外籍家庭看護工照護技能對失能者照護品質和生活品質之探討

Abstract

研究背景 因應少子化及照護需求上升，政府於1992年引進外籍看護工來舒緩照護負荷，然而，由於看護工的品質參差不齊提供的照護品質不穩定，可能影響長照失能者照護品質與生活品質，為了解看護工相關照護因素是否和失能者有關，因此進行這項研究。

研究方法 本研究採橫斷式研究設計，研究對象為居家環境的失能者與印尼籍看護工成對收案，看護工部份透過印尼文問卷進行基本資料問卷調查及人際反應量表進行同理心測量，並以實體技術測試進行照護技術評值；失能者接受生活品質測量，並以回顧病歷方式評估照護品質，以SPSS 22.0進行多變項線性迴歸分析及中介效果分析。

研究結果 本研究印尼籍看護工的平均年齡為36.7（±7.2）歲，總收案數為88名，其中87名為女性，佔98.9%。受照顧的失能者的平均年齡為78.05（±9.99）歲，失能者性別以女性54位居多佔61.4%，男性34名佔38.6%。研究重要結果如下: (一)看護工同理心與其部分照護技術具有顯著正相關(p=.031)。 (二)失能者生活品質和看護工移位技術與行動力等級、疾病診斷及照護滿意度有關，整體迴歸模型R2=.331,p<.001。 (三)失能者照護品質則和其性別、看護工的整體照護技術與中文能力有關，整體迴歸模型R2=.130,p=.002。 (四)失能者照護滿意度會影響照護技術與失能者生活品質之關係；看護工自覺聽懂指令程度也會影響照護技術對照護品質之關係，因此在提升看護工照護技術時，也應注意看護工中文能力及關注失能者照護滿意度。 結論 本研究是首篇同時測量外籍家庭看護工照護技術與同理心，並直接分析看護工變項對失能者生活品質及照護品質影響的研究。研究結果驗證照護者與被照護者間存在密切關連，我們應更加重視外籍家庭看護工的同理心、照護能力及中文能力，建立繼續教育制度，全方位養成看護工能力，不僅能夠讓照護品質上升，也可讓看護工更加快速融入臺灣生活，更重要的是能夠改善失能者的生活品質創造雙贏的局面。

Introduction Taiwan's declining birth rates and rising caregiving demands led to the introduction of foreign caregivers in 1992. However, inconsistent caregiver quality raises concerns about the impact on long-term care recipients' well-being. This study investigates the association between caregiver-related factors and the well-being of disabled individuals.

Methods A cross-sectional design involved disabled individuals in home settings and their Indonesian caregivers (n=88,98.9% female). Data collection included Indonesian-language questionnaires assessing demographics and empathy (interpersonal reactivity scales), alongside practical assessments of caregiving skills. Disabled individuals' quality of life was assessed, and care quality was retrospectively evaluated using medical records. Multivariate linear regression and mediation effect analysis were performed using SPSS 22.0.

Results Caregivers (average age 36.7 ± 7.2 years) showed a positive correlation between empathy and specific caregiving techniques (p = .031). Disabled individuals' quality of life (average age 78.05 ± 9.99 years, 61.4% female) was associated with caregivers' skills in repositioning, mobility assessment, disease diagnosis, and care satisfaction (R² = .331, p <.001). Care quality was linked to the recipient's gender, caregivers' overall skills, and Chinese language proficiency (R² =.130, p =.002). Care satisfaction mediated the relationship between caregiving techniques and disabled individuals' quality of life. Additionally, caregivers' self-perceived understanding of instructions influenced the association between caregiving skills and care quality.

Conclusion This study pioneers the simultaneous assessment of foreign home caregivers' empathy and caregiving skills, directly analyzing their impact on disabled individuals' well-being. Highlighting the crucial caregiver-recipient relationship, the findings emphasize the need for improved empathy, caregiving abilities, and language proficiency among foreign caregivers. Implementing a comprehensive continuing education system can enhance caregiver competencies, ultimately leading to improved care quality, better integration into Taiwanese society, and a mutually beneficial outcome for both caregivers and disabled individuals.