精神病患家庭照護者的負荷研究：跨國文化比較

Cross-cultural, cross-national study of family caregiver burden imposed by the mentally ill.

本研究係針對122位嚴重、慢性精神疾病病患的家庭照護者（family caregiver）、以他們所感受到的負荷（burden）所做的跨國文化比較。資料搜集從台北的52位個案開始，其次進行加州洛杉機的35位中國家庭和35位白人家庭的病患照護者，形成三組樣本群，以八項測量工具用結構問卷會談法完成。三組的資料和結果係用t值檢定、相關矩陣、標準迴歸分析等分別分析後比較之。從文獻探討中得知，本研究為第一次以跨國文化比較方式探討精神疾病家庭照護者負荷的實證研究。本研究發現照顧精神病患的家庭總負荷量三組都呈現相同的嚴重。但是相關的生物－心理－社會因素，卻各以明顯的不同途徑影響家庭照護者的負荷。這個差異除了顯示人的認知、環境中的壓力源、壓力事件和社會資源等都會影響照護者的負荷以外，更肯定社會、文化、和制度，對家庭負荷有顯著的模塑和影響。因此心理疾病的防治政策和計劃實施方面應考慮和檢視有關的文化和社會制度。進而提供有效的精神病患的家庭支持。

This research project is a first ever cross-cultural and cross-national study of family caregiver burden imposed by the serious and chronically mentally ill. In total, 122 caregivers were interviewed in Taipei, Taiwan and Los Angeles, Callifornia in the summer and winter of 1991. Fifty-two caregivers were Chinese living in Los Angeles; 35 caregivers were Chinese living in Los Angeles; 35 caregivers were Caucasians living in Los Angeles. Eight separate bio-psycho-social variables were measured and administered to each subject and the findings along with demographic variables were analyzed by using t-test, Standarized Regression, and Correlation Analysis. The total caregiver burden was the same for each of the three caregiver groups but there were considerable differences in the path of bio-psycho-soceal variables contributing to burden. These differences indicate that Perception, Stressor and Resource Variables play unique and apparently culturally-determined roles in caregiver burden and this in turn points to the importance of cultural issues in formulating treatment and support servicees for the mentally ill and their family caregivers. Findings in this research also raise the possibility of strategic interventions aimed at alleviating the specific burden-producing circumstances for individuals and groups of caregivers.