家庭照顾者照顾行为对台湾 COPD 患者自我护理行为的影响。
Influence of family caregiver caring behavior on COPD patients' self-care behavior in Taiwan.
机构信息
Nursing Department, National Defense Medical Center, Taipei, Taiwan.
出版信息
Respir Care. 2012 Feb;57(2):263-72. doi: 10.4187/respcare.00986. Epub 2011 Jul 12.
BACKGROUND
COPD becomes a long-term burden on family members who serve as day-to-day caregivers, and causes healthcare systems to incur substantial costs. COPD is both preventable and treatable, and one important aspect of COPD treatment is patients' self-management. This study aimed to investigate relationships between self-management and the caregiver burden, and the influence of family caregivers' caring behavior on COPD patients' self-care behavior.
METHODS
In a cross-sectional study conducted between March 2007 and January 2008, 192 pairs of COPD patients (age > 40 years, normal cognitive function) and their primary family caregivers were recruited to answer questionnaires measuring COPD characteristics and COPD knowledge (patients and caregivers); functional status, health beliefs, self-efficacy, and self-care (patients); and caring behavior and caregiver response (family members). All questionnaires were shown to have acceptable validity and reliability, and the data were analyzed using univariate and multivariate techniques.
RESULTS
Patients' ages, scores in health belief, self-efficacy and disease-related knowledge were shown to correlate with patients' self-care behavior. Patients' self-care behavior was negatively correlated with family caregivers' caring behavior (ρ = -0.21, P = .003), but positively with caring duration of family caregiver caring behavior (ρ = 0.15, P = .037). Patients with a spouse as caregiver exhibited higher self-care ability than patients not married to their caregivers (P = .038). However, patients' self-care behavior decreased with higher family caregivers' COPD knowledge (P = .041) and caring behavior (P = .01), and patients regularly taking medication exhibited low self-care scores.
CONCLUSIONS
Family caregivers' caring behavior had a partial negative effect on COPD patients' self-care behavior.
背景
COPD 会给作为日常护理者的家庭成员带来长期负担，并导致医疗保健系统产生大量费用。COPD 是可以预防和治疗的，COPD 治疗的一个重要方面是患者的自我管理。本研究旨在探讨自我管理与照顾者负担之间的关系，以及家庭照顾者的照顾行为对 COPD 患者自我护理行为的影响。
方法
在 2007 年 3 月至 2008 年 1 月期间进行的一项横断面研究中，招募了 192 对 COPD 患者（年龄>40 岁，认知功能正常）及其主要家庭照顾者，让他们回答问卷，以测量 COPD 特征和 COPD 知识（患者和照顾者）；功能状态、健康信念、自我效能和自我护理（患者）；以及照顾行为和照顾者反应（家庭成员）。所有问卷均具有可接受的有效性和可靠性，使用单变量和多变量技术对数据进行分析。
结果
患者的年龄、健康信念、自我效能和疾病相关知识评分与患者的自我护理行为相关。患者的自我护理行为与家庭照顾者的照顾行为呈负相关（ρ=-0.21，P=0.003），但与家庭照顾者照顾行为的持续时间呈正相关（ρ=0.15，P=0.037）。有配偶作为照顾者的患者比与照顾者没有婚姻关系的患者表现出更高的自我护理能力（P=0.038）。然而，患者的自我护理行为随着家庭照顾者 COPD 知识（P=0.041）和照顾行为（P=0.01）的增加而降低，而定期服药的患者自我护理评分较低。
结论
家庭照顾者的照顾行为对 COPD 患者的自我护理行为有部分负面影响。
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