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[中风患者家庭照顾者的经历]

[Experience of family caregivers caring for patients with stroke].

作者信息

Kim S S

出版信息

Kanhohak Tamgu. 1994;3(1):67-88; disucssion 89-92.

PMID:7953884
Abstract

The hospital mortality rate for stroke patients is now approximately 20%. Those who survive stroke are discharged to home disabled and the responsibility for providing adequate care to the patient has fallen primarily on family members. Maintaining the patients in the community may be ideal but it is not without cost. Although it is known that the role of family is critical to stroke rehabilitation, relatively few studies have examined caregiving within context of stroke, and nursing care is still limited to the patients ignoring family caregivers. Therefore, this study using grounded theory method was carried out to explore and explain the experiences of family caregivers from the time of the incidence throughout the course of stroke. The informants of the study were 24 family caregivers caring for the patients with stroke at hospitals or their homes. The study was conducted from March through August, 1992. Data were collected through in-depth interviews, telephone interviews and participant observation. Data collection and analysis were conducted concurrently allowing theoretical sampling and facilitating hypotheses to evolve. According to the results, caregiving has been associated with a range of negative experiences including emotional crisis, physical discomfort, guilty feeling, anxiety, feeling of social isolation, depression, hopelessness, and financial difficulties. Caregiving activities, commitment, recovery pattern accounted for the experiences of family caregivers, and the experiences varied according to the phases of the patient's recovery. The experiences of family caregivers are; emotional crisis upon a sudden occurrence of stroke; physical discomforts during hospitalization and the period the patients need an assistance with bathroom; feeling of social isolation beginning after discharge; and depression, hopelessness thereafter. Anxiety regarding the recurrence of stroke and the patient's prognosis was intensified with the patient's discharge to home. Guilty feeling was related to the caregiver's perceived role inadequacy. The type of relationship between caregiver and patient, sex of caregiver, and caregiver's financial status correlated to the experiences of family caregivers. Considering all the factors being related to such experiences as mentioned above, the following hypothesis were evolved. (1) The family caregivers who perceive that the patient's recovery has not reached their expectation feel higher level of anxiety. (2) Daughters-in-law feel the caregiving experiences more negative than spouses or adult-children. (3) Unmarried adult-children and daughters-in-law feel more of social isolation, depression, and hopelessness when the period of caregiving lasts longer. (4) Family caregivers who are male and self-supportive receive higher family support and feel the caregiving experiences less negatively.(ABSTRACT TRUNCATED AT 400 WORDS)

摘要

中风患者的医院死亡率目前约为20%。中风幸存者出院时往往残疾,为患者提供充分护理的责任主要落在了家庭成员身上。让患者留在社区可能是理想的,但这并非没有成本。尽管众所周知家庭的作用对中风康复至关重要,但相对较少的研究在中风背景下考察护理情况,而且护理仍局限于患者,忽视了家庭护理者。因此,本研究采用扎根理论方法,旨在从中风发病到整个病程中探索并解释家庭护理者的经历。该研究的 informant 是24名在医院或家中照顾中风患者的家庭护理者。研究于1992年3月至8月进行。数据通过深度访谈、电话访谈和参与观察收集。数据收集和分析同时进行,允许理论抽样并促进假设的形成。根据结果,护理与一系列负面经历相关,包括情感危机、身体不适、内疚感、焦虑、社会孤立感、抑郁、绝望和经济困难。护理活动、投入、康复模式解释了家庭护理者的经历,且这些经历因患者康复阶段而异。家庭护理者的经历包括:中风突然发生时的情感危机;住院期间以及患者需要协助上厕所期间的身体不适;出院后开始的社会孤立感;以及此后的抑郁和绝望。随着患者出院回家,对中风复发和患者预后的焦虑加剧。内疚感与护理者感知到的角色不足有关。护理者与患者的关系类型、护理者性别以及护理者的经济状况与家庭护理者的经历相关。考虑到与上述经历相关的所有因素,得出了以下假设。(1)认为患者康复未达期望的家庭护理者焦虑程度更高。(2)儿媳比配偶或成年子女感受到的护理经历更负面。(3)未婚成年子女和儿媳在护理期持续较长时会感到更多的社会孤立、抑郁和绝望。(4)男性且经济自立的家庭护理者获得的家庭支持更高,且对护理经历的负面感受更少。(摘要截选至400字)

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