影響癌末病人主要照顧家屬正向與負向照顧經驗之因素探討

Predictors of Positive and Negative Caregiving Experiences Among Family Caregivers of Terminally III Cancer Patients

本研究利用次級資料分析，探討114對癌末患者與主要照顧家屬之基本特質與所提供的照顧，對照顧者之正、負向照顧經驗的影響。所收集的資料以描述性統計、單變項變異數分析、皮爾遜相關、複迴歸的統計方法進行資料處理，結果顯示：影響正向照顧經驗－自尊的因素有病人的生活品質、照顧者年齡、家庭經濟等；影響負向照顧經驗之因素－（1）時間安排之干擾的影響因素為照顧者的婚姻狀況、照顧時間、協助家事等，（2）影響健康的因素為病人或照顧者患有慢性病、家庭經濟等，（3）影響經濟的因素為病人之生活品質、照顧者的教育程度、家庭經濟等，（4）缺乏家人支持的影響因素為病人的症狀困擾、照顧者的教育程度等；各影響因素可解釋照顧經驗總變異量的百分比，依序分別為30.5%、24.7%、40.0%、67.7%、19.1%。本研究所得的照顧者之正、負向照顧經驗之影響因素，可協助臨床護理人員確認照顧者可能承受負向照顧經驗的高危險群，提供促進照顧者的正向照顧經驗、降低其負向照顧經驗之參考依據。A secondary data analysis study was conducted to identify factors associated with positive and negative caregiving experiences among family caregivers for terminally ill cancer patients. Convenience sampling was used to recruit 114 dyads of eligible subjects. Data were analyzed by one-way ANOVA, Pearson correlations, and multiple regression. Results indicated that: positive caregiving experiences (self-esteem) were predicted by family perceived quality of life of the patients, age, and the financial status of family caregivers. The extent of disrupted scheduling was predicted by caregivers' marital status, the amount of hours spent in providing care to the patients, and the amount of assistance needed in homemaking. Loss of physical strength was predicted by the existence of comorbidity for both patients and caregivers, and family financial status. Financial problems were predicted by the family's perceived quality of life for the patient, caregiver educational levels, and family financial status. Lack of family support was predicted by patients' symptom distress and caregivers' educational status. The total variance could be explained by the fact that the identified predictors for each domain of caregiver experience, in the order given above, was 30.5%、24.7%、40.0%、67.7%、and 19.1%, respectively. The findings of this study provide guidance to clinical nurses to recognize risk factors of negative caregiving experiences and highlight the directions for development of effective program for facilitating positive caregiving experiences for family caregivers of cancer patients.