臺灣長期仰賴氧氣治療孩童的主要照顧者之壓力探討

因為長期仰賴氧氣治療的孩童在人口中的比例已有逐年增加的趨勢，疾病是無法治癒而且仰賴氧氣治療是必須的，所以造成主要照顧者在照顧孩童過程中無比壓力。故本研究目的是為探討長期仰賴氧氣治療孩童的主要照顧者在照顧孩童過程中的壓力情形。採橫斷式描述性相關研究設計，以立意取樣的方式，收集台北地區某醫學中心兒科門診、耳鼻喉科門診、兒科病房、大台北地區居家護理所及歡呼兒基金會中的孩童之主要照顧者共104 位（共76 個家庭），且使用結構式問卷方式收集資料。問卷包含基本資料部份：主要照顧者個人基本資料及孩童個人基本資料，及主要照顧者壓力感受量表；量表內容包含：家庭功能面臨衝擊、主要照顧者本身方面及孩童身體症狀。在壓力類別方面至少有三種，主要照顧者均以「家庭功能面臨衝擊」壓力感受分數最高，而主要照顧者感受壓力次高為「孩童身體症狀」，最後則以「主要照顧者本身方面」之壓力分數最低。在壓力預測方面，孩童身體症狀的壓力，主要照顧者以「家庭經濟狀況」（家庭收入4 萬/月以上>家庭收入未滿4 萬/月）為重要的解釋因子。家庭功能面臨衝擊的壓力及整體主要照顧者壓力，主要照顧者以「自認健康狀況」（自認健康狀差>自認健康普通/好）為重要的解釋因子。孩童身體症狀的壓力，孩童以「年齡」（5 歲以下>其他年齡層）為重要的解釋因子。家庭功能面臨衝擊的壓力，孩童以「性別」（男>女）及「年齡」為重要的解釋因子。主要照顧者本身的壓力感受，孩童以「性別」、「用氧時間」（10 小時以上>未滿10 小時）及「總費用」（總費用高）為重要的解釋因子。整體主要照顧者壓力，孩童以「性別」、「用氧時間」、「年齡」及「總費用」為重要的解釋因子。長期仰賴氧氣孩童之主要照顧者具有上述三種壓力，本研究可使醫療專業人員重視且深入瞭解主要照顧者的壓力感受，進而給予醫療團隊的協助來照護其孩童與主要照顧者，即幫助其家庭尋求有效的資源與支持，以提升居家生活品質。

There has been an increase in the prevalence of children chronically depending on oxygen therapy. For these children, the burden of care at home can be overwhelming for their primary caregivers. There was a lack of research examining the stress of family caregivers of an oxygen-dependent child in Taiwan. The aim of this cross-sectional descriptive study was to examine the stress of the primary caregivers with children who depended on long-term oxygen therapy. One hundred and four subjects were recruited from two settings: 1. the pediatric otolaryngologic outpatient clinic and the pediatric ward of a tertiary medical center in Taipei; and 2. "The Association of Let-Children-Breathing Happily". The results indicated that within the domain of stress, "Disruption in family function" was scored the highest in the level of stress experienced by the subjects, and subsequently followed by the stress of dealing with the adverse physical symptoms of the oxygen-dependent children at home. In addition, the lowest level of stress expressed was related to their own physical problems experienced. There were several predictors of caregivers' stress including the type of occupation, marital status and economic status. Furthermore, predictors such as the child's age, occupations, education levels, and self-perceived health status, were related to the stress in dealing with the adverse physical symptoms of the oxygen-dependent children at home. The implications of this study were to increase health care professionals' understanding of caregivers' stress in taking care of oxygen-dependent children such that appropriate support resources can be integrated and tailored to the needs of individual families.