影響居家護理個案之照顧者對居家醫療整合照護使用意願之探討－以北部某區域醫院附設某居家護理所為例

Caregivers' willingness to use integrated medical care in regional hospital in northern Taiwan

目的：探討北部某區域醫院附設居家護理所之個案，影響參加居家醫療服務的相關因素。方法：橫斷性研究設計，使用Andersen所提出醫療利用性模式為架構，於2021年9至10月對居家護理個案主要決策之照顧者共91位進行結構式問卷，內容為：被照顧者及照顧者基本資料、居家醫療整合照護認知、照顧者知覺量表、照顧者負荷量表。統計方法為描述性統計、t檢定、Anova檢定、卡方檢定、皮爾森積差相關分析與多元邏輯斯迴歸分析。結果：不同的固定就醫場所與參加居家醫療呈統計上顯著差異。照顧者壓力生理負荷對壓力心理與社會負荷有高度正相關，壓力財務負荷對壓力生理、心理與社會負荷有中度正相關，壓力心理負荷與壓力社會負荷有高度正相關。影響居家醫療整合照護之預測因子為固定就醫場所。結論：本研究結果促使因素中個案有固定就醫場所，參加居家醫療整合照護服務達顯著相關。有無固定的就醫場所是消費者對組織易接近或熟悉的地方，常被用來預測醫療服務利用度的高低，有固定就醫地點、醫師，能有連續性及協調性的照護。

 

Objective: To investigate a case of a home care center attached to regional hos-pital in northern Taiwan, and to explore the relevant factors affecting participation in home medical integrated care. Methods: Using cross-sectional study design, a struc-tured questionnaire was administered to 91 caregivers who were the primary decision makers in home care cases from September 2021 to October 2021 using the model proposed by Andersen as a framework, with the following content: basic information about the care recipient and caregiver, home health integrated care perception, care-giver perception scale, caregiver burden scale. The statistical methods were descriptive statistics, t-test, ANOVA, chi-square, Pearson’s product correlation analysis, and multivariate logistic regression analysis. Results: Statistically significant differences were found between different fixed health care settings and participation in integrated home health care. Caregivers stress physiological load was highly positively correlated with stress psychological and social load, stress economic load was moderately positively correlated with stress physiological, psychological and social load, and stress psychological load was highly positively correlated with stress social load. The predictor of integrated home medical care is the fixed location. Conclusion: The re-sults of this study showed that there was a significant correlation between the pres-ence of a fixed medical site and the participation of home medical integrated care. The availability of a fixed health care site is a site that is familiar to consumers and is often used to predict the level of health care utilization. The presence of a regular home medical integrated care.