影響失智症家庭照顧者其照顧酬賞與照顧品質的相關因素之探討

Influencing factors of Caregiving Rewards and Quality of Care for Family Caregivers of Patients with Dementia

本篇研究在探討家庭照顧者在照顧失智症患者的互動過程中照顧酬賞及照顧品質之相關性。本研究屬二次資料分析，為描述性相關性研究，採橫斷性調查研究法，以立意取樣方式針對台灣北部地區某醫學中心之神經內科門診追蹤之失智症患者其主要照顧者共176對。研究工具係採用Archbold and Stewart所發展的照顧者之照顧酬賞量表及徐氏發展的家庭照顧品質量表。結果顯示：照顧者在整體照顧酬賞感受屬中等程度，整體照顧品質得分屬中上程度。預測整體照顧品質較佳的因素為照顧者無宗教信仰者、家中無18歲以下兒童同住者、自覺精神生活層次較高者以及整體照顧酬賞感受愈強者，可解釋的變異量為34.3％，在人口學變項受到控制後，「整體照顧酬賞」對「整體家庭照顧品質」可解釋的變異量為12.7％。研究結果有助於臨床或社區護理人員提供個別性及適切性護理措施的依據，進而增進家庭照顧者有較佳的照顧酬賞感受並提昇家庭整體照顧品質。

The purpose of this study was to explore factors related to caregiving rewards and quality of care for family caregivers of patients with dementia using a secondary analysis. A descriptive cross-sectional design with purposive sampling was used in this study. One hundred and seventy-six dyads of elderly persons with dementia and their family caregivers from the neurological clinics at a medical center in the northern Taiwan were recruited in this study. Instruments were structured questionnaires, including a Rewards of Caregiving scale developed by Archbold and Stewart and a Quality of Family Care scale developed by Shyu. Results of this study indicated that family caregivers had moderate level of “Caregiving Rewards”. Family caregivers of this sample had moderate to high level of “Quality of Family Care”. Family caregivers without religions, without children under 18 years old in household, with higher spiritual level, and with higher levels of caregiving rewards predicted better quality of family care. These variables accounted for 34.3% of the variances in overall quality of family care. After controlling for the demographic variables, “Caregiving Rewards” was able to explain 12.7% of the variance uniquely in overall “Quality of Family Care”. The results of this study may provide guidance to develop individualized and appropriate nursing interventions to facilitate family caregiving rewards and overall quality of family care.