腸胃道癌症手術病人主要照顧者的負荷及相關因素

腸胃道癌症手術病人主要照顧者的負荷及相關因素

Family Caregiver Burden and Its Correlates in Surgical Patients of

Gastrointestinal Cancer

中文摘要 本研究是以橫斷式研究法，探討台北某醫學中心之腸胃道癌症手術病人主要照顧 者的負荷及相關因素。共收集 95 位病人及其主要照顧者，收集資料包含病人人 口學資料、病人疼痛狀況、主要照顧者焦慮及憂鬱情形及照顧者之人口學資料、 照顧照顧型態與睡眠狀況，同時使用照顧者反應評估量表（CRA）測量照顧者的 照顧負荷程度。資料分析方式包含描述性統計、t 檢定、單因子變異數分析、皮 爾森積差相關檢測與逐步迴歸分析結果發現：(1)主要照顧者負荷的嚴重程度依 序為時間安排、健康負荷、經濟負荷及家人支持。（2）時間安排負荷的重要預測 因子為主要照顧者的焦慮程度、照顧類型、主要照顧者睡眠狀況及病人性別為男 性，其解釋時間安排負荷總變異量為 35.2%（p＜.000）。（3）主要照顧者焦慮程 度、主要照顧者睡眠狀況及病人使用 PCA 第三天總量為健康負荷的主要預測因 子，其解釋健康負荷總變異量為 45.8%（p＜.000）。（4）經濟負荷有關的重要的 預測因子有照顧前收入高於支出、照顧後收入低於支出、主要照顧者年齡與照顧 者憂鬱程度，其解經濟負荷總變異量為 37.7%（p＜.000）。（5）家人支持負荷重 要預測因子為疼痛干擾與照顧類型為輪班照顧者，其解釋家人支持負荷總變異量 為 16.0%（p＜.000）。（6）與主要照顧者自尊感受有關的因素為主要照顧者婚姻 狀況。本研究結果可發現主要照顧者在照顧癌症手術病人時會有不同層面的照顧 負荷，建議臨床專業人提供協助降低其照顧負荷，藉此照顧品質。 英文摘要

The cross-section study was designed to discuss that the burden and related factors of caregivers for patients with gastrointestinal cancer post surgery in certain medical center in Taipei.

It included 95 dyads of patents and their caregivers. The data includes of patients＇ demographic, pain condition of patients（Belief Pain Inventory Short Form -

Taiwan ,BPI-T）, caregiver＇s demographics and caregiver＇s psychological distress （measured with The Hospital Anxiety and Depression, HADS）, the type of care and caregiver＇s sleep（measured with Karolinska Sleep Diary, KSD）, and the

caregiver＇s burden（measured with the Caregiver Reaction Assessment, CRA）. The methods of analysis included descriptive statistics, independent t-test, one-way ANOVA, Pearson＇s correlation, and stepwise regressions. The result shows that（1） The severity of care burden on the primary caregiver was in the order: disrupted schedual, health problems, financial problems, and lack of family support.（2）The

main predictors of disrupted schedual were the anxiety of caregiver, type of care, the sleep of caregiver, and male gender.（3）The main predictors of caregiver＇s health problems were caregiver＇s anxiety, caregiver＇s sleep status and total dose of PCA in the 3rd day.（4）The main predictors of financial problems included income more then expanse before care, income less than expanse after care,the caregiver＇s age and depression.（5）The main predictors of lack of family support included the disturbance of pain, and the type of care was in shifts.（6）The factors related to caregiver＇s feeling of self esteem included the caregiver＇s marriage.

The result showed that there are different aspects of caregiver’s burden in caring for cancer patient post surgery; the recommendation is that clinical caregiver supplied the assistance to reduce the burden in order to improve caring quality.