| 摘要: | 本研究旨在探討強迫症家屬經過支持團體介入後，在照顧負荷、生活品質、憂鬱和焦慮程度上的改變情形，並分析強迫症患者家屬在支持團體歷程中的獨特療效因子。
研究方式採用單組前後測實驗進行，以立意取樣方式招募11位符合參與條件之家屬為研究對象，透過專業助人者的帶領，進行共計8次，每次2小時的家屬支持團體。研究參考國內家屬支持團體之相關文獻，並邀請5位專家學者進行團體方案之內容效度評估，建構出適合強迫症患者家屬的團體方案。
資料的蒐集與分析兼採量化與質性方法。量化方式，乃透過受試者在團體前、後，填寫相關量表分數，再以無母數統計方法比較前、後測分數的差異，使用工具包括：強迫症患者照顧負荷量表、臺灣簡明版世界衛生組織生活品質問卷、臺灣人憂鬱症量表、中文版情境特質焦慮量表的情境焦慮部份。質性分析，則逐次觀察團體及團體結束後半結構式訪談，找出強迫症患者家屬支持團體「獨特的療效因子」，使用工具包括：團體歷程觀察記錄表及團體療效訪談大綱。
研究結果顯示在進行八次強迫症患者家屬支持團體後，照顧負荷得到顯著的改善，而生活品質、憂鬱程度、及焦慮程度等三項雖有改善但未達顯著差異。在團體歷程觀察中，分析出十二個療效因子皆有出現，其中又以傳達資訊、灌輸希望、普同感、發展社交、團體凝聚力等五項團體療效因子，在歷次團體中頻繁出現。由此可知家屬支持團體有其必要性與實質意義，可以幫助家屬得到正確的衛教知識及照顧技巧、交流照顧經驗與心得、彼此支持和鼓勵，進而感受到自己並不孤單。
最後，本研究根據研究結果提出建議，供未來研究及臨床實務之參考。
The purpose of this study was to investigate the caregivers of obsessive-compulsive disorder (OCD) patients, observing caregivers’ situation of burden, quality of life, degree of depression and anxiety after the intervention by support groups, and analyzing caregivers’ unique therapeutic factors during the support groups.
This study took Wilcoxon signed-rank test as the method. 11 caregivers as the subjects, who corresponded to conditions of participation, were chosen by means of purposive sampling. Through the professional helpers’ leadership, the researcher held caregivers’ support groups for 8 times, 2 hours per session. This study took domestic caregivers’ support groups as relevant references, inviting 5 experts and scholars to estimate the content validity of group projects and constructing them suitable for the caregivers of obsessive-compulsive disorder patients.
Besides quantitative method, qualitative way of collecting and analyzing data was also used in this study. In quantitative way, this study was based on subjects filling in the relevant scale scores before and after support groups, utilizing nonparametric statistics to compare the differences between pretests and posttests, and the tools contained The Burden Scale on Caregivers of Obsessive-Compulsive Disorder Patients (BSOCOOCDP), WHOOQOL-BREF Taiwan Version, Taiwanese Depression Questionnaire, and STAI-S. In qualitative way, the researcher observed every session completely and held a semi-structured interview at the end of CBGP, using tools like group observational form and the guidelines of interview, in order to find the unique therapeutic factors of the caregivers of OCD patients’ support groups.
The findings of this study showed after 8 times of caregivers of obsessive-compulsive disorder patients’ support groups, situation of burden had been improving obviously, while the quality of life, degree of depression and anxiety also been improved but not reached to significant difference. Observing the group progression, this study had analyzed that 12 therapeutic factors had showed up. Thereinto, the five group therapeutic factors as imparting of information, instillation of hope, universality, development of socializing techniques and group cohesiveness had been frequently represented. According, caregivers’ support groups have material meanings and necessities, they can help caregivers to know correct patient instructions and care methods, to exchange caring experiences and feelings, to support and encourage each other, moreover, to understand caregivers themselves are not alone.
Finally, based on the study result and discussions, suggestions will be presented as the reference for clinic practice and future research. |
