精神分裂症家屬主要照顧者期待病患長期安置之相關因素探討

• Main Authors: Hung Lin Hsieh, 謝宏林
• Other Authors: LY Song
• Format: Others
• Language: zh-TW
• Published: 2000
• Online Access: http://ndltd.ncl.edu.tw/handle/76279603665020505442

碩士 === 國立暨南國際大學 === 社會政策與社會工作學系 === 88 === Abstract The chronicity of mental illness results in a heavy burden for families. The problems related to the future care or treatment for the patients usually cause burnout of family caregivers. Deinstitutionalization has been the main stream policy for care of the mentally ill patients, which emphasizes on short-term hospitalization and community care. However, if the community care system does not function well and meet patients’ needs, the family caregivers have to shoulder the heavy loading of care. This study aimed to understand the contextual factors related to family caregivers’ decision on long-term hospitalization of their ill family members. Specifically, the purposes of this study are: 1. To understand the help-seeking modals of family caregivers of patients with schizophrenia, and their problems during the help-seeking process; 2. To understand the caregivers’ context and subjective perception which direct toward the decision for long-term hospitalization.. Based on the Health Behavior Model (Andersen, 1995), a qualitative approach through in-depth interview was used to gather data. Twelve caregivers were interviewed. The analysis resulted in seven concepts: 1. Patients’ condition; 2. Client''s behavior problems; 3. Family caregivers’ perception and adaptation toward patients’ treatment;, 4. Caregiver''s burden and stress; 5. Caregiver''s distress; 6. Caregiver''s needs/support; 7. Social welfare resources and network. Furthermore, four types of caregivers emerged from the data: Steady-fast type, hesitate type, over-burdened type, and take-over type. The contextual factors which related to caregivers’ expectations are as follows: 1. On the psychological aspect-- hopelessness about recovery, and violent behaviors; 2. On the cultural aspect--stigma, exaggeration from the media; 3. On the social aspect─lack of community resources, imbalance of resource distribution, the barriers on social welfare system, rejection from medical institution , limitation on health insurance coverage , apathy of society ; 4. On the family aspect---hostility from family members, lack of other caregivers, unable to care; 5. On the material aspect-- financial need. On the other hand, the methods applied by the caregivers to cope with these problems are: 1. Resilient behaviors--searching for outside help, soliciting, avoid, immediate prohibition, isolation/control; 2, Help-seeking behaviors─relatives and friends’ referral, formal resources, and informal resources. Based on the results of this study, the following suggestions are proposed: 1. To balance the distribution of medical resources; 2. To enhance family caregiver’ use of services; 3. To actually implement discharge plan; 4. To form family education groups; 5. To encourage the participation of private sector; 6. To increase the manpower of community care; 7. To educate the general publics accurate knowledge of mental illness; 8. To increase the flexibility of the bureaucracy; 9. To set steps for long-term hospitalization.