| 摘要: | 失智症安全駕駛是全球公共衛生關心的主要議題，駕駛與個人自主性、自尊及獨立性有密切相關，一旦失去駕駛權利，則可能產生心理健康的負面效應，而且也可能增加照顧負荷及影響照顧者心理情緒壓力，因此如何在安全駕駛與失智症患及其主要照顧者心理健康之間取得平衡是很重要的議題，本研究目的旨在探討駕駛與失智症患者及其家屬心理健康之關係。研究為橫斷式描述性研究，採方便取樣，使用問卷調查法，研究對象為北部某準醫學中心之失智症個案及其主要照顧者，所得資料運用SPSS統計軟體採卡方檢定、獨立樣本t檢定、單因子變異數分析、皮爾森相關分析及邏輯式迴歸分析。
本研究共收案78組失智症患者與其照顧者，共156人，研究結果發現有41%之失智症患者仍在駕駛，最常使用交通工具為機車（42.3%），停止駕駛者通常年齡較大（M=75.51; SD=7.20）、無配偶者較多16 人（34.8%）、沒參與社交活動居多27人（58.7%）、日常生活功能較差（M=17.43; SD=4.63），以及自覺駕駛對生活品質的重要程度較低（M=2.35; SD=1.45）。失智症患者停止駕駛之預測因子為年齡（OR=1.166; p<.01）及IADL（OR=0.721; p<.01）。停止駕駛組之失智症患者憂鬱（t=0.430; p=.668）及焦慮（t=1.769; p=.081）程度較高，未達統計差異。停止駕駛組與駕駛組之照顧負荷無顯著差異（t=-0.036; p=.972）。停止駕駛組之主要照顧者憂鬱（t=-1.035; p=.304）及焦慮（t=-1.282; p=.204）程度較低，未達統計差異。照顧負荷與失智症患者憂鬱（r= 0.331; p<.05）及照顧者本身之憂鬱（r= 0.646; p<.001）與焦慮（r= 0.371; p<.05）呈現正相關。
建議未來研究可以進行長期追踪研究，以了解停止駕駛之失智症患者及主要照顧者的心理健康變化及預測因子、安全駕駛議題應納入公共衛生教育，並制定失智症患者之安全駕駛規範。
Driving safety of persons with dementia (PwD) is an important global public health issue. Driving is closely related to personal autonomy, self-esteem, and independence. When PwD loss driving privileges, it may lead to negative effect on mental health, and then increase their caregivers’ burden which may become emotional stressor for these caregivers. It is important to keep a balance between driving safety and mental health of PwD and their caregivers. The purpose of this study was to evaluate the relationship of driving and the mental health on PwD and their caregivers. The research design is cross-sectional with convenient sampling, using a battery of questionnaires to collect data. Participants are PwD and their caregivers in a Would-be Medical Center in northern Taiwan. Software SPSS is used to analyze data, using Chi-square test, Independent t-test, one-way ANOVA, Pearson correlation, and Logistic regression analysis.
A total of 78 dyads of PwD and their caregivers were recruited. Results found that 41% of PwD are still driving. Motorcycle is most commonly used type of vehicles (42.3%). The PwD of driving retirement were older (M=75.51; SD=7.20), mostly without spouses 16(34.8%), with less social activity 27(58.7%), poorer function ability (M=17.43; SD=4.63), and with lower perception of the importance of driving to quality of life (M=2.35; SD=1.45). The predictors for driving cessation of PwD are age (OR=1.166; p<.01) and IADL (OR=0.721; p<.01). The depression (t=0.430; p=.668) and anxiety (t=1.769; p=.081) levels of former driver of PwD were higher, however, with no statistical significance. There is no significant difference in the caregiver burden between the former driver and current driver of PwD (t=-0.036; p=.972). The caregivers in the driving retirement group had lower levels of depression (t=-1.035; p=.304) and anxiety (t=-1.282; p=.204); however, with no statistical significance. In addition, there was a positive correlation between caregiver burden and the PwD’s depression (r= 0.331; p<.05), caregiver’s depression (r= 0.646; p<.001) and anxiety (r= 0.371; p<.05).
It is suggested that prospective study in the future, driving safety issues for PwD should be addressed in public health education, and standards of driving safety for PwD should be formulated. |
