老人主要照顧者施虐傾向及其危險因子之研究——以中部地區居家服務老人為例

Potentially Harmful Caregiver Behavior: A Case Study of In-Home Care of Elderly from Central Taiwan

研究目的：本文主要目的在於針對接受居家服務失能老人之主要照顧者施虐傾向及其相關危險因子所進行之分析，並探討被照顧者、主要照顧者、照顧脈絡因素以及照顧者施虐傾向之間的關係，再以多元迴歸的方式分析各個自變項對於照顧者施虐傾向之解釋效果。研究方法：本研究對象以台灣中部五縣市接受居家服務之老人主要照顧者為抽樣對象，經分層隨機抽樣，共計222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：發現照顧者的自覺健康狀況以及與老人的親屬關係，是照顧者施虐傾向的重要危險因子，另外家庭互動、照顧負荷、社會支持與老人干擾行為則是因照顧關係所產生之情境脈絡危險因子，在解釋照顧者施虐傾向有更具顯著性的預測效果；整體預測變項共有42.9%的解釋變異量。研究結論：本研究資料顯示，以照顧脈絡模式運用於老人主要照顧者施虐傾向危險因子的確認，以及作為老人虐待預防與處遇服務與政策之規劃，有著理論與實證資料的支持。本文也針對台灣老人虐待防治與處遇策略之建議進行更進一步的討論。

Purpose: This study investigated the relationships among elderly care-recipient characteristics, caregiver characteristics, caregiving contextual factors and potentially harmful caregiver behavior to understand the predictors of potentially harmful caregiver behavior. Methods: Using stratified random sampling, 222 elders and their caregivers from 5 counties in central Taiwan were selected for the study. Data were compiled through questionnaire interviews. Hierarchical regression analyses were used to test the hypothesized models. Results: The findings indicated 5 major predictors of harmful caregiver behavior: the caregiver’s self-rated health, the caregiver’s relationship with their elderly patient, the caregiver’s burden, the caregiver’s social support, and disruptive behaviors by the elderly patient from the caregiver’s perspective. Together these factors explained 42.9% of the total variance of the dependent variable. Conclusions: The application of a caregiving contextual perspective to identify the risk factors for the potentially harmful behavior of caregivers toward their elderly patients is supported by the theoretical and empirical data. Further discussions on elder abuse prevention and intervention strategies in Taiwan are provided.