調查復原力與接受安寧緩和照顧病人家庭照顧者哀傷經驗的相關性

研究目的：本研究目的為探討生命末期病人在接受安寧緩和醫療之家庭照顧者行為意圖及其行為的之間影響程度。研究方法與資料：本研究採用縱貫式研究設計、自擬問卷調查研究法蒐集資料與數據，研究對象在台灣中部某區域教學醫院之一般內外科病房和加護病房已經接受或曾經接受安寧緩和醫療、安寧共同照護等模式之住院服務個案的家庭照顧者共136位參與研究。本研究經資料回收的有效問卷，以WINDOWS版SPSS 27.0版統計軟體進行統計。問卷內容包括：生命末期病人家屬人口學特性、復原力程度、社會支持、喪親內疚程度。資料分析包括獨立 t 檢定和單因子樣本異數分析，以自變數和因變數之間的相關差異，也進行相關性檢定與階層迴歸分析自變項對依變項之間相關性及影響程度。研究結果：本研究結果，喪親的家庭照顧者對於生命末期病人接受安寧緩和醫療過程的醫療行為過程，基本資料中，以女性家庭照顧者居多，與病人親屬親密程度高，同時為生命末期的醫療決策者或是代理者，對於安寧緩和醫療的認知及曾經接受安寧緩和醫療照顧(64.3%)，包含不施行心肺甦醒術(77.2%)及與醫療人員討論過生命末期的相關議題、及選擇安寧緩和醫療照護(96.3%)，其接受安寧緩和醫療意願越高，在喪親後之社會支持程度未有顯著意義；此外干擾變項分析，病人性別及年齡、罹病屬性在不同時間接受安寧緩和醫療的家庭照顧者之復原力程度上並無顯著差異，在入院時間與喪親後三個月時間，整體復原力有顯著效果，整體復原力能力屬於中等程度。而病人性別、年齡及罹病屬性與家庭照顧者的性別、與病人親密緊密度、是否為需照顧病人及為代理醫療決策者與喪親內疚的反應程度屬於輕度狀況。結論與建議：本研究發現望助於瞭解未來臨終關懷和接受安寧緩和醫療的家庭照顧者之喪親反應和復原力程度調整。期望為臨終關懷患者的家庭照顧者提供實用的社會和心理支持策略，從而協助他們應對喪親之痛和適應過程。該研究預計將為喪親家庭照顧者的遺族關懷照顧和諮詢的發展做出實際貢獻。

Objective: The purpose of this study was to explore the relationship between the behavioral intentions and behaviors of family caregivers of end-of-life patients receiving hospice care.Methods and Materials: This his study adopts a longitudinal research design and uses a self-made questionnaire survey method to collect information and data. The research subjects are those who have received or have received hospice palliative and hospice care in the general medical and surgical wards and intensive care units of a teaching hospital in central Taiwan. A total of 136 family caregivers of model inpatient service cases participated in the study. The valid questionnaire data collected in this study were statistically analyzed using the WINDOWS version of SPSS version 27.0statistical software. The contents of the questionnaire include: demographic characteristics of family members of terminally ill patients, resilience scale, social support scale , and bereavement guilt scale. Data analysis includes independent t-test and single-factor sample anomaly analysis to explore the differences between independent variables and dependent variables. Correlation test and hierarchical regression are also performed to analyze the correlation and degree of influence between independent variables and dependent variables.Results: He results of this study show that in the basic information, the majority of bereaved family caregivers are female family caregivers regarding the medical behavior of end-of-life patients receiving palliative care. They have a high degree of intimacy with the patient's relatives and are also medical decision-makers at the end of life. Or agents who have knowledge of hospice and palliative care and have received hospice and palliative care (64.3%), including not performing cardiopulmonary resuscitation (77.2%) and discussing end-of-life issues with medical staff, and choosing hospice and palliative care Medical care (96.3%), the higher the willingness to receive palliative care, the greater the degree of social support after bereavement has no significant significance; in addition, in the analysis of interference variables, the gender, age, and disease attributes of patients receiving hospice and palliative care at different times have no significant significance There is no significant difference in the degree of resilience among family caregivers. There is a significant effect on overall resilience between the time of admission and three months after bereavement, and the overall resilience ability is moderate. The gender, age and disease attributes of the patient, the gender of the family caregiver, closeness to the patient, whether the patient is a patient requiring care and acting as a surrogate medical decision-maker, and the degree of bereavement guilt are mild conditions.Conclusion and Suggestion : The findings of this study will hopefully contribute to future understanding of bereavement reactions and resilience adjustments among hospice and hospice home caregivers. It is expected to provide family caregivers of hospice patients with practical social and psychological support strategies to help them cope with bereavement and the adjustment process. The research is expected to make a practical contribution to the development of care and counseling for bereaved families.