失能個案主要照顧者照顧負荷及健康狀況之論述

Discussion on the Care Burden and Health Status of Primary Caregivers of Disabled Patients

台灣於2025年正式邁入超高齡社會，長照需求持續攀升，特別是重度居家醫療失能個案，對主要照顧者帶來極大挑戰。本研究透過文獻回顧，系統性分析重度居家醫療個案主要照顧者的照顧負荷、健康狀況及其影響因素。結果顯示，照顧者負荷涵蓋生、心、社會及經濟等多重層面，並受照顧者失能程度、疾病類型、照顧者個人特質、家庭支持與社會資源等因素交互影響。
長期高壓照護情境下，照顧者易出現憂鬱、睡眠障礙等健康問題，進而影響照護品質，目前國內外發展多項評估工具，如主要照顧者負荷量表、家庭照顧者壓力量表、簡式健康量表（BSRS-5）、一般健康問卷（GHQ-12）等，協助評估照顧者負荷與健康狀態。
然而，現行健保及長照政策對照顧者的支持與資源連結仍有不足，建議政府與長照相關單位應加強對照顧者身心健康的關注，推動定期健康篩檢與壓力調適課程，並擴大長照服務資源與社區支持網絡。未來研究可結合質性與量化方法，深入探討不同族群的需求，共同提升照顧者健康與照護品質。

Taiwan officially became a super-aged society in 2025, with a continuous increase in the demand for long-term care, especially for severely disabled patients receiving home-based medical care. This growing need places significant challenges on primary caregivers. Through a literature review, this study systematically analyzes the caregiving burden, health status, and influencing factors of primary caregivers of severely disabled home care patients. Results show that caregiver burden spans multiple dimensions—physical, psychological, social, and economic—and is influenced by the level of patient disability, illness, caregiver characteristics, family support, and available social resources.
Under long-term high-pressure caregiving conditions, caregivers are prone to developing health issues such as depression and sleep disturbances, which in turn affect the quality of care. Currently, several assessment tools have been developed domestically and internationally, including the Caregiver Burden Inventory, Family Caregiver Stress Scale, Brief Symptom Rating Scale (BSRS-5), and the 12-item General Health Questionnaire (GHQ-12), to help evaluate caregiver burden and health status.
However, Taiwan’s current National Health Insurance and long-term care systems provide insufficient support and resource linkage for caregivers. It is recommended that the government and relevant Long-term care policy institutions strengthen their focus on caregivers' physical and mental health by promoting regular health screenings and stress management programs, and by expanding longterm care services and community support networks. Future research should integrate both qualitative and quantitative methods to explore the needs of different caregiver populations and improve caregiver well-being and care quality.