頭部創傷病人家庭照顧者之照護經驗

Experiences of Family Caregivers of Patients with Traumatic Brain Injury

目的：
頭部創傷不僅改變病人生心理狀態，後續長期照護更需耗費相當的人力、物力以及金錢，對家庭與社會影響甚鉅。本研究旨在探討中、重度頭部創傷家庭照顧者的照護經驗。
方法：
本研究採質性研究設計，以立意取樣選取台灣中部某醫學中心，中、重度頭部創傷病人出院返家照顧、且達六個月以上之主要家庭照顧者為受訪者，使用半結構式訪談指引，於2020年8月9日至2021年2月22日進行訪談與資料收集。於2020年8月11日至2021年6月7日以內容分析法進行資料分析。最後共有七位家庭照顧者完成訪談並達資料飽和。
結果：
萃取出三大主題以及十項類屬，分別為：主題一、跟著現狀繞圈：其類屬為「茫然」、「來回奔波」、「不懂如何照顧」；主題二、陷入困境：類屬有「對抗」、「艱辛的照顧任務」、「睡眠不足」；主題三、復原力展現：包含「幽默」、「自我調適」、「選擇相信」以及「感激」等類屬。
結論：
研究結果顯示頭部創傷家庭照顧者在照護過程中面臨照顧任務的困難，以及如何藉由本身的復原力渡過艱難歷程。醫療人員應該充分了解當生活中發生重大事件、個人遭遇逆境時，復原力是個體擁有的重要心理社會資源，必須將家庭照顧者納入診療計畫並透過心理健康促進方案培養復原力，避免照顧者成為隱形的病人，使家庭順利渡過難關，回復穩定的生活。

Purposes:
Traumatic brain injury changes the patient’s physiological and psychological state, and subsequent care requires considerable manpower, material, and financial resources, significantly impacting families and society. The objective of this study is to explore the experiences of family caregivers in caring for patients with moderate to severe traumatic brain injury.
Methods:
A qualitative study design using purposive sampling was used. The family caregivers of patients with moderate to severe traumatic brain injury who had been discharged from amedical center in central Taiwan at least six months were interviewed. Semi-structured interviews were used for data collection. Interviews and data collection were conducted from August 9, 2020, to February 22, 2021. Content analysis was carried out from August 11, 2020, to June 7, 2021. Seven family caregivers completed the interviews, and data saturation was reached.
Results:
Three major themes and ten categories were extracted from the data: The first theme,“going around in circles in the current situation,”comprised three categories: at aloss, running around, and not knowing how to care for patients. The second theme,“being in adilemma,”included antagonism, tough care tasks, and lack of sleep. The third theme,“displaying resilience,”included categories such as humor, self-adjustment, choosing to believe, and gratitude.
Conclusions:
The results show the difficulties faced by family caregivers of traumatic brain injury patients and how they must be resilient to overcome this tough journey. Healthcare professionals should understand that resilience is an important psychosocial resource for individuals who encounter amajor life event and adversity. Family caregivers must be included in the treatment plan, and mental health promotion programs should be used to cultivate resilience. This will allow families to overcome difficulties and resume astable life.