癌症病人主要照顧者疲憊與睡眠障礙之關係──以榮民身分為調節變項

The Moderating Effect of Veteran Status on the Relationship Between Fatigue and Sleep Disturbance in Primary Caregivers of Patients With Cancer

背景：疲憊是睡眠障礙主要原因之一，癌症病人主要照顧者易有疲憊感，進而導致睡眠障礙問題；健康欠佳的榮民長者常有負向情緒，使罹癌榮民照顧更具挑戰。
目的：探討以病人榮民身分為調節變項對主要照顧者疲憊與睡眠障礙相關性之影響。
方法：橫斷式研究設計，隨機抽樣北區某三家醫院共127位癌症病人主要照顧者為研究對象；問卷內容包括癌症病人及主要照顧者人口學之基本資料、台灣版簡明疲憊量表及中文版匹茲堡睡眠品質量表。以描述性統計、獨立t檢定、單因子變異數分析、皮爾森積差相關分析及階層迴歸分析進行資料分析。
結果：主要照顧者疲憊與睡眠品質障礙呈顯著正相關（r = .632, p < .01），且疲憊對睡眠障礙有正向影響（β= .472, p < .001）。迴歸分析顯示榮民病人身分會正向調節主要照顧者疲憊感與睡眠障礙之間的關係，其正向調節解釋力（b = .148, p < .001）高於一般民眾病人身分者（b = .091, p < .001）。
結論／實務應用：罹癌病人具榮民身分為影響主要照顧者疲憊與睡眠障礙關聯性之調節變項，護理人員給予病人護理照護的同時，應加強評估主要照顧者的疲憊狀況，提供適當的資源協助。

Background: Fatigue may lead to disordered sleep. Primary caregivers of patients with cancer may suffer from higher levels of disordered sleep because of care-related fatigue. Older-adult veterans with cancer tend to be emotionally negative, which increases the challenges of care.
Purpose: This study was designed to investigate the veteran status of patients as a possible moderator in the relationship between fatigue and disordered sleep in primary caregivers.
Methods: In this cross-sectional study, 127 primary caregivers of patients with cancer were randomly recruited from three hospitals in northern Taiwan. Data were collected using a demographics datasheet, the Taiwanese version of the Brief Fatigue Inventory, and the Chinese version of the Pittsburgh Sleep Quality Index. Descriptive statistics, independent t-tests, one-way ANOVA, Pearson correlation analyses, and hierarchical regression analyses were used to analyze the obtained data.
Results: Fatigue in the participants was shown to correlate significantly and positively with their sleep quality (r = .632, p < .01), with fatigue found to affect sleep quality positively (β= .472, p < .001). The regression analyses showed the explanatory power of fatigue on sleep disorders (b = .148, p < .001) to be higher in caregivers of veteran patients than in caregivers of non-veteran patients (b = .091, p < .001).
Conclusions/ Implications for practice: Veteran patient status may moderate the relationship between fatigue and disordered sleep in primary caregivers. Nurses should assess caregiver fatigue status and offer appropriate resources.