肺炎重症病人當病情嚴重度下降由加護病房轉出至普通病房期間病人之症狀及照護需求會影響主要照顧者之焦慮及負荷，本研究目的為：(1)探討肺炎重症病人轉出至普通病房期間病人的症狀及照護需求、主要照顧者的焦慮、社會支持及照顧負荷之程度；(2)探討肺炎重症病人轉出至普通病房期間病人的基本屬性、疾病特性、主要照顧者的焦慮、社會支持及照顧負荷之相關性。本研究採橫斷式相關性研究設計，以精簡版回憶症狀量表、需求篩檢工具、病情嚴重度的客觀評分II 工作表、情境焦慮量表、社會支持量表、照顧者反應評估表、主要照顧者基本資料及照顧特性資料表及病人基本資料及疾病特性資料表進行資料收集。收案地點將於北部某學中心內科加護病房及內科病房，以診斷肺炎入住加護病房預轉出至普通病房之主要照顧者為研究對象，針對符合收案之病人進行方便取樣。研究資料以描述性統計及皮爾森積差相關進行分析。本研究共收集40對肺炎重症病人轉出至普通病房期間病人及主要照顧者，研究結果顯示：(1) 主要照顧者照顧負荷得分最高前二個次量表為健康衝擊及經濟衝擊；(2) 照顧者照顧負荷與病人病情嚴重度及病人症狀困擾呈顯著正相關；(3) 照顧者照顧負荷與輪替照顧呈顯著負相關；(4)照顧者照顧負荷與照顧者照顧時間呈顯著正相關。本研究結果將可幫助臨床專業人員瞭解肺炎重症病人轉出至普通病房期間主要照顧者照顧負荷，臨床照護可做為指導照顧負荷之參考。

Critically ill patients with severe pneumonia are often declined admission to the intensive care unit and are transferred to the general ward. Such patients’ symptoms and care needs may cause anxiety and caregiving burden among primary caregivers (PCs). The study aimed to (1) explore patients’ symptom levels and care needs and PCs’ anxiety and caregiving burden and (2) explore correlations among patients’ symptoms, patients’ care needs, PCs’ anxiety, and PCs’ caregiving burden when critically ill patients with pneumonia are transferred from the intensive care unit to a general ward. This study had a cross-sectional, correlational design. Patients were assessed using the Memorial Symptom Assessment Scale, the short-form Supportive Care Needs Survey-Screening Tool, APACHE II Score, a background information form, and a disease characteristics form. PCs were assessed using the State Anxiety Inventory, Medical Outcomes Study Social Support Survey, Caregiver Reaction Assessment, a background information form, and a care characteristics form. Participants were recruited from internal medicine intensive care units and internal medicine general wards in a medical center in northern Taiwan. Data were analyzed through descriptive analysis and Pearson’s product-moment correlation. A total of 40 patient–PC dyads were enrolled in the study. The study findings are as follows: (1) regarding caregiving burden, the two highest subscales were health problem burden and financial problem burden; (2) caregiving burden was positively correlated with patients’ illness severity and symptom distress; (3) caregiving burden was positively correlated with family rotation care; and (4) a significant positive correlation was observed between caregiving burden and time since initial caregiving. The study results can help clinical professionals understand the caregiving burden in PCs and provide a reference for clinical professionals to alleviate the caregiving burden in the PCs of critically ill patients with pneumonia during transition from intensive care units to general wards.

論文目錄
第一章 緒論 1
第一節 研究背景與重要性 1
第二節 研究目的 3
第三節 研究問題 4
第四節 研究假設 5
第五節 名詞解釋 6
第二章 文獻查證 9
第一節 肺炎 9
第二節 重症病人之照護需求 10
第三節 重症病人主要照顧者之焦慮 11
第四節 重症病人主要照顧者之社會支持 12
第五節 重症病人主要照顧者之照顧負荷及其相關因素 13
第三章 研究方法 15
第一節 研究設計 15
第二節 研究對象及場所 16
第三節 研究架構 17
第四節 研究工具 18
第五節 研究步驟 22
第六節 倫理考量 23
第七節 資料處理與分析 24
第四章 研究結果 26
第一節 探討肺炎重症病人轉出至普通病房期間病人的症狀困擾、照護需求及主要照顧者的焦
慮、社會支持及照顧負荷之程度 27
第二節 肺炎重症病人轉出至普通病房期間病人的症狀及照護需求、主要照顧者的焦慮、社會支
持及照顧負荷之相關性 44
第五章 討論 50
第一節 肺炎重症病人轉出至普通病房期間主要照顧者的焦慮 51
第二節 肺炎重症病人轉出至普通病房期間主要照顧者的社會支持 52
第三節 肺炎重症病人轉出至普通病房期間主要照顧者負荷及其相關因素 53
第六章 限制與建議 54
第一節 結論 54
第二節 研究限制與建議 55
第三節 實務運用 56
參考文獻 57
中文部分 57
英文部分 60

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