探討酗酒者出院後主要照顧者的負荷及相關因素

背景：全球每年因酗酒導致總死亡人數逐漸攀升，酗酒導致疾病與失能而造成家庭照顧問題。過去台灣對於酗酒議題研究多聚焦特殊性族群、暴力、急診及長期酗酒引發相關性疾病進行探討，有關酗酒者出院後其主要照顧者負荷之議題值得探討。目的：探討酗酒者出院後主要照顧者的負荷及相關因素。方法：採橫斷式研究設計，針對北部某地區醫院酗酒患者出院後主要照顧者為研究對象，以郵寄問卷或電訪方式共收集54位。研究工具包括酗酒者及主要照顧者之人口學資料、中文版酒精依賴嚴重度評估表、主要照顧者負荷、功能性社會支持量表、自覺健康狀況。以描述性統計含個數、百分比、平均值±標準差；推論性統計含卡方、t test、ANOVA、多元線性迴歸。結果：酗酒者其主要照顧者平均年齡為48.6歲，以女性居多佔74.07%，多為配偶關係44.44%，與個案關係不好者佔37%。主要照顧者負荷情形屬於中度負荷，各項負荷平均值由高至低排序心理負荷、社會負荷、生理負荷、財務負荷。以線性多元回歸分析發現：主要照顧者為女性(β＝-18.67, p＝.0018)、與個案關係不好者(β＝-19.89, p＝<.0001)、收入較差者(β＝-9.07, p＝.0176)及個案酗酒者酒精依賴嚴重度越高者(β＝0.35, p＝.0385)，其主要照顧者負荷越大。而社會支持足夠程度越好者(β＝0.07, p＝.033)則顯著降低主要照顧者負荷。結論：酗酒者之主要照顧者有身心社會面負荷，促進其家庭關係及足夠之社會支持並降低酗酒者之酒精依賴度能減緩主要照顧者負荷。本研究結果能提供醫療照顧及社會政策之參考。

Background: The number of deaths caused by alcoholism worldwide each year is gradually increasing. Alcoholism causes illness, disability, and family care problems. Previous research on alcoholism in Taiwan focused on specific ethnic groups, violence, emergency treatment, and diseases related to long-term alcohol abuse. The burden of primary caregivers after discharge of patients with alcoholism from hospital are worthy of discussion.Objective: To explore the main caregivers’ burden and related factors after patients with alcoholism are discharged from hospital.Methods: This cross-sectional study assessed the primary caregivers of 54 alcohol abuse patients discharged from a hospital in northern Taiwan. Mailed questionnaires or telephone interviews collected demographic data on the patients and primary caregivers, the Chinese version of the alcohol dependence severity assessment scale, the main caregiver load, functional social support scale, and self-conscious health status. Descriptive statistics included numbers, percentages, and mean ± standard deviations; inferential statistics included the Chi-square test, t-tests, ANOVA, and multiple linear regression.Results: The average primary caregiver age was 48.6-years-old; 74.07% were female, 44.44% were spouses, and 37% had poor relationships with the patient. The primary caregiver load was moderate; psychological load was highest, followed by social load, physiological load, and financial load. Linear multiple regression analysis found female caregivers(β=-18.67, p=.0018), a poor relationship with the patient(β=-19.89, p≤.0001), low income(β=- 9.07, p=.0176), and a higher severity of alcohol dependence (β=0.35, p=.0385)were associated with higher caregiver burden. However, better social support was associated with significantly lower caregiver load (β=0.07, p=.033).Conclusion: The primary caregivers of alcoholics experience physical and psychological burdens. Promoting family relationships and adequate social support, and reducing patients’ alcohol dependence can alleviate primary caregivers’ burden. The results of this study provide a reference for medical care and social policies.