出院二週內之居家失能病患其主要照顧者家庭功能與生活品質之研究

Relationship between Family Function and Quality of Life in Family Caregivers of Disabled Patients within the First Two Weeks Following Discharge

本研究目的在探討居家失能病患主要照顧者家庭功能與生活品質現況及其相關因素。研究採橫斷式調查法，以立意取樣選擇中部某醫學中心出院之居家失能病患及其主要照顧者各107位為對象，以訪員進行居家訪談收集資料。研究工具包括家庭功能量表及台灣簡明版世界衛生組織生活品質量表。結果顯示，80.4％病患為嚴重至完全依賴者；女性照顧者佔68.2％，約有23.4％照顧者自覺健康狀況變得不好，44％自覺照顧壓力沉重。整體家庭功能屬於中等偏好的程度，其中「責任分配」層面功能最高，其次為「問題解決能力」，「感情投入」最低。照顧者總生活品質屬於中等偏好之間，由高至低依次為「生理層面」、「社會關係層面」、「環境層面」、「心理層面」。此外，主要照顧者生活品質之重要預測變項為主要照顧者自覺經濟負荷、自覺照護壓力、自覺健康狀況、家庭功能及個案失能程度，其解釋力達59％。根據以上結果，有助於專業人員了解失能個案於出院後過渡期之家庭支持系統對主要照顧者生活品質良窳之影響，且能提供以家庭為中心、持續性照護為導向的出院計畫與居家照護之參考。建議照護團隊應再多關注照顧者於持續照護病患過程中的健康狀態與負荷，同時能提供相關服務與支持，以提昇其家庭功能與生活品質。

The purpose of this study was to explore the relationship between family function and quality of life in family caregivers of disabled patients. Based on the cross-sectional design, 107 disabled patients and their caregivers were recruited from a home care service delivery system after discharge from a single medical center. Data were collected through a questionnaire consisting of the family function and quality of life scales. The results indicate that 80.4% of the disabled patients were highly-to-completely dependent, 68.2% of the caregivers were females, 23.4% of the caregivers reported adverse influences on their health status, and 44% of the caregivers experienced stress from care-giving. According to the survey, overall family function scored average-to-good; among all questions, share of responsibility scored the highest, followed by problem-solving ability, while feeling involved scored the lowest. The overall quality of life of caregivers ranged from average-to-good, with physical, sociological, environmental, and psychological domains scoring from the highest to the lowest. Moreover, multiple regression analysis indicate that perceived economic burden, perceived care burden, perceived health status, family function of the caregivers, and disability level of the patients were important variables of quality of life in 59% of the relationships studied. The results of this study can help health professionals understand the changes and difficulties patients and their caregivers experience during the transition of care. It is very important to provide family-centered, continuous health services, including discharge planning and home care. It is suggested that health care teams focus on the health status and burden of caregivers during continuous care and provide related services to reduce the stress, as well as to improve family function and the quality of life of caregivers.