加護病房主要家屬照顧者壓力感受、睡眠障礙及疲倦之探討

Exploring Stress, Sleep Disturbances, and Fatigue Among Primary Family Caregivers in the ICU

背景：加護病房主要家屬照顧者因病人住院承受壓力，而有睡眠障礙及疲倦等與壓力相關症狀出現，進而引發負面健康問題，直接或間接地影響病人照護及相關決策。目的：探討加護病房主要家屬照顧者在病人第一次入住加護病房初期的壓力、睡眠障礙及疲倦嚴重度，並了解其影響因素及預測因子。方法：為一描述相關性研究，以Lazarus及Folkman的壓力評估因應理論為基礎，運用事件衝擊量表－修訂版、睡眠困擾通性量表、李氏疲倦量表及社會支持量表進行72位初次入住加護病房主要家屬照顧者資料收集，變項採描述性統計及階層複迴歸分析。結果：加護病房主要家屬照顧者有高壓力感受、睡眠品質不佳及疲倦問題，但有相當高的社會支持度。壓力感受與睡眠障礙及疲倦呈正相關，壓力感受高者傾向找尋幫忙，其協助需求也越高。加護病房主要家屬照顧者之年齡及壓力感受是睡眠障礙的預測因子，而疲倦的預測因子僅為壓力感受。結論／實務應用：未來需持續探討加護病房主要家屬照顧者壓力源及不同時期的身心感受，協助了解其需求，發展照護措施以降低壓力感受，進而改善睡眠品質及疲倦等壓力相關症狀。 Background: Primary family caregivers (PFCs) in the intensive care unit (ICU) experienced stress and stress-related symptoms such as sleep disturbances and fatigue. These symptoms may cause physical and mental health problems and affect the quality of care that they provide to their care recipients. Purpose: This study explored the levels of severity of stress, sleep disturbances, and fatigue experienced by PFCs in the ICU in order to understand the associations and to explore the predictors and influencing factors in the period following the first ICU admission of their care recipients. Methods: This descriptive correlational study was based on Lazarus and Folkman's Stress-Coping theory. Four questionnaires including the Impact of Events Scale - Revised, General Sleep Disturbance Scale, Lee's Fatigue Scale, and the Norbeck Social Support Questionnaire were used to measure the psychological stress symptoms and social support received by 72 PFCs. Descriptive statistics and multiple hierarchical regression analysis were utilized for data analysis. Results: The participants suffered from high levels of event stress, poor sleep quality, and fatigue severity. However, they also received generally high levels of social support. Stress perception was found to positively associated with sleep disturbances and fatigue severity. The participants who experienced higher event stress sought additional assistance. The age and perceived event stress of PFCs were significant predictors of sleep disturbances, while perceived event stress was the only significant predictor of fatigue. Conclusions/Implications for Practice: This study provided healthcare professionals with important information to understand the psychological symptoms of PFCs. Future studies should identify the stressors of this caregiver group and explore their psychological symptoms during different hospitalization periods. Further interventions should be developed to help PFCs cope with stress and improve stress-related symptoms such as sleep quality and fatigue severity.