| 摘要: | 背景：隨著人口老化，失智症人口快速增加，失智症的照護是複雜且具挑戰，對專業人員與家屬皆是如此。然而，目前台灣比較少針對失智症家屬進行增能照護衛教介入之相關研究不多，也鮮少以失智症主要照顧者作為研究對象。
目的：1.探討失智症患者背景與家庭主要照顧者照顧負荷、憂鬱、健康生活品質之關係。2.探討家庭主要照顧者背景變項與照顧負荷、憂鬱、健康生活品質之關係。3.探討在增能照護衛教介入後兩組家庭主要照顧者在照顧負荷、憂鬱、健康生活品質、照顧知識、自我效能、及資源知識之差異、以及兩組在長照資源使用及滿意度之差異。
方法：本研究第一階段採用橫斷式問卷調查法、第二階段採隨機對照實驗設計。於雙北失智症服務據點收案，收案條件為疑似失智症患者或經醫師確診為失智症者，實驗組增能照護衛教介入，每週一次共三次，每次2小時; 控制組只給予「臺北市失智照護資源手冊」參閱。
結果：結果顯示照顧負荷與失智症患者確診、疾病嚴重度、及精神困擾行為等有顯著相關性(p<0.05)。家庭主要照顧者背景資料顯示收入較低者之照顧者負荷分數較高; 自覺健康狀況較差者之照顧負荷分數較高。主要照顧者憂鬱與病患者性別、疾病史、精神困擾行為達顯著相關性(p<0.05); 失智症患者性別、失智嚴重度、及精神及困擾行為與照顧者健康相關生活品質總分達顯著相關性(p<0.05)。多元迴歸分析預測健康生活品質結果，失智症患者婚姻、疾病嚴重度、精神或困擾行為、家庭主要照顧者與失智症患者關係、憂鬱總分，未達統計上顯著性，主要照顧負荷總分（p<0.001）可解釋家庭主要照顧者健康生活品質 46.8%。兩組增能照護衛教介入成效顯示，兩組家庭主要照顧達顯著差異（p<0.05），包括:憂鬱、失智知識、資源知識; 組內有顯著差異(p<0.05)，包含照顧負荷、失智知識、資源知識; 兩組與不同時間序列間有交互作用(p<0.05)，包括: 照顧負荷、失智知識、資源知識。
結論: 研究顯示經由增能介入可以降低照顧者照顧負荷及提升失智症知識及資源知識，顯示失智症知識經由教育及傳授，因人制宜提供照顧知能可進而降低照顧負荷。
Background: With population aging rapidly and dementia population increasing, dementia care is complex and challenging both for professionals and family members. However, currently Taiwan has few relevant researches on the empowered health care intervention for families of patients suffering from dementia.
Objectives: 1. To explore the relationship between the background of dementia patients and the care load, depression and healthy quality of life of the main caregivers in the family. 2. To explore the relationship between the background changes of the main caregivers of the family and the burden of care, depression and the quality of a healthy life. 3. To explore the differences in care load, depression, health quality of life, care knowledge, self-efficacy, and resource knowledge between the two groups of primary caregivers in the long-term photography after the intervention of the escort education.
Methods: The first stage of this study adopted the cross-sectional questionnaire method and the second stage was randomized controlled experimental design. In the double north dementia service base to collect cases, the case conditions for suspected dementia patients or by the doctor diagnosed as dementia, the experimental group can increase the ability to follow the escort education intervention, once a week a total of three times, each time 2 hours; The Control Group is only available for reference in the Taipei City Dementia Care Resource Manual.
Results: The results showed a significant correlation between caregiver load and diagnosis, severity of the disease, and mental distress behavior in patients with dementia. In addition, the background data of the main caregivers of the family show that the main caregivers with lower incomes have high load scores; People with poor self-conscious health have higher care load scores. There was a significant correlation between the depression of the primary caregivers and the sex, history of the disease and the behavior of mental distress (p <0.05).
Multiple regression analysis predicted healthy quality of life results, with a total of 46.8% of the healthy quality of life of primary caregivers in the family. The effectiveness of the intervention of the two groups of empowered escorts showed that the two groups of families had significant differences in the main care, including: depression, dementia knowledge, resource knowledge; There were significant differences (p<0.05) within the group, including caregiver load, dementia knowledge, resource knowledge; The two groups interacted with different time series, including: caregiver load, dementia knowledge, resource knowledge.
Conclusions: Studies have shown that intervention through increased energy can reduce the care load of caregivers and enhance the knowledge and resource knowledge of dementia, and show that knowledge of dementia can be reduced by providing care knowledge according to human condition through education and transfer. |
