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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 毛慧芬 | |
dc.contributor.author | Min-Xiu Luo | en |
dc.contributor.author | 羅敏秀 | zh_TW |
dc.date.accessioned | 2021-07-11T15:43:03Z | - |
dc.date.available | 2022-10-05 | |
dc.date.copyright | 2018-10-05 | |
dc.date.issued | 2018 | |
dc.date.submitted | 2018-08-10 | |
dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/79089 | - |
dc.description.abstract | 背景:大多數的失智者住於社區中由非正式照顧者照顧,如何支持失智者及其照顧者面對長期與疾病症狀與照顧負荷的挑戰,維持最佳化的生活品質,是健康照顧照護團隊努力的方向。需求調查文獻指出:失智者需要而未被滿足之處為:參與有意義活動及親友的陪伴,而照顧者最期待患者能維持活動與功能,及營造共享關係,然過去照顧者介入多為針對照顧技巧、減少照顧負面影響為主,少有著重雙方關係維持及正向照顧經驗之介入研究。因此本研究目的為:以訓練照顧者執行居家共享活動、提升共享關係為主之介入方案—居家共享活動衛教方案,探討其對於照顧者與失智者之介入效益。方法:研究採準實驗設計,對象為與家人同住之失智者與照顧者。依據單位隨機分為實驗組,接受為期8週之居家共享活動衛教方案,前4週每週1次,每次120分鐘,共4堂課程,提供認知及感官活動道具包,並教導照顧者如何運用活動與失智者互動,並增加共享及正向的照顧經驗,另在第6、8週加上兩次的電話追蹤;控制組為等待組,在研究結束後給予同等的方案介入。兩組皆會在介入前(前測)、介入結束(後測)進行評估,主要成效指標包含照顧者之正向照顧經驗、共享關係、自我效能及失智者之活動參與度;次要成效指標包括照顧者之生活品質、照顧者負荷、憂鬱症狀,及失智者之行為精神症狀。結果:納入研究並完整分析的共有24對受試者(實驗組14對、控制組10對)。研究結果發現相較於控制組,實驗組照顧者的正向照顧經驗(p=.016; Cohen’s d=.99)及憂鬱症狀(p=.043; Cohen’s d=.87)有顯著的改善,照顧者的生活品質-生理功能(p=.084; Cohen’s d=.84)、失智者的活動參與度(p=.084; Cohen’s d=.92)也有增加的趨勢,在共享關係則可能有保護的作用。而不同家庭照顧模式在本方案獲得的效益也不同,介入方案對於全日家庭照顧的失智者的效益較明顯,而對於半日家庭照顧模式的照顧者則在此方案受益較多。結論:居家共享活動衛教方案教導失智症照顧者如何運用共享活動與失智者互動,傳達正向照顧經驗及共享概念,對於照顧者的正向照顧經驗和憂鬱症狀有正向的效益,且可增加失智者的活動參與度。但其效益可能會因居家照顧模式不同而有所差異,未來須增加樣本數進一步驗證之。 | zh_TW |
dc.description.abstract | Background: Previous research has shown that the most unmet needs of persons with dementia (PwD) are participating in meaningful activities and having families or friends as company. However, most programs for caregivers focus on improving caregiving skills and decreasing the negative aspects of caregiving. Little is known about the effect of positive-aspect-of-caregiving-focused intervention on caregivers and PwD. Therefore, we develop a home-based shared activities education program (HSAEP), which emphasizes on improving the quality of relationship between PwD and caregivers and the activity engagement of PwD. This study aims to investigate the effect of HSAEP on the caregivers and PwD. Methods: A quasi-experimental design was employed. Twenty-four dyads of PwD and caregivers were recruited in the research. The experimental group (n=14) participated in 8-weeks HSAE program, including 1 session/ week, 2 hours/ session for 4 weeks and 2 telephone follow-up. Due to ethical concerning, the waiting-list group (n=10) would join the program after the research finished. The outcomes were measured at pre- and post-trial. The primary outcomes included caregivers’ positive aspects of caregiving (PAC), quality of shared relationship, self-efficacy of caregiving, and the activity engagement of PwD. The secondary outcomes included caregivers’ quality of life (QOL), caregiving burden, depression, and BPSD and agitative symptoms of PwD. Results: In comparison with waiting-list group, the caregivers of experimental group reported more improvement in PAC (p=.016; Cohen’s d=.99), depression symptoms (p=.043; Cohen’s d=.87), physical function of QOL (p=.084; Cohen’s d=.84), and PwD’s activity engagement (p=.084; Cohen’s d=.92). Besides, HSAEP may have protective effect on shared relationship. The results showed that the effect of HSAEP on different family caregiving mode varied. The effect on PwD of whole-day-family-caregiving was more apparent, while the caregivers of half-day-family-caregiving benefited more from HSAEP. Conclusion: HSAEP, conveying the concept of PAC and shared relationship, and educating caregivers how to utilize shared activities to interact with PwD, has positive effects on increasing the caregivers’ PAC, decreasing the depression symptoms and facilitating PwD’s activity engagement. A large sample size will be needed to further validate the generalization of current results. | en |
dc.description.provenance | Made available in DSpace on 2021-07-11T15:43:03Z (GMT). No. of bitstreams: 1 ntu-107-R05429009-1.pdf: 13040555 bytes, checksum: 01203a904a13bbbbefad2dcf2c020cfd (MD5) Previous issue date: 2018 | en |
dc.description.tableofcontents | 口試委員會審定書....................................................................................................I
致謝..........................................................................................................................II 中文摘要.................................................................................................................III Abstract.....................................................................................................................V 第一章 緒論........................................................................................................1 第一節 研究背景與動機............................................................................1 第二節 研究目的........................................................................................4 第二章 文獻回顧探討........................................................................................5 第一節 失智症對照顧者之影響................................................................5 第二節 失智症患者及照顧者的照顧需求..............................................21 第三節 針對失智症照顧者之介入及成效..............................................27 第四節 「共享關係/活動」在失智症照顧者介入之探討.....................34 第三章 研究方法..............................................................................................40 第一節 研究設計......................................................................................40 第二節 研究假設......................................................................................41 第三節 研究對象......................................................................................43 第四節 研究工具......................................................................................45 第五節 介入內容......................................................................................51 第六節 研究流程......................................................................................53 第七節 資料分析......................................................................................55 第四章 結果.....................................................................................................56 第一節 樣本描述與初始資料..................................................................56 第二節 兩組照顧者於前後測各項成效指標之差異..............................63 第三節 兩組失智者於前後測各項成效指標之差異..............................72 第四節 全日與半日居家照顧模式之介入成效差異..............................76 第五節 實驗組之參與度與滿意度..........................................................90 第五章 討論......................................................................................................91 第一節 兩組照顧者前後測結果差異之探討..........................................92 第二節 兩組失智者前後測結果差異之探討..........................................98 第三節 對於不同居家照顧模式之成效探討........................................100 第四節 方案滿意度之探討....................................................................102 第六章 研究限制............................................................................................103 第七章 結論....................................................................................................105 第八章 參考文獻............................................................................................106 附錄.......................................................................................................................126 附錄一:居家共享活動衛教方案課程大綱..........................................126 附錄二:人體研究倫理審查委員會-計畫執行許可書.........................127 附錄三:受試者同意書..........................................................................129 附錄四:研究工具:施測量表..............................................................141 | |
dc.language.iso | zh-TW | |
dc.title | 居家共享活動衛教方案於失智症照顧者之介入效益探討 | zh_TW |
dc.title | The Effects of a Home-based Shared Activities Education Program on Caregivers of Persons with Dementia | en |
dc.type | Thesis | |
dc.date.schoolyear | 106-2 | |
dc.description.degree | 碩士 | |
dc.contributor.coadvisor | 吳建德 | |
dc.contributor.oralexamcommittee | 徐亞瑛,張玲慧 | |
dc.subject.keyword | 正向照顧經驗,共享活動,失智症,照顧者,心理教育性介入, | zh_TW |
dc.subject.keyword | positive aspects of caregiving,shared activities,dementia,caregiver,psychoeducational intervention, | en |
dc.relation.page | 155 | |
dc.identifier.doi | 10.6342/NTU201801855 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2018-08-10 | |
dc.contributor.author-college | 醫學院 | zh_TW |
dc.contributor.author-dept | 職能治療研究所 | zh_TW |
顯示於系所單位: | 職能治療學系 |
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