加護病房病人之家屬照顧者疲憊感、不確定感及其相關因素探討

目的：探討加護病房病人之家屬照顧者的疲憊感、不確定感及其相關因素。方法：採橫斷式量性研究設計，自2020年12月至2021年04月以方便取樣選取北部某區域級教學醫院成人加護病房病人之家屬照顧者為研究對象，以基本資料表、疲憊量表及不確定感量表進行資料收集，有效問卷共81份，所得資料以SPSS 22.0版進行分析。結果：加護病房病人之家屬照顧者有中度的整體疲憊感及中度的生活活動功能干擾，尤其是在情緒、享受生活及正常工作等方面影響最鉅。是否需要照顧其他家人及自覺病人病情嚴重度為疲憊感的預測因子，可解釋總變異量23.8% (F =4.57, p < .001）。家屬照顧者有相當程度的不確定感，以不可預測構面最為嚴重，其次依序為模糊不清構面、缺乏澄清構面，缺乏資訊構面的不確定感最輕。家屬照顧者性別、教育程度及婚姻狀況為不確定感的預測因子，可解釋總變異量20.3% (F = 3.55, p = .002）。生活功能干擾嚴重度構面與不可預測構面及整體不確定感呈顯著正相關；而整體疲憊感與不可預測構面亦呈顯著正相關。結論：加護病房醫護人員應重視家屬照顧者疲憊及不確定的感受，在疫情期間可將衛教資訊上傳雲端，並利用線上會客及說明病情，以緩解家屬照顧者的疲憊及不確定感。期望本研究結果能作為醫護人員照護病人及家屬照顧者時之參考。

Purpose: The purpose of this study was to investigate the fatigue, uncertainty and related factors for family caregivers of intensive care unit (ICU) patients. Methods: By convenience sampling, a crosssectional quantitative designed survey was conducted with a total of 81 family caregivers in a regional teaching hospital in the northern Taiwan from December 2020 to April 2021. The demographic data form, Brief Fatigue Inventory and Parent Perception of Uncertainty Scale were used to collect data, and the SPSS 22.0 version was used to analyze data. Results: Family caregivers of ICU patients exhibited a moderate level of overall fatigue and moderate interference with their usual functioning, particularly in their emotions, enjoyment of life, and ability to work in their daily lives. Having to care for other family members and the perceived severity of patients’condition were predictive factors of fatigue perception, and the total explicable variance was 23.8% (F=4.57, p <.001). Family caregivers perceived a certain level of uncertainty, which was the highest in the unpredictability dimension, followed by the ambiguity and lack of clarity dimensions. They felt the least uncertain about the lack of information dimension. The sex, education level and marital status of family caregivers were predictive factors of uncertainty, and the total explicable variance was 20.3% (F=3.55, p=.002). The interference with usual functioning dimension of fatigue perception was significantly and positively correlated with the unpredictability dimension of uncertainty and the overall uncertainty. The overall fatigue perception was also significantly and positively correlated with the unpredictability dimension of uncertainty. Conclusion: The ICU medical staff should pay attention to family caregivers' feelings of fatigue and uncertainty. Health education information could be uploaded to the cloud, and online meetings and explanations of patient's condition could be used to relieve the fatigue and uncertainty of family caregivers during the epidemic. The results of this study were expected to be a reference for medical personnel to care ICU patients and their family caregivers.