思覺失調症主要照顧者照護患者經歷旋轉門效應之心路歷程

The Journey of Primary Caregiver Providing Care for Schizophrenia Patients Through the Revolving Door Phenomenon

近年來，思覺失調症主要照顧者的議題逐漸受到關注和研究，然而卻少有研究主要照顧者如何面對患者的旋轉門效應。本研究為個案報告，目的為了解思覺失調症主要照顧者經歷旋轉門效應的歷程，如想法及感受等。研究採用半結構式訪談，將旋轉門效應分為住院前、住院時、出院後及再住院等四階段進行探討。研究對象為經精神科醫生診斷為思覺失調症、並於三個月內住院三次以上之患者主要照顧者。研究結果為主要照顧者在歷程中之感受及想法：（1）住院前：主要照顧者對患者生病這件事的焦慮也會延伸到對自己人生的看法，影響到人際、工作及健康；（2）住院時：主要照顧者聽聞患者住院感到放鬆，因有醫院分擔照顧重責；（3）出院後：主要照顧者因又必須獨自照顧患者感到壓力和憂鬱；（4）再住院：主要照顧者對患者反覆住院感受負面，如絕望及疲憊。研究結論為主要照顧者在此歷程中反覆經歷負向的經驗，來自親友、信仰和醫院團隊的心理支持對主要照顧者非常重要。研究貢獻為了解思覺失調症患者主要照顧者的照顧歷程，並了解心理支持對主要照顧者的重要性。建議未來能多探討照顧者心理支持的相關因素。

In recent years, the issues faced by primary caregivers of individuals with schizophrenia have gained increasing attention and research interest. However, few studies have explored how these caregivers cope with the revolving door phenomenon (RDP). This study was a case report, aims to understand the experiences, thoughts, and emotions of primary caregivers as they navigate the RDP. A semi-structured interview approach was adopted, with the questions covering four stages of RDP: pre-hospitalization, hospitalization, post-discharge, and rehospitalization. The subjects of the study were the primary caregivers of patients diagnosed with schizophrenia by a psychiatrist, who had been hospitalized at least three times within three months. The study found the following: (1) Pre-hospitalization: The anxiety over the patient’s illness extended to their own outlook on life, affecting interpersonal relationships, work, and health; (2) Hospitalization: The caregivers felt relief upon hearing that the patient had been admitted, as the hospital shared the heavy responsibility of care; (3) Post-discharge: The caregivers felt pressure and depression because they had to continue caring for the patient; (4) Rehospitalization: The caregivers felt negative emotions, such as despair and exhaustion, in response to the patient’s repeated hospitalizations. The study concluded that caregivers repeatedly experience negative emotions throughout this process, and psychological support from family, friends, and religion is extremely important for them. The contribution of this study is to understand the caregiving process for primary caregivers and the significance of psychological support. The study recommended that future research further explore factors related to psychological support for caregivers.