精神病患照顧者之探究：照顧負荷之程度與其相關因素

本研究採用壓力因應模型，以中部四所精神醫療機構的244位社區病患照顧者為研究對象，瞭解照顧者負荷程度與其相關因素。實證資料乃以結構式問卷透過面對面的訪談加以蒐集。研究結果顯示：在負荷的次向度之間以「案主之依賴」的負荷程度最高、「家庭干擾與緊張」次之、「烙印」為最低。經複迴歸分析發現：病患診斷為精神分裂症、病患行問題程度愈高、照顧者為父母、照顧年數愈長、照顧者健康狀況愈差、一般社會支持愈少、照顧方面之家庭支持少於所需或多於所需者，照顧者的整體負荷程度愈大。其中又以病患行為問題為最重要的影響因素，一般社會支持次之，照顧者健康狀況再次之。再者，負荷次向度之顯著相關因素有些許差異，顯示分別探討負荷次向度之重要性；特別是發現一般社會支持可以減緩病患行為問題對照顧者烙印感之影響。文中進一步根據研究發現回應既有之文獻，並提出精神醫療政策與實務以及研究之建議。

This study uses a Stress-Coping Model as a framework to examine the correlates of caregiver burdens. Data were collected from the 244 caregivers of persons with mental illness from four mental health hospitals/wards in Central Taiwan. The results indicated that ''client dependency'' was the burden mentioned most by the caregivers, followed by ''family disruption and strain'' and ''stigma''. Multiple regression analyses reveal that higher level of overall caregivers burden is associated with the fellowing client characteristics: Clients with schizophrenia and with greater behavioral problems. Higher level of overall caregiver burden is also correlated with some caregiver characteristics, including caregivers as parents (vs. other), with longer caregiving experience, poorer health, less social support, and caregiving support from the family less than needed. Among these factors, a client's behavioral problems were the most important correlate, followed by social support and the caregiver's health. There were different constellations of correlates for each sub-dimension of burden, which revealed the importance of examining the sub-dimensions separately. In particular, this study found that social support could mitigate the effects of client behavioral problems on a caregiver's stigma. The implications on correlates of caregiver burden and mental health practice are discussed. Finally, suggestions for mental health policy and practice as well as for future research are presented.