機構式喘息服務對失能老人主要照顧者負荷之影響

The Impact of Institutional Respite Care on the Burden of Caregivers of Disabled Elderly

目標：本研究旨在探討失能老人主要照顧者的負荷情形，並比較有無使用機構式喘息服務對失能老人之主要照顧者負荷的影響。方法：採個案對照法，以日常生活功能量表、工具性日常生活功能量表，及主要照顧者負荷量表，電話訪談100名接受機構式喘息服務之主要照顧者及100名沒有使用喘息服務之對照組，有關失能老人的失能狀況和對主要照顧者的負荷所造成的影響。結果：（一）二組主要照顧者之負荷均屬普通至輕度。（二）影響主要照顧者負荷之變項包括失能老人的性別以及主要照顧者的性別、婚姻狀況、身份別、工作狀況、家庭每月平均收入、經濟來源、自覺經濟狀態、社交生活受影響程度、自覺與失能老人關係、健康狀況、有無疾病等。（三）沒有使用喘息服務之主要照顧者的身體負荷顯著高於使用喘息服務之個案組。結論：機構式喘息服務可以有效減輕主要照顧者的身體負荷，促進正向的心理健康，重建個人社交生活。不過機構式喘息服務對失能老人以提供生活照顧居多，建議未來應該結合復健項目，促進失能老人維持與恢復部份獨立的功能項目，並提供主要照顧者相關照顧失能老人的諮商，以及轉介至社區式照顧。

The purposes of this study were to determine the burden of main caregiver of disabled elderly, and the impact of institutional respite care on the burden of caregivers. One hundred caregivers who utilized institutional respite care and 100 controls were recruited by convenience sampling. Data were collected by standardized telephone interview using Chinese version of ADL, IADL, and Caregiver Burden Index (CBI). The study results were as the following: 1. The burden of caregivers ranged from slight to fair in both groups. 2. Gender of disabled elderly and gender, marital status, job status, monthly family income, financial resource, affection of social relationship, perception of economic status, perception of relationship with disabled elderly, health status and disease status of caregivers were significantly associated with the burden of caregivers. 3.The score of physical burden in case group was statistically higher than that in the control groups. The institutional respite care seems to benefit caregivers of disabled elderly by decreasing physical burden, improving mental health, and rebuilding social lives. Since most of the institutional respite care provides daily care, this study suggested combining daily care with physical therapies to maintain or restore physical functions of elderly. Consultation services for caregivers and referral to community care units are also needed.