研究生: |
林碧珠 |
---|---|
論文名稱: |
髖部骨折老人出院過渡期照顧者負荷之研究 |
指導教授: | 呂昌明 |
學位類別: |
博士 Doctor |
系所名稱: |
健康促進與衛生教育學系 Department of Health Promotion and Health Education |
論文出版年: | 2003 |
畢業學年度: | 91 |
語文別: | 中文 |
論文頁數: | 125 |
中文關鍵詞: | 老人 、髖部骨折 、照顧自我效能 、社會支持 、照顧者負荷 |
論文種類: | 學術論文 |
相關次數: | 點閱:964 下載:60 |
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本研究目的在追蹤髖部骨折老人出院過渡期主要照顧者負荷及其影響因素。採方便取樣台北市三家醫學中心,住院中65歲以上髖部骨折老人及其主要照顧者共98人。於出院後一週家訪以結構式問卷調查老人身體功能、主要照顧者照顧責任感、社會支持、照顧自我效能、家庭功能、和照顧負荷;出院一個月再追蹤照顧負荷和老人身體功能資料。統計方法包括描述性統計、相關分析、變異數分析、逐步迴歸分析等。主要研究結果如下:
一、主要照顧者以女性(63.3﹪)、老人配偶(30.6﹪)最多;大部分(61.2﹪)沒有工作;77.6﹪有人可輪流照顧或有次要照顧者。
二、主要照顧者在老人出院後一週呈現中度之照顧負荷,並且持續至一個月照顧負荷並未減輕。其中以個人自由層面和情緒層面受影響較大,91.8﹪的主要照顧者表示「看到老人健康衰老,感到難過」,平均得分2.34分,84.7%的主要照顧者表示「須時時刻刻注意到他」,平均得分2.43分。家庭關係和財務層面負荷則較少。
三、老人身體功能狀態隨著出院時間增加逐漸進步(F=164.582, p<.000),並和照顧者負荷呈顯著負相關。
四、無人可輪流照顧、骨折前已照顧老人的主要照顧者,有較高的一個月照顧者負荷。
五、照顧責任感越高、照顧自我效能較佳、家庭功能較好、社會支持幫助較多之主要照顧者,照顧負荷較輕。
六、社會支持需要程度較高的主要照顧者,照顧者負荷較大。
七、一週照顧者負荷之預測因素包括一週老人身體功能、照顧自我效能和社會支持需要程度,共可解釋照顧者負荷22.2%的總變異量。
八、一個月照顧者負荷之預測因素包括一週照顧者負荷和社會支持幫助程度,共可解釋照顧者負荷56.0%的總變異量。
根據研究結果提出下列幾點建議:
一、在病人教育方面:將照顧者負荷之模式推廣至醫院臨床實務工作,設計衛生教育教案,增進主要照顧者照顧老人知能,提升照顧自我效能。並設計老人復健運動計畫,增強老人四肢肌力和走路訓練,增加自我照顧能力和生活獨立性。
二、在研究方面:做更長期縱貫追蹤研究,質性和量性並重,出院前介入措施有效性研究。
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