精神病患主要照顧者之需要及其滿足程度之相關因素探討
Exploring the Related Factors of Needs and Met-needs Levels of Psychotic Patients''Caregivers
中文摘要
本研究為一橫斷性研究，目的在探討精神病患主要照顧者的需要及其滿足程度之相關因素。本研 究選取三家精神專科醫院精神病患之主要照顧者，研究期間自92 年 3 月至 6 月，至三家醫院 隨機抽取門診及住院個案300 名，有效回收問卷共 151 份，有效回收率 50.3%。研究工具為 自擬之「主要照顧者的需要及需要滿足程度量表」，所得資料以描述性統計、t-test、ANOVA 、 Pearson’s Product-moment Correlation、Multiple Regression 進行資料分析。
研究結果顯示， 影響主要照顧者之需要分為「獲得訊息性支持之需要」、「參與病人的治療及照 顧之需要」、「獲得獲得情緒及回饋支持之需要」、「獲得實質性支持之需要」四部分。於主要照顧 者各層面需要之程度依序為：「參與病人的治療及照顧」、「獲得訊息性支持」、「獲得實質性支持」、
「獲得情緒及回饋支持」。於主要照顧者各層面需要滿足之程度依序為：「參與病人的治療及照 顧」、「獲得情緒及回饋支持」「獲得訊息性支持」、「獲得實質性支持」。
主要照顧者整體的需要程度與主要照顧者的婚姻狀況及與病患關係二項，達統計上顯著差異。獲 得訊息性支持與主要照顧者年齡、精神病患發病時間呈負相關。獲得實質性支持與精神病患住院 次數呈正相關。主要照顧者之個人特質變項對於主要照顧者需要程度有明顯影響，其中與病患關 係中，為病患之夫妻者，對於主要照顧者之需要程度較低，達到8%的解釋變異量。獲得訊息性 支持之滿足程度與主要照顧者年齡、醫護人員協助程度呈顯著正相關。參與病人的治療及照顧之 滿足程度，與醫護人員協助程度呈正相關。獲得情緒及回饋支持之滿足程度，與主要照顧者照顧 負擔程度、醫護人員協助程度呈顯著正相關。獲得實質性支持之滿足程度，與主要照顧者年齡、
醫護人員協助程度呈正相關。「主要照顧者之個人特質」、「主要照顧者照顧負擔」對於主要照顧 者需要滿足程度有明顯影響，其中，在與病患關係部分，為病患之子女者，對於主要照顧者之需 要滿足程度較低。在醫護人員協助程度部分，醫護人員協助程度高者，對於主要照顧者之需要滿 足程度較高，達到19%的解釋變異量。
建議：1.鼓勵民間投資增加病人工作訓練場所，及多元化社區復健機構。2.依據主要照顧者年齡、
與病患關係、病患住院次數、病患發病時間，以提供主要照顧者不同的衛教3.將病患安置計畫 納入常規治療計畫中4.提供主要照顧者相關社會資源資訊，並提供各種安置計畫供主要照顧者 選擇。
英文摘要
This cross-sectional study, the purpose were to exploring the related factors of needs and met-needs levels of psychotic patients’ caregivers This study
investigated psychotic patients’ caregivers from three psychiatric center.
From March to June 2003. 300 participating were random selected from outpatient department and inpatient unit. Structured questionnaires were written by
themselves, a total of 300 questionnaires were distributed with 151 questionnaires
being returned. The response rate was 50.3%. Descriptive statistics, T-test,ANOVA, Tukey Post hoc Method, Pearson’s Product-Moment correlation, and multiple regression analysis were used in data analysis.
The results of the study showed: Needs and met-needs levels of psychotic patients’
caregivers were included four subscales: The needs of information support, instrumental support, Emotional support and feedback, participate the Patients care.The priority of needs of the four subscale were: participate the patients care, The needs of information support, instrumental support, Emotional support and feedback. The priority of met-needs level of the four subscale were: participate the patients care, emotional support and feedback, the needs of information support, instrumental support.
It was found significantly related to age,relation to patient of caregivers. The needs of information support were negative correlation between caregiver’s age and years from onset. Instrumental support were postive correlation to hospitalization .The variance of personal characteristics accounted for by related factors were 8%.The met-needs of information support were postive correlation between caregiver’s age and assisted from healthcare members. The met-needs of participate the patients care were postive correlation to assisted from healthcare members. The met-needs of emotional support and feedback were postive correlation between burden of caregiver’s and assisted from healthcare members. The met-needs of instrumental support were postive correlation between caregiver’s age and assisted from healthcare members. The variance of personal characteristics and burden of caregiver’s accounted for by related factors were 19%.
Based on the findings, there are four suggestions:
1. Increase work training unit by encourage business investment.
2. Provide various psycho-educations under caregiver’s age, relation between patient and caregivers, years from onset, and hospitalization.
3. Patients disposition plan be placed to care plan.
4. Providing welfare resource information to caregivers.
