台灣國民平均壽命顯著延長，加上生育率降低，65歲以上老年人佔總人口數比率至2012年底已達11.2%，以及65歲以下領有身心障礙手冊者佔全國人口數的3.03%，且有逐年增加之趨勢，因此長期照護之需求則日漸增加；因應政府推動「在地老化」之政策，失能者回歸社區式照顧，主要照顧者則扮演著重要之角色。是什麼因素促使主要照顧者願意提供照護工作？因此本研究目的欲以社會交換之觀點探討主要照顧者與被照顧者間之關係，是否影響到照顧者負荷及照顧意願，期藉此研究結果幫助家庭照顧者照顧負荷減輕、提高照顧之意願。 本研究工具採問卷調查法蒐集資料，並以台灣南部某醫學中心附設居家護理所收案管理個案之主要照顧者為研究對象，在排除機構、輪住之個案及拒訪者，由家屬擔任主要照顧者或聘有看護工仍參與照顧每日達6小時以上者，總計樣本共116人。問卷回收後，以複迴歸分析的統計方法進行資料處理，探討交換因素之情感性因素、經濟性因素及責任性因素對照顧者負荷及照顧意願之相關性。 結果發現，迴歸分析在控制相關因素之下，照顧者與被照顧者間之情感性因素與照顧意願有正向顯著性，即兩者間情感性因素程度愈高，照顧意願愈高；經濟性因素及責任性因素因受到照顧者照顧年數較久、能維持良好之社交能力及家庭經濟能力狀況佳之干擾因素影響，與照顧意願無顯著相關；照顧者負荷亦受到相關因素影響之下，於本研究與交換因素及照顧意願未呈現顯著相關性，而其間之相關性實值得進一步研究探討。 因此本研究建議將照顧者負荷及照顧意願列入居家護理評估項目，當發現影響照護之相關因素，適時予以輔導或轉介相關單位，進而提升家庭照護之品質；並建議政府能多辦理倡導夫妻相處和諧及促進親子互動溝通之社區活動，強化家庭情感性功能。 The life expectancy is significantly extend and the elderly population ratio reach exceed 11% Taiwan, and the proportion of which have physical disability accounted for a 3.03%, it will increase future demand for long-term care. The purpose of the policy of "aging in place" was backing the disable elderly to the community-based care and the family caregiver role is very important. So it is necessary to understand, what the driving forces are willing to provide care for caregivers The purpose of this study was to explore the relationship between the primary caregiver and care recipients with the social exchange approach, and to analyze effects of the caregiver burden and willing to care . We were use the questionnaire for data collection and the samples were primary caregiver of the home bond cases ? those who receive home care services by a medical center in Tainan. The study excluded cases who live in institutions and interviewed refusing. The caregiver has take care hours more than six hours daily were enrolled in the study, and the total samples were 116. To investigate factors affecting the emotional factors, economic factors and the responsibility factors u caregiver burden and willingness. The results showed that the emotional factors and willingness to care of caregivers have positive effects, the higher degree of emotional, the care willingness is higher. Economic factors and the accountability factor is not significantly associated with the care wishes, it may interfere with other relevant factors and need the further study. We recommended that the caregiver’s burden and willingness should be included in home nursing care assessment project, and provide counseling and referral of caregivers, to improve the quality of home care. The study also recommended more community activities to foster marital relations and promote communication between parents and children and strengthen the family relationship.
