居家呼吸器依賴病患與主要照顧者負荷之初探

Home respiratory care in Taiwan has usually lagged behind advanced countries for years. Under the encouragement of National Health Insurance Program (NHIP), and the popularizing efforts of respiratory therapists, more and more primary caregivers tend to take a care for the ventilator-dependent patients at home. Actually, the primary caregivers usually suffered from heavy burdens without corresponding and pertinent concerns. This study intend to workup on the burden of primary caregivers for home ventilator-dependent patients and the relationships between the burden and their demographic characteristics. The study was designed using a cross-sectional scheme to collect the necessary information by the organized structural questionnaires, including personal demographic information of home ventilator-dependent care, and Caregiver Burden Scale with the permission of the original author. The subjects were collected by purposive sampling from Home Respiratory Care Facilities in central and northern Taiwan. The results of the study showed as follows：(1) The male home ventilator-dependent patients were a little more than females. About 60% patients did not gain any subvention from the government. 80% patients, with good consciousness level, have been hospitalized for more than three times. Certainly, the most prevalent morbid condition of the subjects was pulmonary disease/disorder. Most subjects used assist control mandatory ventilation (ACMV) mode and oxygen flow by 0~2 liter per minute by their ventilator setting. 45% patients had been using ventilators for more than three years, 60% to 70% of them used ventilators up to 19~24 hours per day. (2) Main burden of primary caregivers caring for home ventilator-dependent patients belonged to the financial part, and the others were physiological, social, and psychological counterparts. (3) All burdens of primary caregivers' tend to be more remarkable, when home ventilator-dependent patients didn't work before their current morbidity, younger age, more dependency on primary caregiver, and using lower oxygen flow. Hence, the study can provide the professional therapists engaged in home respiratory care to realize the peculiar situation about care recipients and care givers. We also hoped the study results can provide the basis for the related policymaking and gain access to a holistic and whole family approach to the patients.