腦瘤手術前病人的主要照顧者之照護需求及相關因素之探討

Exploring the Care Needs of Primary Caregivers of Patients Awaiting Brain Tumor Surgery and Related Factors

背景：腦瘤主要照顧者在面對病人疾病的不確定性與必須調整自己的生活以照顧病人，可能出現焦慮及憂鬱，進而產生更高的照護需求。目的：探討腦瘤病人在接受手術前之主要照顧者照護需求及其相關因素。方法　採相關性研究設計，以方便取樣招募80位腦瘤病人及其主要照顧者進行問卷填答，於病人在被診斷為腦瘤並等待手術前，以支持性照護需求量表—照顧者45及醫院焦慮憂鬱量表進行資料收集。以描述性統計及推論性統計法進行資料分析。結果　本研究發現在主要照顧者照護需求方面，以訊息需求與健康照護服務需求二層面之需求最高。較高的焦慮感受（r = .37, p ＜ .01）及憂鬱狀態（r = .27, p ＜ .05）與較高的照護需求有關，此外，病人的身體功能狀態愈差時，主要照顧者較容易有憂鬱狀態，而「焦慮感受」為照護需求的最重要之預測因子（R2 = 12.8%）。結論　臨床醫護人員於病人被診斷出腦瘤在等待手術前，即應開始進行與疾病及照護有關之衛教，有助於主要照顧者減輕其焦慮及憂鬱，進而降低其照護需求。

Background: The prognosis of patients with brain tumor diagnoses is often uncertain. Therefore, the primary caregivers of these patients must not only adjust their lives to patient care but also often deal with patient anxiety and depression, which may significantly increase patient-care needs. Purpose: The present study explores the care needs of primary caregivers of patients awaiting brain tumor surgery and the factors that are associated with these needs. Methods: A correlational research design was used. Convenience sampling was used to recruit 80 pre-brain-tumor operation patient / caregiver pairs. Data were collected using a questionnaire survey, which included Supportive Care Needs Survey-Partners & Caregivers 45 (SCNS-P&C45) and the Hospital Anxiety and Depression Scales (HADS). Descriptive and inferential statistics were used for data analysis. Results: The information-needs and healthcare-service-needs subscales earned the highest subscale scores on the SCNS-P&C45. Higher anxiety perception (r = .37, p ＜ .01) and higher depression status (r = .27, p ＜ .05) were significantly correlated with increased care needs. In addition, decreased patient functional status was significantly associated with increased depression in the primary caregiver. Anxiety perception was the only significant predictor of care needs that was identified (R^2 = 12.8%). Conclusions: Healthcare providers should provide patient education on the disease and disease-related care information soon after a diagnosis of brain tumor in order to decrease the anxiety and depression perceptions of caregivers and to reduce the care needs of caregivers.