思覺失調症病患之主要照顧者復原力與健康狀態之探討

The Resilience and Health Status of Primary Caregivers of Schizophrenia Patients

背景：復原力對健康具有正面影響力，但國內對思覺失調症病患的主要照顧者復原力與健康狀態之研究仍付之闕如。目的：探討思覺失調症病患的主要照顧者復原力與健康狀態之相關性。方法：採橫斷性相關性研究設計，於北部某醫學中心精神科病房收案共有思覺失調症病患其主要照顧者70名參與本研究，以「基本屬性問卷」、「生活品質量表」、「情緒自評量表」、「生命凝聚感量表」收集資料，以SPSS 17.0及SAS 9.2軟體進行統計分析。結果：(1)生活品質量表平均值67.46（SD = 17.74），輕度至極重度憂鬱者佔18.6%，輕度至極重度焦慮者佔17.1%，輕度至極重度壓力者10%。(2)主要照顧者照顧時間越長者其生活品質較差；主要照顧者本身有疾病者，其生活品質及復原力較差；病患住院天數越長，主要照顧者焦慮程度較低。(3)病患暴力或自傷次數越多，主要照顧者復原力及生活品質越差。(4)復原力為主要照顧者基本屬性與生活品質的中介因子。(5)主要照顧者復原力能預測生活品質及焦慮、憂鬱以及壓力。結論：本研究可增進專業人員對思覺失調症病患主要照顧者復原力與健康狀態的了解，以發展復原力為核心目標的精神心理衛生護理照護模式之參考。

Background: Resilience has been shown to have a positive effect on health status. However, little research has been conducted on the impact of resilience on the health of primary caregivers of schizophrenia patients. Purpose: This study investigated the correlations between resilience and the health status of caregivers of schizophrenia patients. Method: A cross-sectional, descriptive research design was used. Data collection was conducted using a set of questionnaires that included a demographic datasheet, the SOC-13 (Sense of Coherence), the DASS-21 (Depression Anxiety Stress Scales), and the SF-36 (short form). Seventy caregivers of schizophrenia patients were enrolled as participants at the psychiatric inpatient department of a medical center. SPSS 17.0 and SAS.9.2 statistical software packages were used to conduct descriptive analysis, the Sobel test, and Tobit model analysis. Results: (1) The mean QOL (quality of life) scale score was 67.46 (SD=17.74). Nearly one-fifth (18.6%) of caregivers were classified in the low to high depression range; 17.1% were classified in the low to high anxiety level; and 10% were classified in low to high stress level. (2) Duration of the caring period correlated negatively with caregiver QOL; having a concomitant disease significantly impacted QOL and resilience; and number of patient hospitalization days correlated negatively with level of caregiver anxiety. (3) The numbers of incidents of patient violence and patient suicide attempts correlated negatively with caregiver resilience and QOL. (4) Resilience was a mediator between caregiver demographic data and QOL. (5) Caregiver resilience was a predictor of QOL, depression, anxiety, and stress. Conclusion: The findings of the present study increase our understanding of the impact of resilience on the health status of caregivers of schizophrenia patients. The authors hope these finding may be referenced in the development of resilience-based nursing caring models in the future.