影響家庭照顧者使用機構喘息服務因素之探討

Factors Related for Using Institutional Respite Care by Family Caregivers

目的：喘息服務旨在讓主要照顧者獲得短暫休息，有助於提升病患與照顧者的生活品質。我國喘息服務推動多年，但實際服務使用率卻偏低，尤其在機構喘息部分。因此，本研究旨在瞭解失能病患主要照顧者使用機構式喘息服務之現況並瞭解相關影響因素。方法：本研究以桃園縣長期照顧管理中心100年度1至6月新核定機構喘息照護個案為對象，採用次級資料分析及電話問卷調查方式進行。第一部份係依核定個案於照管中心所登錄之基本資料及桃園縣鄉鎮市區醫療資源登記資料，以次級資料進行資料分析；第二部分則針對前述對象以鄉鎮市為單位，採分層隨機抽樣方法抽取50%樣本進行電話問卷調查，經電話問卷調查完成有效問卷109份，完成率為45%。結果：研究結果發現：(1)主要照顧者對機構喘息服務使用率僅約9.2%，有近半數的受訪者對機構喘息服務不清楚；(2)居住鄉鎮市有無提供喘息服務機構，對於使用機構喘息服務與否，達統計顯著差異；(3)輕、中、重度失能者的使用機構喘息服務的使用率分別為7%、5.9%、8%，顯示被照護者失能程度與是否使用機構喘息服務無明顯差異。結論：根據研究結果，建議未來應增加機構喘息服務宣導以提高民眾的認知，並在提供服務時，實際考量照顧者在使用服務上的需求與障礙，整合各鄉鎮市照護服務資源，將有助於提升主要照顧者對機構喘息服務的使用意願。

Purposes: Respite care is the provision of short-term relief for caregivers in order to improve the quality of life for both the patient and the caregiver. In Taiwan, respite care was launched several years ago; however, the utilization rate for institutional respite care (IRC) is low. The aims of this study were to determine the utilization rate and to explore the factors related to the use of IRC by family caregivers. Methods: The study subjects were identified from the records of the Long-term Care Management Center of Tao-Yuan County (Tao-Yuan LCMC) from January to June 2011. Information about the characteristics of each subject was obtained from the registry of claim data from the Tao-Yuan LCMC. A telephone interview survey was then used with a 50% stratified random sample based on township contribution to the registry data. A total of 109 subjects completed the survey for a completion rate of 45%. Results: The results showed that: (1) there was only a 9.2% utilization rate for IRC among primary caregivers as nearly half the caregivers did not know about IRC; (2) a statistically significant difference in utilization was found between families who knew about an institute providing respite care and those who did not; (3) the utilization rates for IRC for mild, moderate, and severe disabilities were 7%, 5.9%, and 8%, respectively. No significant differences in degree of disability and rate of utilization of IRC were found. Conclusions: Based on our findings, we suggest providing more information about the availability of respite care for caregivers, considering the needs for and barriers to the use of respite care, and allocating IRC resources appropriately.