| Summary: | 碩士 === 長庚大學 === 護理研究所 === 85 === The proposes of this study were to explore multiple domains of the caregiver''s role strain and demands, and identity the factors that affected those for the spinal cord injury patients discharge during transition period. This study was conducted by a triangulation methodology. Thirty-four family caregivers were investigated by questionnaire and 10 were interviewed with audio-tape recorded by a semi-structured interview guide. The findings were as follows:
1.Demographic characteristics of the spinal cord injury patients and their families: The majority of the spinal cord injury patients were males, blue collar. The age of the patients ranged from 21 to 40 years old. Their income level were from 30,000 to 60,000 dollars before illness. Traffic accident and falling were the major causes leading the spinal cord injury. C-spinal injury, incomplete injury, and quadriplegia were the major types of spinal cord injury. The majority of the family caregivers of spinal cord patients were female, lower education, homeworks, and their spouses.
2.Role strain were categorized from nine sources which included: (1)direct care and difficulty; (2)worry; (3)lack of resources; (4)economic burden; (5)role conflict; (6)role expectations; (7)feelings of being manipulated; (8)increased tension/care receiver relationship; and (9)global strain. First, the most frequent direct care was activities of daily living before and after discharge. The difficulties of “lack of instrument” and “management emergency status” increased after discharge. Second, the most frequent worry of family caregivers was “patients'' physical and mental health” before and after discharge. However, the levels of worrying “patients'' mental health” and “other members in family” decreased after discharge. Third, the highest level of lack of resources of family caregivers was “physical condition of family caregivers” before discharge. After discharge, the levels of “lack of life space” and “lack of human resource” increased. Fourth, the major factor of economic burden was due to “no job”. The economic burden became better after discharge than before because of expense decreasing. Fifth, the major factor or role conflict came from “work role conflict”. The level of role conflict decreased after discharge. Sixth, the role expectation of family caregivers was “do your best” before and after discharge. The expectation of “do your best” increased after discharge. This increase resulted in the more difference between the expectation of care of family caregivers and patients. Seventh, the feelings of being manipulated resulted from the physical dependence. This negative feelings decreased after discharge because of the improvement of physical condition. Eighth, the negative tension of relationship resulted from the emotional reaction of patients. The positive tension of relationship resulted from the increased time of dependence and getting together. Finally, the negative feelings of care were bitterness, tiredness, and patience before and after discharge. On the other hand, the positive feeling of care was learning. The feeling of tiredness increased after discharge because of the long period of caring.
3.The demands of the caregivers for the spinal cord injury patients were categorized to the personal demands and social welfare. First, the family caregivers felt the need of others to substitute in personal demands and this demands increase after discharge. The family caregivers needed the informatin of disease, treatment, and care before discharge. Information of law was needed most after discharge. Additionally, in social welfare, the family caregivers expected the emotional support and other''s sharing of experiences before and after discharge. Before discharge, the family caregivers sought more need of financial support. The needs of home health care, home aid servies, institution of long term care service, and transportation were increased after their discharge.
4.There were significant differences between role strain and spinal cord injury type, sex, and relationship. The role strain of the patients with complete injury was higher than those of the patients with incomplete injury. The level of role strain of female was higher than the level of male. The level of role strain amount of patients'' children was higher than the spouse.
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