| Summary: | 碩士 === 國立臺灣大學 === 護理學研究所 === 88 === In Taiwan, most of the frail elders are cared by the families, thus the quality of family caregiving is a very important issue in community nursing. The aim of this study was to determine the level and related factors of quality of family caregiving of frail elders receiving home nursing services in central Taiwan.
One hundred and sixty four frail elders and their caregivers recruited from 11 teaching hospitals in Taichung were interviewed with a structured questionnaire. The theoretical model was modified from Phillips'' "family caregiving dynamic model" and Shyu''s "finding a balance point process model". QUALCARE Scale developed by Phillips was used to assess the quality of family caregiving in this study. Factors related to QUALCARE were tested and factor analysis was used to illustrate the direct and indirect effects of these factors.
The mean of QUALCARE in this study was 3.68 (1 for worst and 5 for best) and the means of environmental, physical and psychological subscale was 3.58, 3.83 and 3.63, respectively. The worst provided cares were "caregiver provides regular attention to elder''s need for exercise and movement" and "Elder''s preferences for recreation, stimulation and play are respected". The important predictors of quality of family caregiving were "self-perceived relationship with the frail elderly", "finding a balance point", "educational level of the elderly", "hired worker for caregiving", and "ability of daily activities". Path analysis revealed that most of the "situational factors" and "process factors" indirectly affected the quality of family caregiving through the "burden of caregiver". The staged dynamic model proposed by Phillips was verified in this study.
The study concluded that QUALCARE could help identify specific problems regarding to the quality of family caregiving. A modified short version of QUALCARE could be circulated to the home-healthcare nurses for routine use. Through the nursing interventions of process factors, e.g., changing the inappropriate caregiving belief, equipping the caregiver better knowledge and skill of caregiving, helping the caregiver finding a better balance point and providing more social support and resources to reduce the burden and in the long run improving the quality of family caregiver of the frail elderly.
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