精神分裂症患者主要照顧者照顧負荷及其相關因素初探

A Research to Investigate the Relatives Factors of Burden in Schizophrenia Caregivers

本文研究設計採橫斷式結構問卷調查，以立意取樣方式進行分析以驗證研究的目的與假設，研究工具內容包含基本資料表及「照顧者負荷量表」。於2011年6月至10月期間，針對高屏地區社區精神分裂症患者之主要照顧者共收取有效樣本116人。研究結果顯示：研究對象照顧負荷總平均得分為28.43（標準差 =10.12），最低得分為13，最高得分為54，屬中度負荷。在迴歸模式中獲選解釋變項有「自覺個人健康狀況」、「每週社交活動頻率」、「與患者關係」及「家庭結構」，可預測照顧負荷的總變異量為36.81%，表示此四項因素為精神分裂症患者主要照顧者照顧負荷之重要預測因子；在「自覺個人健康狀況」方面，個人自覺健康「尚可」者與「好」者在照顧負荷上較「差」者平均減輕4.73分(P=.020)與3.84分(P=.046)，顯示主要照顧者自覺個人健康愈好，則照顧負荷愈輕。在「每週社交活動頻率」方面，每週社交3次以上者比每週無社交活動者平均少了5.82分(p=0.003 )，顯示主要照顧者若仍能參與社交活動且每週達3次以上者，其相對應遭受之照顧負荷便會愈覺輕鬆。在「與患者關係」方面，主要照顧者為手足者較為配偶、為父母或為子女者都分別低了9.87分(p<.001)、10.91分(p<0.001)與8.20分(p=0.009)，顯示主要照顧者與病患關係是手足者，其感受之照顧負荷最為輕鬆。在「家庭結構」方面，三代同堂與單親家庭分別比大家庭高出5.05分(p=0.016)及9.06分(p<0.001)，顯示主要照顧者若為單親家庭或三代同堂，則照顧負荷感受較重，若為大家庭結構由於家庭人數較多，較能減輕或分擔主要照顧者的照顧負荷。期望研究結果可提供醫療照護人員擬定適當或相關的健康照護措施，以減輕其主要照顧者的照顧負荷，並促使相關健康福利政策等社會資源建立，讓精神病患能真正回歸社區，減緩家庭和社會的問題，並減少未來的健康醫療照護成本。

All valid samples, the 116 Schizophrenia Caregivers, were selected by using questionnaires from June, 2011 to October, 2011 in Kaohsiung and Pingtung area. The cross-sectional study design was used to explore the related factors of burden in schizophrenia caregivers by collecting the questionnaires. The questionnaires included demographic characteristics and Caregiver’s Burden Scales. The results showed that the range of the total score from primary caregivers in Caregiver’s Burden Scales was from 13 to 54 points, and their mean (sd) was 28.43 (10.12) points and was regarded as moderate burden. Moreover, according to the regression analysis, four factors (Self-perceived Health Status, Frequency of Social Activity in weekly, Relationship between Patient and Caregiver, and Family Structure) were considered into the model and its total variance explained reached 36.81%. In Self-perceived Health Status factor, we found the total score of care burden of caregivers in normal or well status could be reduced by 4.73 points (p=.020) or 3.84 points (p=.046) by comparing to the caregivers in ill status, and both of them were statistically significant. In Frequency of Social Activity in weekly factor, we found the total score of care burden of caregivers with 3 times (and more than 3 times) social activity in weekly be reduced by 5.82 points (p=.003) by comparing to the caregivers without social activity, and it was statistically significant. In Relationship between Patient and Caregiver factor, we compared couples, parents or issues to sibs for care burden of caregivers, and they could be reduced by 9.87 points (p<.001), 10.91 points (p<.001)or 8.20 points (p=.009), and all of them were statistically significant. In Family Structure factor, we found the total score of care burden of caregivers in stem family or single parent family could be arise up 5.05 points (p=.016) or 9.06 points (p<.001) by comparing to the caregivers in extended family, and both of them were statistically significant. Finally, we hope this study can be used to frame appropriate precaution for the medical career during the caring time in the future. Besides, it can help to build up the relative health social welfare, to help the schizophrenia returning to the community, to ease off the problems between family and society, and to reduce the cost of health-medical caring in the future.