303 Farré et al., 2005; MacIntyre et al., % 67.5% % 91.7% ㈡ Exel, Koopman

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1 302 The Care Needs of Caregivers 探討居家呼吸器依賴患者其主要照顧者之照顧需求及相關因素郭文芳簡姿娟 * 隨著我國健保局推行的呼吸器依賴患者整合性照護計劃, 居家照顧將成為呼吸器依賴患者之主要照顧重點, 而照顧者將會面臨許多壓力與責任, 因此須進一步探討照顧者需要協助之問題, 以作為護理人員提供照顧之參考探討居家呼吸器依賴患者主要照顧者的照顧需求情形及相關因素採橫斷式相關性研究設計, 以方便取樣方式選取中部地區居家照顧之呼吸器依賴患者的主要照顧者, 以結構性問卷收集資料, 有效問卷共 138 份 ⑴ 照顧相關知識為最重要的需求項目,⑵ 主要照顧者之照顧需求與患者之診斷與疾病情況有顯著相關,⑶ 主要照顧者每日照顧的時間與照顧相關技能及照顧相關服務需求呈現顯著正相關由於主要照顧者對於照顧相關知識有高度的需求, 故建議制定完整的居家照顧指引, 包括 : 症狀評估疾病監測及處置藥物營養及復健等內容, 減少因知識不足帶來的壓力與傷害關鍵詞 : 居家呼吸器依賴患者主要照顧者照顧需求㈠ * 卷 4 期中華民國 98 年 12 月

2 303 Farré et al., 2005; MacIntyre et al., % 67.5% % 91.7% ㈡ Exel, Koopmanschap, Berg, Brouwer, Bos, 2005 Morimoto, Schreiner, & Asano, 2003 ㈢ % 94.1% Leff et al., Farré, Giró, Casolivé, Navajas, & Escarrabill, 2003; Warren et al., 卷 4 期中華民國 98 年 12 月

3 304 The Care Needs of Caregivers Simonds, ~290 30~ ㈠㈡ ~ SPSS10.0 t one-way ANOVAPearson s productmoment correlation p <.05 5 卷 4 期中華民國 98 年 12 月

4 % % % % % % % % % % % % % % % % % % % % % n % N = 138 n % ~ ~ ~ ~ ~ ~ 卷 4 期中華民國 98 年 12 月

5 306 The Care Needs of Caregivers N = % % % % % % % % % 3~9761~ % 1~192 8~ ~ % 4~24 17~ % % 81% 67% % 99% 96% 93% %93% 92% 92% 91% 91% 91% 99% 96% 93% 92% 92% 91%91% 93% 89%88% 81% 81% 81% 100%24 93% ㈠ 1. t = 3.59, p <.01 F = 6.39, p <.01F = 5.47, p < > r = 0.27, p <.01 5 卷 4 期中華民國 98 年 12 月

6 307 % 2. F = 8.37, p <.01 t = 9.50, p <.01 F = 95.42, p <.01F = 80.78, p <.01F = 26.35, p <.01 N = * * * * * * * * * * * * * * * * * * * * * > > r =.69, p < F = 3.63, p <.01 r = -.20, p <.05 r =.20, p <.05 ㈡ r =.29, p <.01 r =.16, p <.05 5 卷 4 期中華民國 98 年 12 月

7 308 The Care Needs of Caregivers t / F / r F = 8.37** F = 3.63* t = 3.59** t = 9.50** F = 6.39** F = 95.42** - F = 5.47** F = 80.78** - - F = 26.35** r = -0.20* r =.27** r =.69** r =.20* r =.29** r =.16* *p <.05. **p < % 3~97 8~24 50% 43.5% 63.8% 37.0% 66.7% %88% 56.3% 0 75% 68.8% ~ % 35.5% 56.7%65% 37.7%18~ ± ~ ± 47.44~ ± % 69.6% 83.3% Hung Liu Kuo Hung % 115 3~ 卷 4 期中華民國 98 年 12 月

8 Simonds, Hung http:// 5 卷 4 期中華民國 98 年 12 月

9 310 The Care Needs of Caregivers NHRI-GT-EX89P706C NSC B Exel, N. J. A., Koopmanschap, M. A., Berg, B., Brouwer, W. B. F., & Bos, G. A. M. (2005). Burden of informal caregiving for stroke patients. Cerebrovascular Diseases, 19(1), Farré, R., Giró, E., Casolivé, V., Navajas, D., & Escarrabill, J. (2003). Quality control of mechanical ventilation at the patient s home. Intensive Care Medicine, 29(3), Farré, R., Lloyd-Owen, S. J., Ambrosino, N., Donaldson, G., Escarrabill, J., Fauroux, B., et al. (2005). Quality control of equipment in home mechanical ventilation: A European survey. European Respiratory Journal, 26(1), Hung, L. C., Lin, C. C., & Kuo, H. W. (2002). Unmet nursing care needs of home-based disabled patient. Journal of Advanced Nursing, 40(1), Leff, B., Burton, L., Mader, S., Naughton, B., Burl, J., Clark, R., et al. (2006). Satisfaction with hospital at home care. Journal of the American Geriatrics Society, 54(9), Morimoto, T., Schreiner, A. S., & Asano, H. (2003). Caregiver burden and health-related quality of life among Japanese stroke caregivers. Age and Ageing, 32(2), MacIntyre, N. R., Epstein, S. K., Carson, S., Scheinhorn, D., Christopher, K., & Muldoon, S. (2005). Management of patients requiring prolonged mechanical ventilation. Chest, 12(6), Simonds, A. K. (2006). Risk management of the home ventilator dependent patient. Thorax, 61(5), Warren, M. L., Jarrett, C., Senegal, R., Parker, A., Kraus, J., & Hartgraves, D. (2004). An interdisciplinary approach to transitioning ventilator-dependent patients to home. Journal of Nursing Care Quality, 19(1), 卷 4 期中華民國 98 年 12 月

10 311 The Related Factors and Care Needs of Caregivers Responsible for Home Ventilator-Dependent Patients Wen-Fang Kuo Tzu-Chuan Chien Chen * Abstract Background: The Integrated Nursing Care Plan for Ventilator-Dependent Patients proposed and promoted by the National Health Insurance Bureau mandates home care for most ventilator-dependent patients. Implementation of this policy greatly increases the stress and responsibility of caregivers. This paper discusses key problems faced by caregivers in caring for this group of patients and identifies areas of particular need as a reference for nurses. Objective: This paper explored the needs and related factors of caregivers responsible for the care of home-based ventilator-dependent patients. Method: A cross-sectional correlation design was used to sample caregivers of home ventilator-dependent patients in central Taiwan. A structured questionnaire was used to collect data. A total of 138 valid questionnaires were collected. Results: 1) Relevant caretaking knowledge was the most important needs-related item; 2) A significant correlation was identified between caregiver needs and patient diagnoses and severity of illness; 3) As expected, a significantly positive correlation between caregiver hours of daily service and caretaking-related skill and service needs. Conclusion/Practical Application: The high level of identified need for amongst caregivers for relevant caretaking knowledge suggests a need to establish sound home care guidance that addresses physical assessments, disease monitoring, management, medication, nutrition and rehabilitation in order to reduce stress and injury risks. Key Words: home ventilator-dependent patient, caregiver, care needs. RN, MSN, Respiratory Intensive Care Unit, Department of Nursing, Taichung Veterans General Hospital; *RN, PhD, Assistant Professor, School of Nursing, HungKuang University. Received: June 11, 2009 Revised: September 1, 2009 Accepted: October 13, 2009 Address correspondence to: Tzu-Chuan Chien Chen, No. 34, Chung-Chie Rd., Sha Lu, Taichung 44302, Taiwan, ROC. Tel: +886 (4) ext. 3074; june1678@hotmail.com 5 卷 4 期中華民國 98 年 12 月

7_6論文.indd

7_6論文.indd 一黃春滿董道興 * 師慧娟 ** 中文摘要本篇個案報告是探討一術後病的, 期間為 94 年 4 月 28 日至 5 月 13 日筆藉由 Gordon 十一項健康功能評估為工具, 運用身體評估觀察及會談的方式收集資料, 在期間發現個案出現體溫過高焦慮疼痛