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標題: | 失智症病人家庭照顧者的健康識能、社會支持與生活品質 之相關性研究 The Relationship of Health Literacy, Social Support, and Quality of Life among Family Caregiver of Patient with Dementia |
作者: | 謝寧惠 Ning-Huei Sie |
指導教授: | 鍾國彪 Kuo-Piao Chung |
關鍵字: | 失智症,家庭照顧者,健康識能,社會支持,生活品質, Dementia,Family Caregiver,Health Literacy,Social Support,Quality of Lif, |
出版年 : | 2023 |
學位: | 博士 |
摘要: | 目標:本研究目的在於發展出針對失智症家庭照顧者健康識能結構問卷以了解照顧者之健康識能、社會支持與生活品質程度及三者之間相關性,並採質性訪談方式,深入探討及分析照顧者的健康識能、社會支持及生活品質。方法:量性研究部分進行橫斷性調查,包括健康識能之失智症疾病知識、獲得、理解、評價及應用的能力,社會支持來源與情感性、資訊性、工具性與評價性社會支持,及生理健康、心理健康、社會健康與環境等生活品質構面,同時納入家庭照顧者人口學特性與照顧型態。調查對象為雲林嘉義地區失智症患者之家庭照顧者,應用雙變量、複迴歸模型及結構方程式來探討健康識能、社會支持對於生活品質的影響,並採質性研究方法,完成訪談11位照顧者,以主題分析法,進行健康識能、社會支持與生活品質之資料分析與歸納。結果:完成384位失智症家庭照顧者調查,回收率86.7%。平均照顧者的年齡為58.08±14.7歲、女性佔61.72%,平均照顧年數3.97±2.53年。健康識能以理解能力最高(32.9±12.2分),其次是應用的能力(30.1±12.0分),整體平均分數30.0±11.7分,說明照顧者的健康識能代表有問題(分數介於26-33分);社會支持以醫療專業人員社會支持較家人親友高(35.96±0.78分 vs 31.26±0.69分),生活品質以(13.69±2.36分)、心理健康最低分(12.81±2.46分)。大學/專科以上學歷者其獲得、理解、評價及應用之健康識能程度皆顯著高於國中以下及高中職者(Wilks Λ= 0.700, p<0.001),由配偶擔任主要照顧者,其健康識能的各面向程度皆顯著低於由兒子媳婦(Wilks Λ= 0.773, p<0.001),全職照顧者在各面向的健康識能程度也顯著較低(Wilks Λ= 0.909, p<0.001);女性的心理健康較差(p=0.03),配偶與全職照顧者其生活品質的各面向皆顯著較低(Wilks Λ= 0.906, p<0.001;Wilks Λ= 0.918, p<0.001)。整體而言,健康識能越好,社會支持越好(β=0.429,p<0.05),其生活品質越佳(β=0.373,p<0.05),且社會支持為中介因子(β=0.264,p<0.05)。結論:此研究指出雲嘉地區失智病人家庭照顧者的健康識能程度越好時,其社會支持程度較高,也會正向影響其生活品質,結果可作為偏鄉制定失智症照顧政策之參考。 Objective: This study aims to develop a questionnaire to assess the health literacy of caregivers of dementia patients and understand their levels of health literacy, social support, and quality of life, as well as the correlations between these factors. Additionally, qualitative interviews are conducted to explore further and analyze the caregivers' health literacy, social support, and quality of life. Methods: The quantitative study conducts a cross-sectional survey to examine the caregivers' health literacy, knowledge, and ability to access, understand, evaluate, and apply dementia-related information. It also assesses the sources of social support, including emotional, informational, instrumental, and appraisal support, and different dimensions of quality of life, such as physical health, psychological health, social relationships, and environment. The survey also collects demographic characteristics and caregiving patterns of the caregivers. The participants of the study are caregivers of patients with dementia in the Yunlin and Chiayi areas. Bivariate and multiple regression analyses and structural equation modeling are used to evaluate the corrections between health literacy, social support and quality of life. In addition, in qualitative research, semi-structured interviews are conducted with 11 caregivers. Thematic analysis is performed to analyze and summarize the data related to health literacy, social support, and quality of life. Results: A total of 384 caregivers of dementia patients complete the survey, and the response rate is 86.7%. The average age of the caregivers is 58.08 years, and 61.72% were female. The average duration of caregiving is 3.97±2.53 years. Among the dimensions of health literacy, understanding has the highest score (32.9±12.2), followed by application (30.1±12.0), with an overall average score of 30.0±11.7, indicating some problems with caregivers' health literacy (score=26~33). Healthcare professionals provide higher levels of social support compare to family and friends (35.96±0.78 vs 31.26±0.69). In terms of quality of life, physical health receive the highest score (13.69±2.36) and psychological health receive the lowest score (12.81±2.46); caregivers with undergraduate/college degree whose access, understand, appraisal and apply abilities are significantly higher than others(Wilks Λ= 0.700, p<0.001); the spouses and full-time caregivers has significantly lower scores in all aspects of health literacy (Wilks Λ= 0.773, p<0.001; Wilks Λ= 0.909, p<0.001); female caregivers has poorer psychological health(p=0.03). Spouses and full-time caregivers have significantly lower scores in all aspects of quality of life (Wilks Λ= 0.906, p<0.001;Wilks Λ= 0.918, p<0.001). Overall, better health literacy and social support is better (β=0.429,p<0.05), and health literacy is associated with better quality of life (β=0.373,p<0.05) , with social support acting as an indirect mediating factor (β=0.264,p<0.05). Conclusion: This study reveals that caregivers of dementia patients in the Yunlin and Chiayi areas have relatively good health literacy and higher levels of social support, which positively influences their quality of life. The family caregivers of patients with dementia in rural areas receive more social support and have a better quality of life. Cooperation among medical professionals, the community, and family members is essential for effective dementia care. These findings can be used as a reference for developing dementia care policies. |
URI: | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/90313 |
DOI: | 10.6342/NTU202301863 |
全文授權: | 同意授權(限校園內公開) |
顯示於系所單位: | 健康政策與管理研究所 |
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