轉移性癌症病患之居家主要照顧者的照顧負荷及其影響因素

The Caregiving Burden and Related Factors of Primary Caregivers of Metastatic Cancer Patients at Home

本研究旨在探討轉移性癌症病患出院後四週內，其居家主要照顧者之照顧負荷變化情形，以及壓力性照顧負荷之盛行率，同時瞭解影響照顧負荷的重要變項（包括病患、照顧者及居家照顧之特性等因素）。採縱貫式相關設計調查法，在某醫學中心之癌症病房，以立意取樣41位癌症轉移病患之居家主要照顧者為研究對象，分別於病患出院時(T0)及出院後第一週(T1)、第二週(T2)及第四週(T3)追蹤調查其研究變項的變化。研究發現，若不考慮其他因素，出院後四週內(T1-T3)照顧者之照顧負荷較出院前(T0)有顯著下降，而43.9%的照顧者於出院時出現壓力性照顧負荷，而出院後不同時間點出現壓力性照顧負荷之百分比則為24.0%～30.0%。分析影響照顧負荷的因素則發現病患之疾病症狀嚴重程度、功能狀態、照顧者年齡、照顧者之工作及月收入改變情形、照顧者擔任照顧工作的時間長短及每天照顧病患之時數等與主要照顧者的照顧負荷呈顯著相關。本研究結果提供臨床護理人員在協助癌症病人之家庭照顧者的一個實證基礎。

The purposes of this study were to describe how caregiver's burden changed during the first 4 weeks after a loved one with cancer was discharged from the hospital; to evaluate the prevalence of stressful burden in the caregivers; and to examine the important factors influencing caregiver's burden, such as patient, caregiver, and at-home care related characteristics. A longitudinal correlation survey was used to collect data from a convenience sampling of 41 caregivers who cared for cancer patients discharged to home from a medical center in northern Taiwan. Data were collected at the time of the patient's discharge from hospital (T0) and 1, 2, and 4 weeks post-discharge (T1-T3). Results showed that the caregiver's burden scores at T0 were higher than T1 through T3 without adjusting other covariates. The prevalence rates for stressful burden were 43.9% at T0 and 24.0%-30.0% at T1-T3. The following factors were significantly associated with caregiver's burden: the symptom severity and functional status of the patient; the age, the change of occupation, and the income of caregiver; the length of being a caregiver; and hours of daily care by the caregiver. The findings of this study provide clinical nurses with empirical basis while helping family caregivers of cancer patients.