復健期燒傷病患照顧者壓力感受、社會支持及其相關因素

Factors Associated with Stress and Social Support for Caregivers of Burn Patients During the Stage of Rehabilitation

燒傷造成病患身心煎熬甚鉅，居家復健期間主要照顧者壓力感受強度及社會支持足夠與否，攸關燒傷病患復健期的照護品質。國外有關此方面的研究相當少見，國內尚缺乏文獻探討。本研究目的在探討復健期燒傷病患主要照顧者壓力感受、社會支持及其相關因素。研究採描述性橫斷式調查法，以立意取樣方式，收取兩所醫學中心燒傷病房，二年內出院之135位病患主要照顧者為研究對象，研究工具包括壓力感受及社會支持量表。結果發現照顧者呈現中度壓力感受，對病患身體症狀的壓力最高，尤其疤痕增厚、癢及疼痛是最困擾的事項。社會支持需要程度及足夠程度尚可，但其協助程度略偏不足。從逐步回歸分析中發現，對照顧者壓力感受最具預測力的變項是社會支持需要程度、家庭每月收入、病患活動功能、病患燒傷面積及協助家屬人數，可解釋全部變異量的57% ；整體壓力感受、病患燒傷面積分別影響照顧者社會支持的需要程度、協助程度及足夠情形。本研究結果，有助於了解燒傷病患主要照顧者在居家照護期間的壓力感受及社會支持需求，提供出院衛教及醫療照護之參考。

Burn patients undergo tremendous physical and mental stress. The stress and social support of caregivers of these patients has a great impact on the quality of patient care. Little study has been done in this area. The purpose of this study was to investigate the stress and social support of caregivers for burn patients during the rehabilitation stage as well as to determine the factors affecting them. This was a descriptive and cross-sectional study. The subjects included 135 primary caregivers of burn patients discharged from two medical center in Taipei. A stress and social support scale were used to collect data. We found that caregivers of burn patients perceived medium-degree stress. The highest stress came from “burn symptoms”, including hypertrophic scar, itch, and pain. These caregivers had a fair needs and satisfaction level of social support. Nevertheless, the social support they received was poor. Needed degree of social support, family income, degree of activity of the patients, total affected body area, and number of family member assisting the patients were significant predictors of stress of these caregivers. By stepwise regression analysis, these five predictors explained 57% of the total variance in perceived stress. The needs level, help level and satisfaction level of social support of burn patient's caregivers were influenced by stress and total affected body area. This study may help health personnel to understand the stress and the social support needed for caregivers of burn patients during home care. It can be used as a reference for organizing discharge plan and provide better support for caregivers of burn patients.