探討照顧管理服務成效與主要照顧者照顧負荷之相關性研究

Relationship of the Effectiveness of Care Management Services and Burdens of Primary Family Caregivers

背景：在台灣「長期照顧管理中心」是推動照顧管理制度的主要單位。照顧管理專員的角色，分擔家庭主要照顧者龐大的照顧責任，目前探討與照顧管理服務成效及照顧負荷有關的研究有限。目的：以照顧管理中心轉介至居家服務支援中心，接受居家服務的家庭主要照顧者之觀點，探討照顧管理中心及照顧管理專員的服務成效與照顧負荷之相關性。方法：採立意取樣方式，對接受居家服務的154位家庭主要照顧者，以電話訪談方式進行結構式問卷調查。結果：主要照顧者對照顧管理中心的「整體滿意度」最高；對照顧管理專員專業能力滿意度越高，身體功能負荷越輕。研究發現，主要照顧者心理、社會功能負荷與照顧管理中心整體滿意度，以及照顧管理專員服務品質滿意度皆具顯著相關性。結論：照顧管理專員的專業能力，可以減輕照顧者身體功能負荷，但無具體實證據顯示可以降低心理及社會負荷，這表示目前所施行照顧管理服務可以提升滿意度，卻不足以減輕心理及社會功能負荷，建議未來應落實密集性照顧管理，介入多元化的照顧服務模式與內涵，以滿足複雜且具個別性的照顧需求。

Background: In Taiwan, long-term care management centers hold primary responsibility for administering long-term care services, assisting with long-term care placements, and sharing the care burden with family caregivers in need. Research into the effectiveness of current care management services and the effectiveness of these services in reducing care burdens remains limited.Purpose: This study investigates the relationship among care management center service effectiveness, care management personnel, and burdens in relation to the provision of care services from the prospective of caregivers.Method: A purposive sampling method and structured questionnaire survey were used to conduct telephone interviews with 154 home caregivers who had been transferred from care management centers to homecare service centers.Results: Participants expressed overall satisfaction with care management centers and with the services provided by these centers. Satisfaction toward the care managers' professional competence was associated with lower physical burden for caregivers. Participants' psychological and social burdens were associated with overall satisfaction with the care management centers and their satisfaction with the services provided by care managers.Conclusions: The implementation of care management services has improved satisfaction. However, center services remain inadequate to reduce the psychological and social burdens of caregivers. Greater focus on these two aspects will be critical to the successful implementation of the proposed intensive care management model and multiple services intervention in order to meet the complex care needs of home service recipients and their primary caregivers.