居家服務使用對老人家庭照顧者照顧負荷之緩衝性影響研究

The Moderating Impacts of In-Home Services Utilization on Informal Caregiver’s Burden of Dependent Elders

背景與目的：本研究參考壓力過程模式架構來檢視社區內失能老人所使用的正式照顧服務，對家庭照顧者的照顧負面效應是否產生緩衝性影響。此一模式將正式照顧服務定義為一種正式社會支持的形式，藉以降低因照顧各種失能程度被照顧者所產生的照顧壓力與負荷。研究方法：本研究對象以中部某縣市接受居家服務之家庭照顧者為抽樣對象，經分層隨機抽樣，共計300人參與本研究；資料蒐集方法為問卷訪談，研究架構則以階層迴歸模式分析之。研究結果：被照顧者所使用的居家服務對於其干擾行為所造成的照顧負荷有降低的效果；此外，本研究也發現居家服務能有效緩衝家庭照顧者的照顧負面效應，在解釋家庭照顧者的照顧負荷具顯著性的預測效果與調節效果。研究結論：本研究資料顯示，以壓力過程模式檢視失能老人所使用的正式照顧服務對家庭照顧者的照顧負面效應產生緩衝性影響的確認，有著理論與實證資料的支持。本文也針對台灣長期照顧服務策略與方向之建議進行更進一步的討論。

Purpose: This investigation adopts the stress process conceptual framework to examine the moderating influence of formal services use by impaired elders on the negative consequences of caregiving for informal caregivers. The model is modified by defining formal services as a type of formal social support that can counteract the stress associated with various care recipient impairments. Methods: Using stratified random sampling, 300 caregivers receiving home care services were selected for the study. Data were compiled through self-administered questionnaires. Hierarchical regressions were used to test the hypothesized models. Results: The findings indicate home care service for care recipients can reduce the adverse effects of certain impairments on informal caregivers. Disruptive behaviors of the elders are significantly lowered. In addition, this study also confirms the moderating effects of formal services use by impaired elders on caregiving burden for informal caregivers. Conclusions: According to the results of this study, the application of a stress process conceptual perspective to identify the moderating effects of formal services use by impaired elders on the negative consequences of caregiving for informal caregivers are with theoretical and empirical data supported. Further discussions and suggestions on long-term care policies and strategies in Taiwan are provided.