輕度失智病患之家屬不確定感及相關因素探討

研究背景：初期失智病患所表現出的症狀常被誤以為是正常老化，但情況逐漸退化後發生嚴重混亂，家屬面對可能經歷曖昧不明、不可預期的不確定感受。研究目的：探討輕度失智病患之家屬的不確定感程度，以及瞭解影響輕度失智病患的家屬不確定感的相關因素。研究方法：本研究採橫斷式描述相關性研究設計，立意方式取樣，以中部某醫學中心神經內科門診輕度失智病患為研究對象，收案期間由研究者以結構式問卷與研究對象親自面對面訪談，共收案128位家屬。研究量表包括家屬基本資料問卷、家屬不確定感量表、社會支持感受量表、神經精神評估量表。統計：描述性統計以百分比、平均數、標準差，推論性統計使用獨立樣本t檢定、單因子變異數分析、皮爾森積分相差、多元迴歸等。研究結果：家屬不確定感平均分數為79.62分(SD=18.49)，屬於中等程度。親屬關係、教育程度、婚姻狀況、工作狀況、家庭月收入、是否有參加過相關課程、想法是否與照顧病患經驗一致與不確定感皆有顯著差異；年齡、訊息性支持與不確定感有顯著正相關，醫護人員幫助程度、工具性支持、情緒性支持與不確定感有顯著負相關。不確定感預測因子中，「過去的想法與照顧失智病患後的經驗一致」、「醫護人員的幫助程度」、「訊息性支持」及教育程度「不識字及國小的教育程度」，可以聯合解釋不確定感42%的變異量。研究結論：臨床護理人員可以針對研究結果，提供個別化的失智症照顧，協助降低家屬的不確定感，提升病患與家屬的生活品質。

Background：Early symptoms of dementia are often mistaken for normal aging. As the condition progresses, severe confusion may develop, leaving family members to experience ambiguous, unpredictable, and uncertain feelings.Purpose：This study examined the level of uncertainty among family caregivers of patients with mild dementia and explored the factors influencing this uncertainty.Method：A cross-sectional descriptive correlational design was employed. Using purposive sampling, 128 family caregivers of patients with mild dementia were recruited from the neurology outpatient clinic of a medical center in central Taiwan. Data were collected through face-to-face structured interviews using a demographic questionnaire, the Family Uncertainty in Illness Scale (PPUS-FM), the Perceived Social Support Scale, and the Neuropsychiatric Inventory (NPI).Statistics：Descriptive statistics (percentages, means, standard deviations) and inferential analyses, including independent samples t-tests, one-way ANOVA, Pearson’s correlation, and multiple regression, were performed.Result：The mean uncertainty score was 79.62 (SD = 18.49), indicating a moderate level. Uncertainty differed significantly by kinship relationship, education level, marital status, employment status, monthly household income, participation in related courses, and whether prior perceptions matched actual caregiving experiences. Age and informational support showed a positive correlation with uncertainty, while assistance from healthcare professionals, instrumental support, and emotional support showed negative correlations. Significant predictors of uncertainty were: (a) whether prior perceptions aligned with actual caregiving experience, (b) level of assistance from healthcare professionals, (c) informational support, and (d) low education level (illiteracy or elementary school). These factors collectively explained 42% of the variance in uncertainty.Conclusions：The findings suggest that clinical nurses should provide individualized dementia care strategies to help reduce uncertainty among family caregivers, thereby enhancing the quality of life for both patients and their families.