓ αэԴԃΓαϐКǴஒҗ25.1%ϲԿ43.2%(୯ৎวہ, 2014)Ƕ
ਥᏵШࣚፁғಔᙃ2012ԃޑȨѨඵੱǺϦӅፁғᓬӃᚒȩൔύǴࡰрܿ
٥Ӧ60ྃаԴԃΓαѨඵੱՉࣁ4.98%(World Health Organization &
Alzheimer’s Disease International, 2012)ǶќѦǴԖࣴزࡰр2010ԃǴӄౚѨඵੱ
ΓαՉࣁ4.7%ǴځύаऍࢪѨඵੱՉനଯࣁ6.5%ǴՠࢂѨඵੱԴԃΓα ኧ߾ࢂ٥ࢪۚ߷ǶԶ٥ࢪΞаܿ٥Ϸࠄ٥ޑѨඵੱՉനଯ(Prince et al., 2013)Ƕ
ѠԴԃΓαԃᚹϲǴѨඵੱΓαΨஒᒿϐቚуǴѨඵੱՉΨஒၟ
ᚹϲǶ2014ԃፁғᅽճہૼѠѨඵੱڐჹѠΓα܌ޑѨඵੱፓύǴ 2014ԃ65ྃаԴԃΓѨඵੱΓαኧऊࣁ22ΓǴޗ65ྃаѨඵ՞ӄ୯ᕴΓ αКࣁ1.02%ǶѠѨඵੱڐаࡌ2014ԃԿ2061ԃѠΓαीኧൔϐ եीǴ2061ԃ65ྃаѨඵ՞ӄ୯ᕴΓαКஒၲ5.60%ǴԶ65ྃаѨඵ Γኧஒၲ92Γ(߄2-1-2)Ƕ
߄ 2-1-2! ѠѨඵੱՉ(2014 ԃԿ 2061 ԃ)
ԃ 2014 2016 2026 2036 2046 2056 2061 ӄ୯ᕴΓα
ኧ 23,433 23,478 23,313 22,269 20,376 17,939 16,628 65ྃаѨ
ඵΓኧ 227.13 251.09 376.17 563.93 785.05 896.53 924.99 65ྃаѨ
ඵ՞ӄ୯ᕴ ΓαК
1.02% 1.12% 1.67% 2.58% 3.90% 5.04% 5.60%
(ൂՏǺщΓ)
ၗٰྍǺѠѨඵੱڐ(ᘏڗВයǺ2015ԃ11Д) ѨඵੱޣନΑᇡޕጄᛑ(Cognitive Domains)ڙډቹៜаѦǴ۳۳р
ୢᚒՉࣁϷᆒઓੱރޑׯᡂǶόӕᜪࠠޑѨඵੱǴрޑୢᚒՉࣁϷᆒઓੱރ ΨԖ܌όӕǶFuh(2006)ӣ៝Ѡ1990ԃԿ2005ԃЎ(߄2-1-3)Ǵวߓੇᓨ
ੱޣౢғኁᢠੱރऊ՞22%Կ55%ǹԖขቾऊ՞35%Կ76%ǹԖӰགྷ
ऊ՞30%Կ63%ǹԖЄੱރऊ՞21%Կ26%ǹԖᅵምᛖऊ՞Ԗ26%Կ61%ǹԖ ߟౣՉࣁ/ᐟޣऊ՞10%Կ57%ǹԖᅃޣऊ՞39%Կ47%(J. Fuh, 2006)Ƕ
ϖǵλ่
ШࣚӚ୯ᒿԴԃΓαޑቚуǴѨඵੱΓαΨᒿϐቚߏǶѨඵੱޣᇡޕ фૈຫٰຫଏϯਔǴԶቹៜډޣޑВதғࢲǴаϷ൩ౢғምᛖǶѨඵੱ
ޣӧঁੰำය໔ǴౢғӭୢᚒՉࣁϷᆒઓੱރǴԶόӕѨඵੱΨౢғ όӕޑੱރǴᒿ੯ੰੰำޑวǴஒ़ғࡐӭྣ៝ޑୢᚒǶ
߄ 2-1-3! ѠߓੇᓨੱޣੱރᆶՉࣁϐՉ
ੱރ բޣ ԃҽ ঁਢኧ(Γ) ٬Ҕπڀ Չ(%)
ኁᢠ Liu et al. 1999 141 SCID ख़ᢠੱ5%ǹᇸᢠੱ
8%ǹځд҂ຏܴϐ ኁᢠ੯4%
ቅຽ ᆶ ቅذ݄ 1999 103 BEHAVE-AD 22%
J.-L. Fuh, Liu, Wang, Wang, & Liu
1999 76 RMBPC 50%
J.-L. Fuh, Liu, Mega, Wang, & Cummings
2001 95 NPI 38%
Chow et al. 2002 230 NPI 49%(ѠчӦ) 44%(ଯӦ) JL Fuh, Wang, &
Cummings
2005 320 NPI 47%
ขቾ ቅຽ ᆶ ቅذ݄ 1999 103 BEHAVE-AD 35%
J.-L. Fuh et al. 1999 76 RMBPC 76%
J.-L. Fuh et al. 2001 95 NPI 54%
Chow et al. 2002 230 NPI 39%(ѠчӦ) 38%(ଯӦ) JL Fuh et al. 2005 320 NPI 37%
Ӱགྷ J.-P. Hwang, Yang, Tsai, & Liu
1996 54 BEHAVE-AD 63%
ቅຽ ᆶ ቅذ݄ 1999 103 BEHAVE-AD 30%
J.-L. Fuh et al. 2001 95 NPI 47%
Chow et al. 2002 230 NPI 31%(ѠчӦ) 40%(ଯӦ) JL Fuh et al. 2005 320 NPI 31%
Є J.-P. Hwang et al. 1996 54 BEHAVE-AD 26%
ቅຽ ᆶ ቅذ݄ 1999 103 BEHAVE-AD 26%
J.-L. Fuh et al. 2001 95 NPI 21%
Chow et al. 2002 230 NPI 25%(ѠчӦ) 19%(ଯӦ) JL Fuh et al. 2005 320 NPI 24%
(ុΠ।)
ᅵምᛖ J. P. Hwang, Yang, Tsai, & Liu
1997 75 BEHAVE-AD 61%
ቅຽ ᆶ ቅذ݄ 1999 103 BEHAVE-AD 26%
J.-L. Fuh et al. 2001 95 NPI 36%
Chow et al. 2002 230 NPI 36%(ѠчӦ) 35%(ଯӦ) JL Fuh et al. 2005 320 NPI 42%
ߟౣՉࣁ /ᐟ
Tsai, Hwang, Yang, &
Liu
1996 47 BEHAVE-AD 57%(يᡏ) J. P. Hwang et al. 1997 75 BEHAVE-AD 55%(يᡏ) ቅຽ ᆶ ቅذ݄ 1999 103 BEHAVE-AD 21%(قᇟ) 10%(يᡏ) J.-L. Fuh et al. 1999 76 RMBPC 35%(قᇟ) J.-L. Fuh et al. 2001 95 NPI 46%
Chow et al. 2002 230 NPI 46%(ѠчӦ) 40%(ଯӦ) JL Fuh et al. 2005 320 NPI 39%
ᅃ J.-L. Fuh et al. 2001 95 NPI 44%
Chow et al. 2002 230 NPI 47%(ѠчӦ) 39%(ଯӦ) JL Fuh et al. 2005 320 NPI 42%
SCID: structure clinical interview for DSM-IIIR; NOS: not otherwise specific; BEHAVE-AD:
Behavioral Pathology in Alzheimer’s Disease rating Scale; NPI: Neuropsychiatric Inventory; RMBPC:
Revised Memory and Behavior Problem Checklist
ၗٰྍǺFuh, 2006
ಃ
ಃΒ! Ѩඵੱৎྣ៝ޣӭϡຑᆶቹៜ
PearlinΓӧ1990ԃගрᓸΚၸำኳԄ(Stress Process Model)ჹܭߓੇᓨ Ѩඵੱྣ៝ޣޑᓸΚࡌᄬрঁᓸΚၸำᆛ๎(კ2-2-1)ǴౢғᓸΚޑၸำϩԋ6 εሦୱǺ(1)ྣ៝ޣޑङඳՅ(ٯӵǴޗݩǵྣ៝ޣ܄)ǹ(2)ᓸΚྍǴΞ ϩԋЬाᓸΚྍ(ٯӵǴᇡޕǵୢᚒՉࣁ)ǹ(3)ԛाᓸΚྍ(ٯӵǴৎፂँǵ πբᆶྣ៝ޑፂँ)ǹ(4)ᓸΚፓӛ(ٯӵǴޗЍ)ǹ(5)ЈϣᓸΚ (ٯӵǴԾ൧ǵفՅ߳ज़Ր)ǹ(6)่݀ᡂ(ٯӵǴኁᢠǵขቾǵܰࡗ)Ƕ
ԜϤεሦୱϐ໔܌ౢғޑᜢᖄ܄(Pearlin, Mullan, Semple, & Skaff, 1990)Ƕࡺ
ҁࣴزаᓸΚၸำኳԄ(Stress Process Model)ٰৎྣ៝ޣޑ҅ॄӛቹៜǶ
17
კ2-2-1!ߓੇᓨྣ៝ޣᓸΚኳԄ
่݀ 1.ኁᢠ 2.ขቾ 3.ܰࡗ 4.ᇡޕڙཞ 5.଼நيᡏ 6.فՅܺவ
ЈϣᓸΚ ᡏ 1.Ծ൧ 2.ᆒ೯ ნ 1.ԾךޑѨѐ 2.فՅڙज़ 3.ωૈ 4.ᕇள
ԛભᓸΚྍ 1.ৎፂँ 2.πբᆶྣ៝ πբፂँ 3.ᔮୢᚒ 4.ޗҬғࢲڙ ډᓸॐ
߃ભᓸΚྍ Ьᢀ 1.ᇡޕރᄊ 2.ୢᚒՉࣁ 3.Вதғ୯ф ૈϐ٩ᒘ ࠼ᢀ 1.ၸࡋॄ 2.࣬ᜢগღ
ङඳᆶნ 1.ޗӦՏ 2.ྣ៝ᐕў 3.ৎ܈ޗ ᆛ๎ޑಔԋ 4.ё٬Ҕޑी ฝ ፓ 1.ӢᔈኳԄ 2.ޗЍ
ၸѐЎӧଞჹྣ៝ޣຑǴஒځϩࣁྣ៝ޑ҅ӛቹៜຑϷॄӛቹៜຑ
ՉǶྣ៝ޑॄӛᡍӢનх֖ΑғǵЈǵޗҬϷ୍Ƕྣ៝ޑ҅ӛ
ᡍӢનх֖ഉՔǵዛᓰаϷܭௗڙྣៈπբ(Beinart et al., 2012)Ƕ҅ӛྣ៝
ᡍᆶॄӛྣ៝ᡍϕ࣬ቹៜǴྣ៝ޣԖၨଯޑ҅ӛྣ៝ᡍਔǴځғǵЈ
ॄၨե(Chiao, Wu, & Hsiao, 2015)Ƕ
ǵѨඵੱॄӛྣ៝ᡍޑቹៜ
ӧྣ៝ޣॄӛຑǴႽࢂғǵЈǵޗҬϷ୍Бय़ຫৡǴ߄ҢѨඵੱ
ྣ៝ޣޑғࢲࠔ፦ຫόӳ(Ankri, Andrieu, Beaufils, Grand, & Henrard, 2005; Mills et al., 2009; Mohamed et al., 2010; Vellone, Piras, Talucci, & Cohen, 2008)ǶЪѨඵ
ੱޣޑୢᚒՉࣁჹྣ៝ޣҁيԋғϷЈޑቹៜǴྣ៝ޣౢғྣ៝ॄ
ਔǴԶቹៜډྣ៝ޣғࢲࠔ፦(Fauth et al., 2006; Herrmann et al., 2006; K.
Eagar et al., 2006)Ƕॄӛྣ៝ᡍӧޗҬӢનБय़ёૈჹྣ៝ޣౢғېᐱགک
ჰགǵޗҬᐒᆶুࢲޑ෧Ͽǵ܈ࢂৎғࢲޑׯᡂǴӧЈӢનБय़ౢ
ғኁᢠǵขቾǵғǵϣސ܈คΚགǴӧғӢનౢғੲമǵੵภǵЈՈ ᆅ܈ཥഋжᖴ੯ੰǵᅵόىǴԶӧ୍ӢનБय़ԖѨǵౢғ࣬ᜢᇶ ڀԋҁǵ܈ځдᙴᕍճҔԋҁ(ٯӵǴՐଣҔǵ࣮ៈҔǵӼᎦҔ)(Donaldson, Tarrier, & Burns, 1997; Weiler, Chiriboga, & Black, 1994; Zarit et al., 1987)Ƕ
ྣ៝ޣӧޗҬϷЈౢғॄਔǴჹྣ៝ޣౢғኁᢠǵขቾϷېᐱགቹ ៜǴԶቹៜྣ៝ޣϷྣ៝ޣޑғࢲࠔ፦ǶႽࢂྣ៝ޣӢྣ៝πբޗҬࢲ෧ ϿǴ߾ԖၨଯޑېགϷኁᢠޑౢғǶ܈ࢂჹྣ៝ޣޑୢᚒՉࣁϷᆒઓ
ੱރೀૈΚၨեޣǴ߾ԖၨଯޑኁᢠϷขቾޑᆣౢғǶMohamed et al.(2010) аߐບੰΓࣁࣴزჹຝǴϩձჹྣ៝ޣϷྣ៝ޣՉୢڔຑǴӧྣ៝ޣޑ
ϩଞჹځྣ៝ॄᏼǵྣ៝ኁᢠำࡋکྣ៝धཱำࡋՉຑǴӧྣ៝ޣ߾ଞჹ ᇡޕфૈǵВதࢲૈΚ(ADCS-ADL)ǵғࢲࠔ፦کྣ៝ำࡋՉෳໆǴ่݀ว
ྣ៝ޣᆒઓރᄊᝄख़ำࡋǵՉࣁምᛖᝄख़ำࡋکྣ៝ޣޑғࢲࠔ፦Бय़Ǵ ᆶྣ៝ޣޕϷྣ៝ॄᏼԖࡐεޑᜢೱǴԶྣ៝ޣԖᝄख़ޑᆒઓ੯ੰǵՉࣁ
ୢᚒਔǴ܈ྣ៝ޣғࢲࠔ፦Πफ़ਔǴቚуྣ៝ޣޑॄϷኁᢠǶ
ྣ៝ޣऩࢂલЮྣ៝ޕǴჹܭྣ៝ޣ୷ܭৎޑၰቺೢҺǴӧόޕၰ܈
ࢂคݤ൨ڐΠǴԶவޑޗᕉნଏрٰྣ៝ྣ៝ޣǴ೭ቚуྣ៝ޣޑ ႖ᚆǵېᐱϷኁᢠޑᆣ(Beeson, Horton-Deutsch, Farran, & Neundorfer, 2000;
Mahoney, Tarlow, & Jones, 2003)ǶMahoney et al.(2003)ଞჹޗޑߓੇᓨࠠѨ ඵੱྣ៝ޣՉႝ၉ЍسՉ18ຼޑϟΕࣴزǴϩձӧ6ঁДǵ12ঁДϷ18
ঁਔǴՉྣ៝ޣޑ֚ᘋǵขቾϷኁᢠՉෳໆǴ่݀วྣ៝ޣऩࢂྣ៝
ޑඓૈΚၨեǴӧ֚ᘋǵขቾϷኁᢠޑౢғᡉޑቹៜǶၸѐྣ៝ࣴز εӭӧ٬Ҕ୍ܺࢤਔ໔ࡕՉຑǴ܌аҁࣴزޑ٬Ҕ୍ܺયΕచҹǴࣁ٬
Ҕ၀୍ܺၲΟঁДаǶBeeson et al.(2000)аऍ୯ύՋ܌ᙴᏢεᏢޑߓ
ੇᓨ੯ੰࣴزύЈ܌ԏޑԛભၗՉࣴزǴࣴزх֖242Տߓੇᓨੱޣ
܈ځдѨඵੱޣޑΡϻǵۀη܈ζٽϐৎྣ៝ޣǴ٬ҔCES-D(Radloff, 1977)Ǵ
Չྣ៝ၸำ܌ౢғޑېགᆶኁᢠϩǴࣴز่݀วߓੇᓨੱޑྣ
៝ޣऩԖᜢ߯গღ(ٯӵǴޗҬࢲ෧Ͽ)܈ࢂᆶྣ៝ޣ໔ޑᜢ߯όӳޑݩǴ Զྣ៝ޣౢғၨଯޑېགϷౢғޑኁᢠǶ
ྣ៝ޣӧғॄቹៜډځيᡏ଼நǵᅵࠔ፦ϷЈՈᆅ੯ੰޑቚуǶࣴ
زЎࡰрǴྣ៝ޣӧت܄ޑଛଽၨζ܄ଛଽǴӢޣޑѨඵੱำࡋԶ٬ᅵ
ࠔ፦Πफ़ǹӧྣ៝ޣ፦ǴऩࢂᅵόӳǵଯᏉՈૈΚǴቚуՈᆅ੯ੰϷ ځд੯ੰޑ॥ᓀ(Mills et al., 2009)ǶќѦǴԖࣴزࡰрζ܄ޑৎྣ៝ޣКت܄
ޑৎྣ៝ޣǴԖၨեޑيᡏ଼நރݩǹқᅿΓၨځдϿኧᅿޑৎྣ៝ޣǴ Ԗၨଯޑيᡏ଼நݩ(Martin Pinquart & Sörensen, 2005, 2006)ǶMartin Pinquart
ΓǴࣴزࡰрྣ៝ޣԃសၨଯǵեޗӦՏϷၨեޑߚ҅ԄЍǴྣ៝ޣԖ يᡏ଼நၨৡǶ(Martin Pinquart & Sörensen, 2007)
ΒǵѨඵੱ҅ӛྣ៝ᡍቹៜ
҅ӛྣ่៝݀ёаϩࣁٿঁቫय़Ǵࣁྣ៝ቫय़(Caregiving aspect)Ϸᜢ߯ቫय़ (Relation aspect)ٰፕǴྣ៝ቫय़ࡰޑࢂྣ៝ޣӢࣁྣ៝πբӧЈᡫளډᅈى܈
҅ӛޑׯᡂǴٯӵȨྣ៝ᅈཀ(Caregiving satisfaction)ȩǵȨྣ៝ճ(Gain)ȩǵȨӣ ൔ(pay back)ȩǵȨྣ៝ཀကȩǹᜢ߯ቫय़߾ࢂࡰྣ៝ޣӢྣ៝ၸำύǴᆶྣ៝
ޣԖؼӳޑགҬࢬϷᜢ߯ϕǴٯӵȨᒃஏࡋ(Mutuality)ȩǵȨϕඁ(Reciprocity)ȩ
(Ֆᛏޱ, 2000)Ƕ
ྣ៝ޣޑ҅ӛᡍၨӳޣǴྣ៝ޑᅈཀࡋၨଯǶHarris(1998)аѨඵੱޣ ޑٽηࣁࣴزჹຝǴჹ30Տྣ៝ޣՉ፦܄ೖፋǴٰྣ៝ޣޑྣ៝ᐕำǴࣴ
ز่݀วԖ11Տޑྣ៝ޣගډྣ៝πբ܌ளډ҅ӛྣ่៝݀ǴԖȨԖᐒൔเ Р҆ȩǵȨԖҞགϷঁΓԋߏȩаϷȨࢂηζᅿाޑفՅڂጄȩ(Harris, 1998)Ƕ Kramer(1993)ଞჹ72ՏѨඵੱޣޑζ܄ଛଽՉୢڔፓǴࣴزόӕӢᔈౣ
ᆶ ҅ ॄ ӛ ྣ ៝ ่ ݀ ޑ ᜢ ߯ Ǵ ӧ ҅ ӛ ྣ ៝ ่ ݀ Б य़ ٬ Ҕ Ȩ ྣ ៝ ᅈ ཀ ࡋ ໆ ߄ (Caregiving satisfaction scale, CCS)ȩՉຑǴॄӛྣ่៝݀߾ෳໆኁᢠำࡋǴ
٬ҔCES-D(The center for epidemiologic studies depression scale)ՉຑǴࣴز่
݀วȨаୢᚒࣁᏤӛȩǵȨ҅ӛᜢ߯ȩࣁӢᔈБԄޑྣ៝ޣǴځྣ៝ޑᅈཀࡋၨ
ଯǴՠኁᢠำࡋคᡉ࣬ᜢǴ߄Ң҅ӛྣ៝ᡍቹៜډྣ៝ޑᅈཀࡋ(Kramer, 1993)ǶLópez et al(2005)ྣ៝ޣޑྣ៝ቹៜӢηǴǴჹྣ៝ޣޑॄӛϷ҅ӛ ቹៜϩձ٬Ҕόӕޑໆ߄ՉຑǴϩձࣁᓸΚྍ(ٯӵǴྣ៝ය໔ǵԖӭϿྣ៝
ޣΓኧ)ǵྣ៝ॄᏼຑǵྣ៝ޣၗྍ(ٯӵǴԾ൧ǵޗЍϷᔈჹౣ)ǵྣ
៝ޣୢᚒ(ٯӵǴኁᢠǵขቾϷ଼நׯᡂ)Ǵӧྣ៝ॄᏼຑ٬Ҕྣ៝ॄᏼ ໆ߄(caregiver burden interview, CBI)(Zarit, Reever, & Bach-Peterson, 1980)Ǵྣ៝
ၗྍޑԾ൧ϩаԾ൧ໆ߄(Rosenberg, 1965)ෳໆǵޗЍаᙁอޗЍໆ ߄(social support questionnaire short form-revised, SSQSR)(Sarason, Sarason, Shearin,
& Pierce, 1987)ෳໆǵᔈჹౣаᙁอᔈჹໆ߄(brief COPE)(Carver, 1997)ෳໆǴ
่݀аྣ៝ޣᅈཀࡋໆ߄(Caregiving Satisfaction Scale, CSS)(Lawton, Kleban, Moss, Rovine, & Glicksman, 1989)ՉຑǴനࡕวྣ៝ޣᆶྣޣӃԖؼ ӳޑᜢ߯ޣǴྣ៝ޑᅈىགၨଯǴ҅ӛᆣନΑڙډྣ៝ޣᆶྣ៝ޣӃᜢ߯
ޑቹៜѦǴԖӳޑ࠹ࢻᆅၰǵӕྣ៝ޣǵߥԖؼӳޑҶ໕ਔ໔ǴаϷόሡѦр ӅբǴࣣቹៜྣ៝ޣޑ҅ӛྣ៝ᡍǶόၸࣴزΨќѦวྣ៝ޣޑᅈཀࡋᆶ ᓸΚྍคᜢǴջԖၨଯ࠼ᢀޑॄᏼޣǴᆶځྣ៝ޑᅈཀࡋคᜢǶ
ྣ៝ޣ҅ӛᡍၨӳޣǴځྣ៝ޣᆶྣ៝໔ޑᜢ߯ၨᆙஏǴЪৎឦ໔ޑᜢ
߯Ψၨᒃ߈ǶFarran et al(1991)а94ՏѨඵੱྣ៝ޣࣁࣴزჹຝǴՉъ่ᄬБ ԄՉࣴزǴԖ90%ޑྣ៝ޣख़ຎྣ៝ޑ҅ӛᡍǴႽࢂӧྣ៝ቫय़х֖ྣ៝ޣ ߞЈޑගϲǵჹྣ៝ޣԖӳޑϸᔈǴӧᜢ߯ቫय़х֖ྣ៝ޣᆶྣ៝໔҅ӛ ᜢ߯ගϲǵࣔெৎΓᜢ߯ǹԶྣ៝ޣᜢ߯ࣁଛଽ࣬ၨܭߚଛଽޣၨଯޑ҅ӛ ᄊࡋ(Farran, Keane-Hagerty, Salloway, Kupferer, & Wilken, 1991)ǶNeufeld et al(1998) ଞჹ22Տت܄ྣ៝ޣՉ፦܄ࣴزǴྣ៝ޣϷᇡޕфૈምᛖԴΓϷдΓ໔ޑ ϕඁᜢ߯Ǵϕඁᜢ߯ࡰޑࢂྣ៝ޣख़ຎྣ៝ޑفՅǵྣ៝πբёբࣁηζޑڂጄ
Ǵࣴزวྣ៝ޣᆶྣ៝ޣ໔Ԗϕඁᜢ߯Ǵ߾҅ӛྣ៝ᡍၨӳ(Neufeld &
Harrison, 1998)ǶBeach(1997)ჹ20Տ14Կ18ྃޑѨඵੱԃᇸྣ៝ޣՉъ่ᄬࣴ
زǴྣ៝ᅈཀࡋᆶྣ៝ය໔ޑ҅ӛྣ៝ቹៜǴࣴز่݀ว73%ޑྣ៝ޣǴ ځྣ៝πբჹৎ໔ϕᜢ߯Ԗ҅ӛቹៜǴٯӵᆶৎΓ໔ᜢ߯ᡂᒃ߈ǴΨቚуځ ӕЈǴ߄ҢԖၨӳޑ҅ӛᡍǴځྣ៝ޣϷྣ៝ޣޑᜢ߯ၨᆙஏǶ
ࣴزᡉҢԖၨଯޑ҅ӛྣ៝ϩኧޣǴྣ៝ޣޑኁᢠၨեǶRoff et al(2004) வऍ୯୯ৎፁғࣴزଣޑቚமߓੇᓨੱ଼நྣ៝ၗྍResources for Enhancing Alzheimer’s Care Health, REACH)ύՉࣴزǴКၨߚࢪဴϷқΓޑྣ៝ޣӧྣ
៝ޑ҅ӛϩ(positive aspects of caregiving, PAC)ৡ౦ǴϩձܜኬΑ275Տߚࢪဴ
ྣ៝ޣǴϷ343ՏޑқΓྣ៝ޣǴࣴز่݀วԖၨଯޑ҅ӛྣ៝ϩኧޣǴځኁ ᢠၨեǶFarran et al(1997)а215ՏѨඵੱޣޑଛଽྣ៝ޣࣁࣴزჹຝǴ
Չྣ៝ཀကჹྣ៝ኁᢠϷفՅᆙޑቹៜՉୢڔፓǴࣴزวϺྣ៝ࢲ
ჹྣ៝ޣཀကຫଯޣǴྣ៝ޑኁᢠำࡋϷفՅᆙำࡋ߾ຫե(Farran, 1997)Ƕྣ
៝ޣޑ҅ӛྣ៝ᡍၨӳǴᆶኁᢠϷᓸΚॄևॄ࣬ᜢǶ(Beach, Schulz, Yee, & Jackson, 2000; Cohen, Colantonio, & Vernich, 2002; López, López-Arrieta, &
Crespo, 2005; Roff et al., 2004)
ΟǵቹៜѨඵੱྣ៝ޣຑϐ࣬ᜢӢη
όॊޑӢનቹៜډྣ៝ޣޑ҅ॄӛྣ៝ᡍǴΨڙډྣ៝ޣϷ
ྣ៝ޣޑ୷ҁ፦ޑቹៜǴӧྣ៝ޣБय़ڙډԃសǵ܄ձǵྣ៝ਔ໔ޑߏ อǵπբॄǵ௲ػำࡋǵԏΕǵ൩ǵ଼நǵޗЍǵᆶྣ៝ޣ ᜢ߯Ӣનቹៜǹӧྣ៝ޣБय़ёૈڙډੰਔ໔ߏอǵ੯ੰᝄख़ำࡋǵ
ୢᚒՉࣁޑᝄख़ࡋǵيᡏфૈǵᇡޕڙཞǵғࢲࠔ፦ǵ௲ػำࡋӢࣁቹ ៜ(Beinart et al., 2012; Farran et al., 1991; Kramer, 1997; Riedel, Fredman, &
Langenberg, 1998)Ƕ
ቹៜ҅ӛྣ่៝݀ޑྣ៝ޣ፦ǴԖԃសǵ܄ձǵ௲ػำࡋǵ଼நݩǵޗ
ЍǵৎԏΕԖᜢ(Kramer, 1997; Riedel et al., 1998; ඁ࣓, ቅᒸᑻ, & ৪ ٥ྻ, 2006)Ƕྣ៝ޣόӕޑ፦ቹៜډ҅ӛྣ่៝݀ǴႽࢂྣ៝ޣԾךྣ
៝ޑૈΚǵᏫǵୢᚒՉࣁ੯ੰޑ܄Ԗᜢ(Farran et al., 1991; ቅഓে, 1992)Ƕቹ ៜྣ៝ޣ҅ӛྣ៝ᡍޑ҅࣬ᜢӢનԖྣ៝ޣᆶྣ៝ޣϐᜢ߯ޑᅈىགǵ
ྣ៝ޣᇡޕڙཞǵྣ៝ޣޗЍޑᅈىགǵྣ៝ޣيᡏ଼நำࡋၨӳϷୢ
ᚒှ،ౣޑ٬Ҕ(Tarlow et al., 2004)Ƕӧྣ៝ၸำύౢғޑ҅ӛྣ៝ᡍቹៜ ӢનǴӵྣ៝ޣԃសຫεǴ߾ྣ៝ޑ҅ӛᡍຫৡǹѨඵੱޣޑ੯ੰᝄख़ำࡋǴ ᝄख़ำࡋຫଯޣǴ҅ӛྣ៝ᡍຫեǹྣ៝҅ӛᡍΨڙډྣ៝ޣޑৎᔮ ԏΕϷғࢲރݩޑቹៜ(ᔎߎम & ঞذݯ, 2006)Ƕྣ៝ޣঁΓޑྣ៝፦ቹៜ ډ҅ӛޑྣ៝ᡍǴႽࢂԃសǵ଼நރݩǵࢂցԖҶ໕ਔ໔ǵᆶੰ໔ޑᜢ߯٬
ցؼӳϷၨϿޑᆣ࠹ࢻǴԶ೭٤ቹៜڗ،ܭྣ៝ޣঁΓჹܭޗЍޑᒧϷ ᅈཀำࡋǶྣ៝ޣޑ҅ӛྣ៝ᡍၨӳǴᆶኁᢠϷᓸΚॄևॄ࣬ᜢǴᆶ ғࢲࠔ፦ϷԾၨӳيᡏ଼நރݩԖ҅࣬ᜢ(Beach et al., 2000; Cohen et al., 2002;
López et al., 2005; Roff et al., 2004)Ƕ
ቹៜॄӛྣ៝ᡍޑྣ៝ޣ፦ǴԖԃសǵ܄ձǵ௲ػำࡋǵ଼நݩǵޗ
Ѝ(Martin Pinquart & Sörensen, 2007)Ƕቹៜॄӛྣ៝ᡍޑྣ៝ޣ፦Ǵ Ԗੰਔ໔ߏอǵ੯ੰᝄख़ำࡋǵୢᚒՉࣁޑᝄख़ࡋǵيᡏфૈǵ௲ػำࡋǵᇡ ޕфૈ(Germain et al., 2008; Mohamed et al., 2010; Martin Pinquart & Sörensen, 2007; Schölzel-Dorenbos, Draskovic, Vernooij-Dassen, & Rikkert, 2009)ǶPinquart
Γ(2007)ࣴزࡰрྣ៝ޣԃइၨεǵեޗӦՏǵόӳޑৎᜢ߯ǵեޗЍ
ޣǴԖၨଯޑྣ៝ॄǶԖࣴزࡰрǴζ܄ৎྣ៝ޣǴܰౢғЈॄǴ ԖၨଯޑېགϷኁᢠޑǹԶت܄ޑৎྣ៝ޣǴၨܰౢғғॄǴٯ ӵЈՈᆅ੯ੰޑౢғ(Beeson et al., 2000; M Pinquart & Sorensen, 2004; Schölzel- Dorenbos et al., 2009)ǶၸѐЎࡰрǴߓੇᓨࠠѨඵੱޣޑྣ៝ޣǴځྣ៝
ॄᆶྣ៝ޣਔ໔ߏอǵޣ௲ػำࡋϷޣޑኁᢠำࡋԖଯࡋ࣬ᜢ(García- Alberca, Lara, & Berthier, 2011; Mohamed et al., 2010; Martin Pinquart & Sörensen, 2007)ǶύࡋߓੇᓨࠠѨඵੱޣޑୢᚒՉࣁ(ٯӵǴၯوϷقᇟװᔐ)Ǵჹྣ
៝ޣౢғྣ៝ॄ(Gaugler et al., 2010; Gaugler et al., 2011; Mahoney et al., 2003)Ƕ
ಃ
ಃΟ! ѠѨඵੱྣ୍៝ܺ
ѠߏයྣៈၗྍᅿᜪᕷӭǴ٩୍ܺᜪࠠЬाϩࣁΟεᜪྣៈኳԄǴϩձࣁ
ۚৎԄྣៈǵޗԄྣៈϷᐒᄬԄྣៈǴۚৎԄྣៈх֖ۚৎ୍ܺ(ٯӵǴଌᓓǵ ᆙ࡚ڥћ୍ܺǵҬ೯ௗଌǵഉՔ୍ܺǵঁΓ୍ܺྣ៝ǵৎ٣୍ܺ)Ϸۚৎៈǹޗ
Ԅ୍ܺх֖ഹ৲୍ܺǵВ໔ྣ៝Ϸڹ໔Ԏ៝ǹԶᐒᄬԄ୍ܺ߾х֖Ꭶៈᐒᄬǵ ӼᎦᐒᄬǵៈϐৎ(Ξϩ܄ៈϐৎϷфૈ܄ៈϐৎ)Ϸᄪ҇ϐৎǶ
Ѡӧྣ៝Ѩඵੱޣᆶځৎྣ៝ޣي܌วрޑߏයྣៈ୍ܺ࣬
ӭϡǴ٩୍ܺᜪࠠϩࣁۚৎԄǵޗԄϷᐒᄬԄ୍ܺǶۚৎԄх֖ۚৎ୍ܺǵ
ۚৎៈǵۚৎൺ଼ϷۚৎᔼᎦ୍ܺǴۚৎ୍ܺࢂҗྣ୍៝ܺගٮৎ٣୍ܺǵ يᡏྣ៝ǵഉՔᆶڐշ൩ᙴǹۚৎៈ߾җៈΓډ۬ගٮޑៈ
πբ܈ᙴғ܌ࡰҢޑᙴᕍࡼǹۚৎൺ଼ϷۚৎᔼᎦ୍ܺ߾ࢂҗޑൺ଼ৣᆶ ᔼᎦৣගٮނݯᕍǵᙍૈݯᕍϷᔼᎦࡌǶ(Ϊᅋ, ֆలᛏ, & ླྀਦስ, 2003)
ޗԄх֖В໔ྣ៝ύЈϷྷඵᏢǴВ໔ྣ៝ύЈЬाගٮৎឦӧқϺଌ ߏ፸ډύЈԎ៝ǴύЈӼ௨ፐำϷҶ໕ࢲǴఁᡣߏ፸ӣډৎύᆶৎΓ࣬ᆫǹ
ྷඵᏢЬाගٮᇸࡋѨඵੱޣՉག۔ڈᐟޑፐำǴٯӵ᛬ೌǵॣǵ ၮǵᚶᙑǶ(Ϊᅋ et al., 2003; ෯ҏ et al., 2013)
ᐒᄬԄх֖ӼᎦǵᎦៈϷៈϐৎǴৎឦคΚॄᏼྣ៝ѨඵੱޣޑᓸΚ ਔǴૈගٮৎឦԎ៝ѨඵੱޣܭᐒᄬύǴ൨ΓӄВޑྣ៝ǶѠѨ ඵੱߏයྣ៝ҭวр಄ӝѨඵੱޣޑྣ୍៝ܺኳԄǴٯӵიᡏৎࡂǵਸྣ
៝ൂϡϷྷඵϕշৎ୍ܺኳԄǴวр׳ӭϡޑѨඵੱྣ៝ኳԄǴ٬ځૈ
׳಄ӝѨඵੱޣޑሡǴᡣѨඵੱޣளډ׳ӳޑྣ៝(Ϊᅋ et al., 2003; ෯
ҏ et al., 2013)Ƕ
ߏයྣ៝Ѩඵੱޣޑৎྣ៝ޣǴӧيЈБय़ԋཱུεޑፂᔐǴ۳۳ԋࣁ
ᗦޑޣǴྣ៝ѨඵੱޣߚதόܰǴाय़ჹځୢᚒՉࣁϷᆒઓੱރǴਔத ъڹाᏼЈѨඵੱޣόᐱԾрߐǴ܈ࢂଆٰၯوǴߏයΠٰคݤளډкϩ ޑҶ৲Ƕৎឦྣ៝ၶډᓍǴགډੲᏩਔǴЪВதғࢲύΨԖӭ٣ሡाമ ЈǴЪคݤӆ׳ӭЈΚഉՔѨඵੱޣਔǴВ໔ྣ៝ύЈࢂঁӳޑᒧǴқ ϺஒѨඵੱޣଌډВ໔ྣ៝ύЈǴޣёаӧύЈளډӳޑྣ៝ǴఁΞёа ӣৎᆶৎΓ࣬ೀǴԶόࢂޔௗ൩ஒޣଌډᐒᄬԄޑ୍ܺǴёаᅈىύ୯Γ ޑֵၰǴٰफ़եྣ៝ޣޑൾགǶѨඵੱޣόૈӢࣁғੰԶᇻᚆΓဂǴ׳ሡ
ाѦࣚޑڈᐟǴѦࣚޑڈᐟёа෧ѨඵੱޣੰำวޑೲࡋǴၸᆶΓޑௗ
Ǵ๏ϒག۔ޑڈᐟǶ
Ѩඵੱޣޑྣ៝Ǵਔ๏ϒྣ៝ޣഹ৲ޑޜ໔ࢂѸाޑǶӧВ໔ྣ៝ύ ЈϷྷඵϕշৎٿᅿ୍ܺኳԄǴૈ๏ϒྣ៝ޣਔޑഹ৲ǴаΠϟಏٿᅿܺ
୍ኳԄޑၮբБԄǺ
ǵВ໔ྣ៝ύЈኳԄ
1997ԃԴΓᅽճݤಃԛঅݤύǴஒԴΓВ໔ྣ୍៝ܺયΕځύǴ1998ԃঅ
҅ԴΓᅽճᐒᄬҥྗǴቚуВ໔ྣ៝ࡼ࣬ᜢޑೕۓǶӧ2007ԃԴΓᅽճݤ
ಃΒԛঅݤύǴঅ҅࣬ᜢచЎǴಃ19చύࡰрሡᇶᏤԴΓᅽճᐒᄬගٮВ໔ྣ៝
୍ܺǶВ໔ྣ୍៝ܺ܌ගٮޑ୍ܺǴਥᏵȨԴΓᅽճ୍ܺගٮޣၗाҹϷ୍ܺ
ྗ߾ȩ୍ܺϣӵΠǺ (1) ғࢲྣ៝Ƕ (2) ғࢲԾҥ૽ግǶ (3) ଼நߦǶ (4) ЎநҶ໕ࢲǶ
(5) ගٮ܈ೱ่Ҭ೯୍ܺǶ (6) ৎឦ௲ػϷᒌ၌୍ܺǶ (7) ៈ୍ܺǶ
(8) ൺ଼୍ܺǶ (9) ഢᓓ୍ܺǶ
ᏵϣࡹȨቶޗᅽճံշҙፎံշҞϷ୷ྗȩǴவ҇୯88Կ100ԃ ࡋǴࡹ۬ஒВ໔ྣ୍៝ܺયΕံշҞǴᙖҗံշٰวВ໔ྣ୍៝ܺǶӧ2011 ԃፁғᅽճՉȨВ໔ྣ៝ڡԭΒीฝȩǴӧ2013ԃၲډӄѠВ໔ྣ៝
120ৎޑҞǴځύѨඵੱВ໔ྣ៝ύЈीӅԖ21ৎ(߄2-3-1)Ƕ ߄ 2-3-1! Ѡ 2013 ԃۭВ໔ྣ៝ύЈৎኧ
ԃ
ԃࡋ 2008 2009 2010 2011 2013 2014
Ҟ ൂ
Տ ኧ
ൂ Տ ኧ
ൂ Տ ኧ
ൂ Տ ኧ
ൂ Տ ኧ
ൂ Տ ኧ
В໔ྣ៝ύЈ 26 31 54 58 99 103
ѨඵੱВ໔ྣ៝ύЈ 5 8 12 15 21 20
ӝी 31 39 66 73 120 123
ၗٰྍǺፁғᅽճޗϷৎ(2014)
ࣴزࡰр٬ҔВ໔ྣ៝ёаफ़եྣ៝ޣޑॄय़ᆣǵЈ଼நϷኁᢠୢᚒ (Cox, 1997; Gilleard, Gilleard, & Whittick, 1984; Jarrott, Zarit, Stephens, Townsend,
& Greene, 2000)ǴΨԖࣴزࡰр٬ҔВ໔ྣ៝όёа෧Ͽྣ៝ޑਔኧǴΨૈफ़ եྣ៝ޣӧᆣϷЈޑୢᚒ(Zarit, Stephens, Townsend, & Greene, 1998)ǹՠ Ԗ٤ࣴزी఼ᇂၨӭόӕ୍ܺኳԄޑࣴز่݀ᡉҢǴВ໔ྣ៝ޑ٬Ҕჹܭॄय़
ᆣϷЈ଼நޑؒԖᡉቹៜ(Lawton, Brody, & Saperstein, 1989; Montgomery RJV, 1989)Ƕ
ӧࢌ٤ࣴزวВ໔ྣ៝ύЈǴૈफ़եྣ៝ޣޑॄᏼǶMossello et al(2008) ჹ٬ҔВ໔ྣ៝ύЈޑѨඵੱޣϷځྣ៝ޣՉቹៜຑǴஒ٬ҔВ໔ྣ៝ύ ЈޑѨඵੱޣᆶۚৎྣ៝ޑѨඵੱаԃសϷᇡޕфૈՉଛჹǴځЬाྣ៝
ޣΨ٩ԜБԄՉଛჹǴଛჹֹԋࡕǴٿঁДࡕӆՉઓᆒઓੰቻໆ߄ ȐNeuropsychiatric Inventory, NPIȑϷྣ៝ޣॄᏼໆ߄(Caregiver Burden Interview, CBI)ՉෳໆǴࣴز่݀วઓᆒઓੰቻໆ߄ளϩӧВྣ៝ύЈԖᡉޑΠफ़Ǵ
ӧྣ៝ޣॄᏼໆ߄ϩӧۚৎྣ៝คᡉቹៜǴԶӧВ໔ྣ៝ЈύԖᡉޑቹៜ (Mossello et al., 2008)Ƕ߄ҢٿঁДޑВ໔ྣ៝٬ҔǴૈ෧ᇸྣ៝ޣޑॄᏼϷफ़ եѨඵੱޣޑᆒઓੱރǶВ໔ྣ៝ύЈޑ٬ҔӧЈቫय़ჹܭྣ៝ޣԖ҅ӛቹ ៜǴૈ٬ྣ៝ޣ෧ᇸྣ៝ޑॄǶZarit et al(1998)௦ҔྗჴᡍीǴჴᡍಔࣁ٬
ҔВ໔ྣ៝ޑ୍ܺǴჹྣಔ߾ࢂؒԖ٬ҔВ໔ྣ୍៝ܺ܈٬ҔϿϩޑഹ৲୍ܺǴ
ՉԃޑຑǴϩձӧ໒ۈǵ3ঁДջ12ঁДՉ6ঁᄬय़ෳໆǴϩձࣁفՅޑ
״ᑛǵॄǵᏼЈǵᓸΚǵኁᢠǵғᆶ҅ӛޑቹៜՉຑǴࣴز่݀วჴ ᡍಔᆶჹྣಔӧ3ঁДޑ٬ҔВ໔ྣ៝ࡕǴჴᡍಔӧኁᢠکғаϷॄکᓸΚ ޑϩኧԖᡉޑफ़եǴӧԃޑ٬ҔΠǴӧॄϷኁᢠԖᡉޑफ़ե(Zarit et al., 1998)Ƕ܌аǴВ໔ྣ៝ޑ٬Ҕૈගϲྣ៝ޣӧЈ଼நǴЪफ़եྣ៝ޣޑྣ៝
ᓸΚǶ
В໔ྣ៝ύЈගٮԴԃΓқϺԖӦБёаԎ៝ǴᡣৎΓёӼЈπբ܈ၸբԾ ρགྷޑ٣ǶВ໔ྣ៝όૈߦԴԃΓޑ଼நᆶғࢲࠔ፦Ǵ๏ϒྣ៝ޣഹ৲
ޑᐒǴΨૈ෧ѨඵੱޣۯߏՐᐒᄬޑਔ໔(Hasselkus, 1997; Johnson &
Maguire, 1989; Neufeld & Strang, 1992; ௵ስ et al., 2004)Ƕ௵ስ(2004)ଞჹ9 ՏѨඵੱޣϷځৎྣ៝ޣǴՉ፦܄ࣴزǴ่݀ࡰрǴВ໔ྣ៝ૈගٮྣ
៝ޣЈቫय़ޑЍǴྣ៝ޣளЈॄёӢ٬ҔВ໔ྣៈ෧ᇸᓸΚǴᕇளഹ
৲ޑᐒǴՠࢂӧᔮቫय़ॄࢂቚуޑݩǶќѦǴӧᆣᆶགЍቫय़Ǵ
ྣ៝ޣளᆶѨඵੱޣ໔ᜢ߯ᕇளׯ๓ǴჹܭޣΨૈុ߄ၲᜢᚶϷᜢངǴ ᅈىύ୯ֵၰޑሡǴЪᔅշᆢৎޑֹ܄Ƕ
В໔ྣ៝ჹܭѨඵੱޣёаගٮғᅱෳǵቚуѨඵੱޣޑޗௗǵ ቚѨඵੱޣޑזϷᅈىགǵᆢᇡޕфૈϷۯᇡޕфૈଏϯǵׯ๓Ѩඵ
ੱޣቹៜϷफ़եኁᢠکݪ഼གǶჹܭྣ៝ޣ߾ࢂૈኩਔᔅԆྣ៝ྣ៝
ޣǴ๏ϒྣ៝ޣਔ໔ၮҔޑቸ܄ǹ෧ᇸྣ៝ޣޑྣ៝ॄǹૈ٬ྣ៝ޣᅰֵၰǹ ᡣྣ៝ޣёаπբǴόҔӢྣ៝πբԶᜏᙍ܈ׯᡂπբࠠᄊǹྣ៝ޣᕇளӳޑғ
ࢲࠔ፦(ֈᝊᓉ et al., 2014)Ƕ
ΒǵྷඵϕշৎኳԄ
ӕኬឦܭޗѨඵੱߏޣྣៈ୍ܺྣៈޑᅿ୍ܺޑྷඵϕշৎӧޗ
ගٮৎឦϷѨඵੱޣޑࢲޜ໔Ǵࢂᅿ่ӝߚᛰނݯᕍǵৎឦიᡏǵྣ៝מ ѯ૽ግϷΓωᎦޑྣ៝ኳԄǶᡣৎឦૈӧқϺѨඵੱޣୖᆶޗҬࢲǴ ᙖҗৎឦ໔ϕ࣬ᔅշᆶྣ៝מѯҬࢬΠǴගϲৎឦᆶѨඵੱޣޑғࢲࠔ፦Ǵۯ
ΕВ໔ྣ៝Ϸᐒᄬޑਔ໔ǶЪӧୖᆶޑၸำύǴόৎឦ໔ёа࣬ϕྣ៝Ǵ Ѩඵߏ፸ϐ໔ΨૈᙖҗიᡏࢲޑୖᆶǴౢғ࣬ϕྣ៝ޑਏ݀Ǵ׳ᜤளޑࢂǴё аᙖҗྣ៝όӕޑߏ፸Ǵ٬ளচҁᆙޑྣ៝ᜢ߯ᕇளှ(Цቚ߿ & ጰ᐀ݒ, 2014; ෯ҏ et al., 2013)Ƕ
2005ԃѠѨඵੱڐ໒ۈȨྷඵᏢȩޑ୍ܺǴৎឦჹܭԜ୍ܺۯѨඵ
ੱޣଏϯޑำ๏ϒ࣬εޑޭۓǴՠࢂԜ୍ܺኳԄа10ຼࣁఊԛǴՏ
ޣຼѝૈୖᆶፐำǴৎឦॺ׆ఈૈୖᆶ׳ӭޑፐำǴӧৎឦϷѨඵੱ
ޣޑሡΠǴ໒ܫচҁᏢޑޜ໔Ǵ๏ৎឦԾՉߏ፸ᆶځдৎϕǴՉޗ ҬࢲǶҗܭৎឦϷѨඵੱޣሡा܌Ǵ٬дॺёаᆶдΓՉޗҬࢲǴ2011 ԃȨྷඵϕշৎȩ҅ԄԋҥǴ೭ঁ܌ό๏ϒѨඵੱޣѦӧڈᐟǴΨ๏ϒ ৎឦྣ៝ޑЍǴԋঁϕշޑᆛ๎Ƕৎឦ໔ޑЍǴૈ෧ᇸྣ៝ޑᓸ ΚǴΨёаϩ٦۶Ԝޑྣ៝ᡍǴϕ࣬ᏢಞϷԋߏǶ
ৎឦЍიᡏჹܭྣ៝ޣࢂԖᔅշޑǶChien et al(2011)ޑࣴزύวǴவό ӕޑၗύǴԏΑ1998ԃԿ2009ԃ໔ǴৎឦЍიᡏޑ࣬ᜢࣴزՉࡕϩ
(Meta-analysis)Ǵࣴز่݀วྣ៝ޣЍიᡏᆶྣ៝ޣޑЈ଼நݩǵኁᢠ
ǵॄаϷޗҬ่݀Ԗᡉޑᜢ߯(Chien et al., 2011)Ƕীী(2004)аъ໒ ܫԄୖᆶࣴزჹѨඵੱޣޑྣ៝ޣՉࣴزǴ٠ৎឦЍიᡏჹྣ៝ޣޑ ԋਏǴࣴز่݀วྣ៝ޣයࡑவৎឦЍიᡏύᕇளྣ៝ޑࡌǵྣ៝מѯ
ک҂ٰྣ៝ޑБӛǴЪԜࣴزϕޑࠠᄊεӭࣁࡌ܄ࣁЬ(ীী, 2004)Ƕ
෯ҏ(2000)ଞჹѨඵੱৎឦიᡏԋਏՉǴՉ10ԛޑৎឦЍიᡏǴ
ၗϩϩ٬ҔYalomޑიᡏݯᕍӢનࢎᄬٰߞՉϩǴYalomޑიᡏݯᕍԖ ਏݯᕍӢનԖ11ᅿǴϩձࣁȨ׆ఈޑឲݙ(instillation)ȩǵȨදϷ܄ȐUniversalityȑȩǵ Ȩޕૻ৲(imparting information)ȩǵȨճд܄ȐAltruismȑȩǵȨԐයৎᡍ ޑᕖ҅ख़(corrective reenactment of primary family group)ȩǵȨวޗҬמѯ (development of social interaction techniques)ȩǵȨኳүՉࣁ(imitative behavious)ȩǵ ȨΓሞᏢಞ(interpersonal learning)ȩǵȨӸӧӢન(existential factors)ȩǵȨᆣ࠹ࢻ (catharsis)ȩǵȨიᡏᏉᆫΚ(group cohesiveness)ȩǴࣴز่݀วৎឦЍიᡏܴᡉ ޑݯᕍӢηԖ׆ఈޑឲݙǵදၹ܄ǵޕૻ৲ǵճд܄ǵวޗҬמѯǵ
ᆣ࠹ࢻϷიᡏᏉᆫΚǴ߄Ң໒ܫԄޑৎឦЍიᡏჹܭྣ៝ޣࢂԖᔅշޑ(෯
ҏ, ယࣂம, ഋؼী, & ᖴᅸ, 2000)Ƕ
аࣴز߄ҢৎឦЍიᡏૈቚуྣ៝ޣྣ៝Ѩඵੱޑࠔ፦Ƕྷඵϕ շৎޑ୍ܺኳԄёаᙖҗৎឦ໔ޑϕշӝբᜢ߯ǴٰၲډৎឦЍޑਏ݀Ǵᙖ җ۶Ԝϐ໔ޑᡍϩ٦Ǵٰගଯྣៈࠔ፦Ƕᙁզػ(2010)ࣴزࡰрǴЍიᡏޑ ϟΕჹྣ៝ޣޑЈ଼நǵኁᢠǵॄࣣԖᡉ࣬ᜢǴԶԖӭङඳޑሦᏤޣ
ԖၨଯޑЍიᡏׯ๓ਏ݀(ᙁզػ, 2010)Ƕ
ΟǵВ໔ྣ៝ύЈᆶྷඵϕշৎϐКၨ
В໔ྣ៝ύЈᆶྷඵϕշৎٿᅿ୍ܺኳԄനεޑόӕೀǴԖаΠ൳ᗺǶ(1)
٬Ҕ୍ܺޑਔ໔ǺВ໔ྣ៝ύЈ೯தВ٬Ҕ8λਔǴࡐϿԖଌѨඵੱޣϺ 4ঁλਔԿύЈǴԶྷඵϕշৎ٬Ҕ୍ܺਔ໔࣬ჹቸ܄Ǵёаᒧຼ٬ҔϺ ኧǴЪёаᒧВ٬ҔਔࢤǴёа๏ϒѨඵੱޣቸ܄Ӽ௨ځд࣬ᜢࢲǹ(2) ࢲӼ௨ޑቸ܄ǺВ໔ྣ៝ύЈڬӼ௨ڰۓፐำǴѨඵੱޣВډၲВ໔
ྣ៝ύЈሡՉύЈ܌Ӽ௨ࢲǴԶྷඵϕշৎόӼ௨ፐำ๏ޣǴᡣѨඵ
ੱޣԾҗᒧВགྷाவ٣ޑࢲǹ(3)ᆶޗௗᐒǺВ໔ྣ៝ύЈޣ܌
ௗډޑΓǴаځдޣϷπբΓۚӭǴՠࢂӧྷඵϕշৎёаௗډځд
ޣϷৎឦǴௗ׳ӭόኬޑڈᐟǹ(4)ৎឦୖᆶำࡋǺВ໔ྣ៝ύЈྣ៝ޣό ሡाഉՔޣǴԶྷඵϕշৎྣ៝ޣሡाഉӕޣǴаӢᔈँวݩǹ(5)ྣ៝
ࠔ፦ගϲǺྷඵϕշৎᙖҗόӕৎ໔Ǵྣ៝ᡍޑϩ٦Ǵගϲྣ៝ૈΚǴ٬
Ѩඵੱޣૈளډྣ៝ࠔ፦ޑගϲǹ(6)ྣ៝ޣਔ໔ޑቸ܄ǺВ໔ྣ៝ύЈ җܭྣ៝ޣόሡഉՔޣǴВதғࢲԖ׳ӭޑਔ໔ёаӼ௨Ծρޑࢲǹ(7)
ΓǺВ໔ྣ៝ύЈሡाӭՏΓǴྷඵϕշৎࡰሡाՏᆅΓǴε ൯फ़եΓΚޑ٬ҔǶ
Ѥǵλ่
ᗨฅВ໔ྣ៝ύЈᆶྷඵϕշৎӕኬឦܭ๏ѨඵੱߏޣޑޗԄྣៈǴᗨ ฅ೭ٿᅿኳԄჹৎឦޑЍᆶৎឦޑୖᆶځჴࢂό࣬ӕޑǴՠࢂჹ೭ٿᅿ୍ܺჹ ৎྣ៝ޣޑቹៜǴҞѠၨલЮ࣬ᜢޑຑǶࡺᔈவӭϡفࡋٰٰຑ೭ٿ ᅿόӕ୍ܺኳԄჹܭྣ៝ޣϷྣ៝ޣޑቹៜǶ
ಃ
ಃѤ! ຑπڀӣ៝
୯ϣѦࣴزჹܭѨඵੱྣ៝ޣޑຑၨத٬ҔǴྣ៝ޣຑໆ߄(CAS)ǵZarit
ॄᏼໆ߄(ZBI)ǵྣ៝ޣᓸΚໆ߄(CSI)Ϸ҅ӛྣ៝ᡍໆ߄(PAC)ໆ߄Ǵҁࣴز ਥᏵࣴزҞޑϷЎӣ៝ࡕǴᒧྣ៝ޣຑໆ߄(CAS)Ϸྣ៝ޣᓸΚໆ߄(CSI)
ՉୢڔፓǴаΠஒ၁ಒϟಏԜٿᅿໆ߄Ƕ
ǵྣ៝ޣຑໆ߄(Caregiver Appraisal Scale,! CAS)
Lawton(1989)܌วޑྣ៝ޣຑໆ߄(Caregiver Appraisal Scale, CAS)Ǵୢ
ڔวࣁΑෳໆྣ៝ޣޑ٬Ҕ࣬ᜢߏයྣ୍៝ܺՉຑǴୢڔᚒӅ47ᚒǴϩ ኧጄൎ47~235Ǵх֖Αϖঁय़ӛǴϩձࣁЬᢀྣ៝ॄᏼ(Subjective caregiving burden)Ǵྣ៝ޑቹៜ(Impact of caregiving)Ǵྣ៝ޑዕግૈΚ(Caregiving Mastery)Ǵ
ྣ៝ޑᅈىག(Caregiving satisfaction)Ǵख़ཥຑޑᇡޕ(Cognitive reappraisal)Ǵ
ঁय़ӛᚒኧӚࣁ13ᚒǵ9ᚒǵ12ᚒǵ9ᚒϷ4ᚒǴ௦ҔϖᗺЁࡋीϩǴϩኧຫଯ߄ ҢำࡋຫଯǶЬᢀྣ៝ॄᏼޑୢᚒх֖ǴȨӢࣁྣ៝ޣǴԶԋғࢲѨѐඓඝ?ȩǵ Ȩளόૈӆྣ៝ྣ៝ޣࡐΦΑ?ȩǵȨգྣ៝ޣਔǴགډғ?ȩǶྣ៝
ޑቹៜᚒԖǴȨாޑޗҬғࢲӢࣁྣ៝ޣԶౢғ֚ᘋ?ȩǵȨாޑਔ໔ϩଛӢࣁ
ྣ៝ޣԶ٬ளாؒԖىޑਔ໔๏Ծρ?ȩǵȨாӢࣁྣ៝ޣԶؒԖঁΓޑᗦ د?ȩྣ៝ޑዕግૈΚᚒԖǴȨόዴۓ၀ࣁޣࣗሶ٣?ȩǵȨாᔈ၀ाӆࣁ
ޣޑ׳ӭ?ȩǵȨךૈమཱޕၰޣޑሡ?ȩǶྣ៝ޑᅈىགᚒԖǴȨாܭ ᆶޣӧଆ?ȩǵȨྣ៝ޣǴᡣாளᆶޣ׳ᒃ߈?ȩǵȨӆᆶޣޑᜢ߯Ǵ
ாΑࡐӭѸޑ٣ǴԶόࢂாགྷाޑ٣?ȩǶख़ཥຑޑᇡޕᚒԖǴȨா
ྣ៝ޣځύঁख़ाচӢࢂӢࣁৎޑ?ȩǵȨӢࣁྣ៝ޣԶ٬ளգૼ
ے௲ߞһ?ȩǵȨாᇡࣁྣ៝ޣࢂჹܭޣޑᅿൔเ?ȩǶϣठ܄ߞࡋࣁ (Cronbach's alpha)ࣁ0.90(Lawton, Brody, et al., 1989; Lawton, Kleban, et al., 1989;
Lawton, Moss, Hoffman, & Perkinson, 2000)Ƕ
Βǵঅुހྣ៝ޣᓸΚໆ߄(Modified Caregiver Strain Index,! MCSI)
ྣ៝ޣᓸΚໆ߄(Caregiver Strain Index, CSI)ࣁRobinson(1983)܌วޑໆ߄Ǵ Robinsonখ໒ۈࣴزჹຝࣁӢᢇᜢЋೌԶՐଣ܈ӢЈ᠌ੰԶՐଣޑੰΓϐྣ
៝ޣǴྣ៝ޣԃសϟܭ22~83ྃǴёࣁޣޑଛଽǵৎΓǵᎃۚ܈ܻ϶Ƕྣ៝ޣ ᓸΚໆ߄(CSI)ᚒӅ13ᚒǴीϩБԄ௦ҔΒϩݤǴȨ1ȩ߄ҢࢂǴȨ0ȩ߄ࢂցǴᕴ ϩࣁ0~13ϩǴϩኧຫଯ߄ҢᓸΚຫεǶԜໆ߄ޑϣठ܄ߞࡋ(Cronbach's alpha) ࣁ0.86ǴࡌᄬਏࡋޑϩёவΟϩڗளǴϩձࣁੰΓޑྣ៝፦ǵྣ៝ޣᆶ
ྣ៝ޣ໔ޑЬᢀགڙϷྣ៝ޣޑᆣ଼நǶࣴز่݀ྣ៝ޣᓸΚໆ߄(CSI) ёаଞჹߚ҅Ԅྣ៝ޣޑྣ៝ᓸΚԖਏޑՉෳໆ(B. C. Robinson, 1983)Ƕ
অुހྣ៝ޣᓸΚໆ߄(Modified Caregiver Strain Index, MCSI)ܭ2003ԃҗ Thornton܌ගрǴӢࣁྣ៝ߏයྣ៝ᄌ܄੯ੰޑԴΓԃεӭҗߚ҅Ԅޑྣ៝ޣྣ
៝Ǵྣ៝ޣӧޗᜢ߯۳۳ౢғኁᢠǵੲമǵൿϷׯੰޑǴ٬ளྣ៝
ޣޑيᡏ଼நрୢᚒϷԋമಕǶਠ҅ࡕޑྣ៝ޣᓸΚໆ߄(MCSI)ᚒࣁ13 ᚒǴीϩБԄ௦ҔΟᗺЁࡋǴȨ2ȩ߄ҢததӵԜǴȨ1ȩ߄ҢԖਔӵԜǴȨ0ȩ߄ࢂ
ؒԖǶᕴϩࣁ0~26ϩǴϩኧຫଯ߄ҢᓸΚຫεǶୢڔᚒԖǴȨךޑᅵڙډυ ᘋ(ٯӵǴڹ໔ሡྣ៝ޣΠ܈ၯوݩ)ȩǵȨӢྣ៝܌ԋޑيᡏᓸΚ(ٯӵǴ
ޣ౽֤ՏਔࡐΚ܈ሡࡐεݙΚྣ៝ޣ)ȩǵȨӢࣁྣ៝Զགډڙज़(ٯ ӵǴӢࣁྣ៝ޣज़ڋΑԾҗਔ໔܈คݤᒿཀѦр)ȩǶ
অुހޑໆ߄ϣठ܄ߞࡋ(Cronbach's alpha)ࣁ0.90Ǵӆෳߞࡋࣁ(test–
retest reliability)ࣁ0.88ǴԜπڀჹܭߏයྣ៝ሦୱྣ៝ޣޑᓸΚёՉᛙۓޑໆ
ෳ(Thornton & Travis, 2003)Ƕ
MCSIໆ߄ଞჹCSIໆ߄ՉҞޑፓǴ٬CSIໆ߄ૈჹߏයྣ៝ޑྣ៝
ޣՉຑǶԋྣ៝ޣॄޑচӢԖࡐӭӢનǴႽࢂৎفՅޑፂँǵ୍ॄ
ᏼǵྣ៝فՅޑፂँǵྣ៝ޣޑޗЍǵѨඵੱޣޑᇡޕфૈำࡋکୢᚒՉ
ࣁǴࣣቹៜྣ៝ޣޑᡏॄຑǴ܌аྣ៝ޣޑॄຑᔈՉ׳ӄय़ޑ ԵໆǶ
Οǵλ่
Ϟྣ៝ޣ܌٬Ҕޑຑໆ߄εӭࣁॄӛޑຑǴЪલЮӄय़܄ޑຑໆ߄Ǵ คݤӕਔჹྣ៝ޣՉ҅ӛϷॄӛޑຑǴҁࣴزஒԾՉวཥޑໆ߄Ǵ٬Ҕਠ
҅ࡕޑྣ៝ޣᓸΚໆ߄(MCSI)Ϸᘏڗϩྣ៝ޣຑໆ߄(CAS)ϐᚒǴวࣁ ཥޑӭϡྣ៝ޣຑໆ߄ǴයఈૈаᆒᙁޑᚒǴჹྣ៝ޣՉԖਏޑຑǶ
ಃ
ಃΟക! ࣴزБݤᆶी
ಃ! ࣴزࢎᄬ
ҁࣴزࣁᐉᘐ܄ࣴزǴ௦ҔҥཀڗኬǴаѨඵੱޣޑЬाྣ៝ޣࣁԏਢჹ ຝǴஒ٬Ҕ่ᄬԄୢڔǴՉୢڔፓǶ
ҁࣴزགྷΑှӧВ໔ྣ៝ύЈϷྷඵϕշৎٿᅿόӕޑྣៈኳԄΠǴόӕ ޑྣ៝፦ࢂցΨቹៜྣ៝ޣޑॄǴ٠ӧڋΓαᏢ፦ࡕǴྣ
៝ޣޑྣ៝ॄࢂցԖ܌όӕǶ
კ 3-1-1! ࣴزࢎᄬ Ծᡂ!!
ྣ୍៝ܺኳԄ!
В໔ྣ៝ύЈ!
ྷඵϕշৎ!
٩ᡂ!
ྣ៝ޣӭϡຑ!
ڋᡂ!! ΓαᏢ܄!
ྣ៝ޣ୷ҁ܄!
ྣ៝ޣ୷ҁ܄!
ಃ
ಃΒ! ࣴزჹຝ
ҁࣴز௦ҥཀڗኬǴଞჹᆵчѱϖ໔В໔ྣ៝ύЈѨඵੱޣޑЬाྣ៝
ޣǴаϷྷඵϕշৎޑѨඵੱޣޑЬाྣ៝ޣǴࣴزયΕచҹǺ(1)20ྃа
ǹ(2)ᙴৣዴບࣁѨඵੱϐޣޑЬाྣ៝ޣǹ(3)قᇟૈྎ೯ޣǹ(4)ӧৎ ύനӭਔ໔ޔௗ܈ᅱ࿎ྣ៝πբޑৎឦ(ߋ௴ዎ et al., 2002)ǶऩࢂЬाǵ ԛाྣ៝ޣคݤղۓਔǴٿޣࣣวܫୢڔ(෯ҏ, 1991)Ƕ௨ନచҹǺ(1)Ѩඵੱ
ޣ٬Ҕ၀୍ܺਔ໔҂ᅈ3ঁДǹ(2)Ѩඵੱޣຼ٬ҔϺኧեܭ3Ϻǹ(3)௨ ନѦᝤྣ៝ޣǶӧቻЬाྣ៝ޣӕཀࡕǴჹЬाྣ៝ޣՉୢڔፓǴЬा
аԾ༤ޑБԄ༤เୢڔǴऩࢂԖሡाਔΨૈаೖፋޑБԄՉǶ
ಃΟ! ࣴزၸำ
ҁࣴزၗԏਔ໔ࣁ2015ԃ3Д9ВԿ2015ԃ6Д30ВǴӅी17ຼǴႣीԏ ਢᕴኧࣁ100ҽǶࣴزኬҁԏࢬำԿВ໔ྣ៝ύЈϷྷඵϕշৎՉԏਢǴ ஒځϩࣁٿಔǴಔࣁ٬ҔྷඵϕշৎޑЬाྣ៝ޣǴќಔࣁ٬ҔВ໔ྣ
៝ޑЬाྣ៝ޣǶВ໔ྣ៝ԏਢБԄǴҗܭ٬ҔԜ୍ܺኳԄϐྣ៝ޣǴεӭ ࣁᐒᄬҬ೯ௗଌ۳߇Ր܌ǴऩाՉय़ჹय़ԏਢԖՉ֚ᜤǴ܌аہૼВ໔
ྣ៝ύЈޑՉࡹൂՏՉวܫୢڔǴୢڔวܫǴࣴزΓᒃԾ۳В໔ྣ
៝ύЈǴჹॄೢжวୢڔϐΓ၁ಒᇥܴࣴزޣيϩǵࣴزҞޑǵࣴزჹຝϷ
ୢڔϣǴЪჹВ໔ྣ៝ύЈϐගୢՉှᇥǶࡑୢڔӣԏࡕǴᔠୢڔ༤ เֹࡋǴऩࢂԖᅅเޑݩǴ߾ᆶВ໔ྣ៝ύЈڐǴࢂցёааႝ၉ೖፋ ޑБԄஒගံሸǴԶऩࣁคਏୢڔǴ߾ՉΒԛวܫୢڔǴٰቚуୢڔӣ ԏǶྷඵϕշৎޑԏਢБԄҭӕܭВ໔ྣ៝Ƕ܌ԏޑၗٮीฝЬ
ΓϷࣴزΓ٬ҔǴόஒঁΓၗࢻᅅ๏ൂՏǴߥៈԏਢჹຝޑ٬ҔǴ നࡕѝஒࣴز่݀ᆶൂՏϩ٦Ǵࣴز่݀ගٮ๏ൂՏǴࣁВࡕׯ๓୍ܺϐࡌ
Ƕӧቻڙ၂ޣӕཀǴᛝڙ၂ޣӕཀਜࡕǴω໒ۈՉୢڔޑፓǶӧ༤
เୢڔǴӃၟڙ၂ޣ၁ಒᇥܴୢڔϣǴЬाҬҗڙ၂ޣԾՉ༤เୢڔǴѸ
ाਔࣴزޣаೖፋޑБԄжࣁ༤เǶҽୢڔऊ༤เ10Կ20ϩដǶֹԋޣග ٮλᘶࠔаҢགᖴǶ
ಃ
ಃѤ! ࣴزπڀ
ҁࣴز௦Ҕ่ᄬԄୢڔǴୢڔϩࣁٿঁϩǴࣁ୷ҁၗ߄ǵৎྣ៝ޣӭ ϡຑǶ၁ಒϣϩॊӵΠǶ
ǵ୷ҁၗ߄
୷ҁၗ߄ᡂ٩ᏵЎӣ៝Ϸࣴزᑫ፪ᒧۓǴϩԋٿεϩǴಃϩࣁ Ьाྣ៝ޣ୷ҁၗǴх֖܄ձǵԃសǵᆶྣ៝ޣᜢ߯ǵࢂցᆶྣ៝ޣӕՐǵ ஆ࠷ݩǵ௲ػำࡋǵᙍǵ൩ރݩǵྣ៝ࡕ൩ރݩࢂցׯᡂǵྣ៝ੰ
ය໔ǵВྣ៝ਔኧǵࢂցԖ࣮ៈڐշྣ៝ੰϷৎԃԏΕǶЬाྣ៝ޣ୷ҁ
ၗᡂᏹբࠠۓကǴӵ߄ 3-4-4ǶಃΒϩࣁྣ៝ޣ୷ҁၗǴᡂх֖٬
Ҕ୍ܺᜪࠠǵ܄ձǵԃសǵۚՐݩǵஆ࠷ݩǵ௲ػำࡋǵӧࢂց൩ǵ
ӧࢂցሦДଏॲǵੰᙍǵวੰԃសǵੰය໔ǵѨඵੱำࡋϷЬाྣ៝ޣ
܈ྣ៝ޣԖ٬Ҕډޑߏයྣៈ࣬ᜢ୍ܺǶྣ៝ޣ୷ҁၗᡂᏹբࠠۓကǴ ӵ߄ 3-4-5ǶҁࣴزԾᡂࣁ٬Ҕޑ୍ܺᜪࠠǴځᏹբࠠۓကӵ߄ 3-4-1Ƕ
Βǵৎྣ៝ޣྣ៝ॄຑ
ҁࣴزޑୢڔӧৎྣ៝ޣྣ៝ӭϡຑϩࣁΟঁηໆ߄Ǵϩձࣁྣ៝ޣᓸ Κࡰኧໆࡋ߄ǵྣ៝ޑᅈىགϷྣ៝ޑዕግૈΚǶୢڔᚒӵ߄ 3-4-2Ƕྣ៝ޣ ᓸΚࡰኧໆࡋ߄Бय़௦Ҕ Thornton(Thornton & Travis, 2003)܌วޑ Modified Caregiver Strain Index(MCSI)ǴमЎހୢڔᚒӅԖ 13 ᚒǴीϩБԄ௦ҔΟᗺЁ ࡋǴȨ2ȩ߄ҢததӵԜǴȨ1ȩ߄ҢԖਔӵԜǴȨ0ȩ߄ࢂؒԖǶᕴϩࣁ 0~26 ϩǴ ϩኧຫଯ߄ҢᓸΚຫεǶҁࣴزୢڔǴΨஒԜϩࣁΟঁЁࡋǴȨ1ȩ߄ҢֹӄคǴ
Ȩ2ȩ߄ҢԖਔǴȨ3ȩ߄ҢதǴԜϩᕴϩࣁ 13~39 ϩǴϩኧຫଯ߄Ңॄӛቹ ៜຫεǶ
ӧྣ៝ᅈىགϷྣ៝ޑዕግૈΚБय़٬Ҕ Lawton(Lawton, Kleban, et al., 1989)วޑྣ៝ޣຑໆ߄(Caregiver Appraisal Scale,CAS)ύٿঁ҅ӛຑޑη ໆ߄Ǵϩձࣁྣ៝ޑᅈىགϷྣ៝ޑዕግૈΚǴᚒ٩ࣴزҞޑϷୢڔߏࡋޑԵ ໆΠǴׯࣁ 5 ᚒϷ 4 ᚒǴीϩБԄҗচҁ٬ҔϖᗺЁࡋीϩǴȨ1ȩ߄Ңߚதόӕ ཀǴȨ2ȩ߄ҢόӕཀǴȨ3ȩ߄Ңද೯ǴȨ4ȩ߄ҢӕཀǴȨ5ȩ߄ҢߚதӕཀǴࣁΑ ᆶྣ៝ޣᓸΚࡰኧǴׯ௦Ҕ 3 ᗺЁࡋǶԶচҁޑीϩБԄǴᆶॄӛྣ៝ቹៜ
܌ຑໆЁࡋόӕǴЪ௦ҔӕόӕཀࣁຑໆБԄǴҗܭӕόӕཀޑຑϩБԄၨคݤ КၨрભǴ܌аׯ௦ҔᓎޑБԄՉຑໆǶԜϩᕴϩࣁ 9~27 ϩǶ
Զৎྣ៝ޣӭϡຑໆ߄ࢂஒ 3 ঁηໆ߄уᕴǶࣁΑ٬ӚᚒҞև࣬ӕ БӛǴ܌аӧᕴϩीᆉਔǴஒྣ៝ޑᅈىགϷྣ៝ޑዕግૈΚηໆ߄ׯҔϸӛी
ϩǴȨ3ȩ߄ҢֹӄคǴȨ2ȩ߄ҢԖਔǴȨ1ȩ߄ҢதǴӧྣ៝ޑᅈىགϷྣ៝
ޑዕግૈΚ೭ٿϩޑϩኧຫଯ߄Ңྣ៝ޑᅈىགϷዕግૈΚຫόӳǶᡏໆ߄ ᕴϩጄൎࣁ 22~66 ϩǶϩኧຫଯ߄Ңྣ៝ޣॄຫεǶ
ҁୢڔਏࡋϩՉࡌᄬਏࡋϩǴ٬Ҕᡍ܄Ӣનϩ(confirmatory factor analysis, CFA)ᔠᡍǶߞࡋ߾ӃՉႣෳǴᔠۓୢڔޑϣठߞ(Cronbach alpha)ॶǶᡂᏹբࠠۓကǴӵ߄ 3-4-3Ƕ