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題名：外籍看護與家庭照顧者對接受居家照顧老人住院與死亡風險之差異
書刊名：臺灣公共衛生雜誌
作者：黃郁超／吳建賢／張淑惠／陳雅美
作者(外文)：Huang, Yu-chao／Wu, Chien-hsien／Chang, Shu-hui／Chen, Ya-mei
出版日期：2016
卷期：35:3
頁次：頁304-315
主題關鍵詞：長期照顧；外籍看護；家庭照顧者；居家照顧品質；Long term care；Foreign care worker；Family caregiver；Quality of home care
原始連結：連回原系統網址new window
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  • 被引用次數被引用次數:期刊(4) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:4
  • 共同引用共同引用:21
  • 點閱點閱:32
目標：為解決老人照顧人力之需求，我國從1992年開始引進外籍看護，目前已經成為長期照顧人力的主要來源。有鑑於我國開放引進外籍看護二十多年，對於其照顧品質的相關研究仍然相當缺少。因此本研究希望探討由外籍看護照顧，相較於家庭照顧者，對於居家照顧老人預後風險之影響，並分析造成老人預後差異可能的因素。方法：研究資料取自273位新北市某區域醫院附設居家護理所之居家老人護理紀錄，所涵蓋之資料日期從2003年7月至2015年5月。以收案期間死亡與住院事件進行存活分析，比較外籍看護與不同性別、不同親屬關係之家庭照顧者照顧，對居家老人死亡與住院風險之影響。結果：由女性(HR= 0.715)、女兒或媳婦(HR= 0.653)所照顧之老人，其住院風險明顯低於由外籍看護照顧。短期由子女照顧住院風險同樣低於於外籍看護(HR= 0.552)，但子女照顧時間超過1.1年之後兩者則無顯著差異。結論：本研究顯示家庭照顧者照顧之老人預後優於外籍看護照顧。政府應重新考量目前外籍看護的開放政策，並對於願意投入照顧工作的家庭照顧者提供更多的長照資源與協助。
Objectives: The purpose of this study was to evaluate the quality of home care provided to older adults in Taiwan whose caregivers were either family members or foreign care workers. Methods: Data from July 2003 to May 2015 was retrieved from the records of a home care agency in new Taipei city. A total of 273 older adults were included for analysis. Cox proportional hazards and recurrent event models were applied to compare the risk of mortality and hospitalization for disabled older adults with caregivers who were foreign workers or family members; in addition, the effects of gender and family roles were determined. Results: Older adults who were taken care of by female family members (HR = 0.715), such as a daughter or daughter-in-law (HR = 0.653), had a significantly lower risk of hospitalization than older adults who were taken care of by foreign care workers. Older adults who were taken care of by their children during early episodes of disability also had lower rates of hospitalization compared to older adults who were taken care of by foreign care workers (HR = 0.552). The differences between these two caregiver roles (children vs. foreign care workers) were not significant when the duration of care lasted ＞ 1.1 years. Conclusions: The study findings showed that family caregivers provided better care to older adults than foreign care workers. The government should re-evaluate the open-door policy for foreign care workers and provide more long-term care resources and support for family caregivers who are willing to take care of disabled older relatives.
期刊論文
1.胡玉瑗、葉莉莉、王琪珍(20091200)。居家照顧需求初探--外籍看護工與家屬主照顧者比較。長期照護雜誌，13(3)，339-350。  延伸查詢new window
2.陳秀惠、劉雪娥、李佳琳、高振益(20120300)。外籍看護工生活品質及其相關因素之探討。醫護科技期刊，14(1)，57-68。new window  延伸查詢new window
3.林秀純、徐亞瑛、姚開屏、吳淑瓊(19990200)。臺灣北部地區失能老人家庭照顧品質及相關因素之探討。護理研究，7(1)，15-28。new window  延伸查詢new window
4.Lamura, G.、Chiatti, C.、Di Rosa, M.(2010)。Migrant workers in the long-term care sector: lessons from italy。Geneva Association Information Newsletter: Health and Ageing，22，8-12。  new window
5.Fusco, S.、Corsonello, A.、Chiatti, C.(2015)。Migrant care workers and rehospitalization among older patients discharged from acute care hospitals。Geriatr Gerontol Int，15，196-203。  new window
6.Carey, E. C.、Covinsky, K. E.、Lui, L. Y.、Eng, C.、Sands, L. P.、Walter, L. C.(2008)。Prediction of mortality in community-living frail elderly people with long-term care needs。J Am Geriatr Soc，56，68-75。  new window
7.Temkin-Greener H.、Bajorska, A.、Peterson, D. R.(2004)。Social support and risk-adjusted mortality in a frail older population。Med Care，42，779-788。  new window
8.Weland, D.、Lamb, V. L.、Sutton, S. R.(2000)。Hospitalization in the program of all inclusive care for the elderly (pace): rates, concomitants, and predictors。J Am Geriatr，48，1373-1380。  new window
9.Friedman, S. M.、Steinwachs, D. M.、Temkin-Greener H.、Mukamel, D. B.(2006)。Informal caregivers and the risk of nursing home admission among individuals enrolled in the program of all-inclusive care for the elderly。Gerontologist，46，456-463。  new window
10.Kuzuya, M.、Hasegawa, J.、Hirakawa, Y.(2011)。Impact of informal care levels on discontinuation of living at home in community-dwelling dependent elderly using various community-based services。Arch Gerontol Geriatr，52，127-132。  new window
11.King, B. D.(2006)。Functional decline in hospitalized elders。Medsurg Nurs，15，265-271。  new window
12.Peterson, M. J.、Giuliani, C.、Morey, M. C.、Pieper, C. F.、Evenson, K. R.、Mercer, V.、Simonsick, E. M.(2009)。Physical activity as a preventative factor for frailty: the health, aging, and body composition study。The Journals of Gerontology Series A: Biological Sciences and Medical Sciences，64(1)，61-68。  new window
13.Oyama, Y.、Tamiya, N.、Kashiwagi, M.、Sato, M.、Ohwaki, K.、Yano, E.(2013)。Factors that allow elderly individuals to stay at home with their families using the Japanese long-term care insurance system。Geriatr Gerontol Int，13，764-773。  new window
14.Kesselring, A.、Krulik, T.、Bichsel, M.、Minder, C.、Beck, J. C.、Stuck, A. E.(2001)。Emotional and physical demands on caregivers in home care to the elderly in switzerland and their relationship to nursing home admission。European Journal of Public Health，11(3)，267-273。  new window
15.Yaffe, K.、Fox, P.、Newcomer, R.(2002)。Patient and caregiver characteristics and nursing home placement in patients with dementia。JAMA，287(16)，2090-2097。  new window
16.Lin, D.、Wei, L.、Yang, I.、Ying, Z.(2000)。Semiparametric regression for the mean and rate functions of recurrent events。J R Stat Soc Series B Stat Methodol，62，711-730。  new window
17.黃偉城、周騰達、蕭添木、黃志芳、王培銘、曾嵩智、陳朝棟、陳秀偵(20061200)。腦中風居家護理個案預後因素的探討--202例個案病例之回顧。臺灣家庭醫學雜誌，16(4)，251-259。  延伸查詢new window
18.Bonsang, E.(2009)。Does informal care from children to their elderly parents substitute for formal care in europe?。Journal of Health Economics，28(1)，143-154。  new window
19.蔡鐿安(2006)。論家庭變遷下老人之家庭照顧支持系統。網路社會學通訊期刊，55，1-2。  延伸查詢new window
20.Anderson, L. A.、Edwards, V. J.、Pearson, W. S.、Talley, R. C.、McGuire, L. C.、Andresen, E. M.(2013)。Adult caregivers in the united states: characteristics and differences in well-being, by caregiver age and caregiving status。Prev Chronic Dis，10，135。  new window
21.陳美如、盧玉華、陳秋君、李愛誠(20140800)。降低外籍看護執行管路照護錯誤率之改善專案。護理雜誌，61(4)，66-73。new window  延伸查詢new window
研究報告
1.國家發展委員會(2014)。中華民國人口推計(103至150年)。臺北：國家發展委員會人力發展處。  延伸查詢new window
2.行政院國家發展委員會(2014)。103年度政院管制「長照服務網計畫」查證報告。台北：國家發展委員會。  延伸查詢new window
3.勞動部。2014產業及社福外籍勞工人數。  延伸查詢new window
學位論文
1.李宗霖(2011)。家庭看護工國籍與居家照護病患壓瘡發生之相關性探討-以彰化縣市內四家居家護理所病患為例(碩士論文)。中國醫藥大學。  延伸查詢new window
2.林金蘭(2012)。醫院住院病患之外籍看護照護能力評價及相關因素探討(碩士論文)。中國醫藥大學。  延伸查詢new window
3.謝昌成(2010)。探討居家照護服務與個案照護結果之間的相關性(碩士論文)。國立成功大學。  延伸查詢new window
4.楊純純(2010)。老年家庭照顧者的生活經驗與福利需求之探討--以照顧配偶的老年人為例(碩士論文)。國立暨南國際大學。  延伸查詢new window
5.郭書吟(2012)。日本基於EPA協定之護理・看護勞動者引進政策之考察(碩士論文)。淡江大學。  延伸查詢new window
6.李春味(2013)。外籍看護工來台工作滿意度的評價及期待之研究-以南投縣老人長照機構為例(碩士論文)。南開科技大學。  延伸查詢new window
7.蘇嫺敏(2009)。主要照顧者的照顧信念與照顧負荷相關研究--以台中市居家服務使用者為例(碩士論文)。國立暨南國際大學。  延伸查詢new window
圖書
1.UNPD(2013)。World Population Prospects: The 2012 revision。New York, NY：United Nations Publications。  new window
2.衛生福利部(2015)。長期照顧服務量能提升計畫（104至107年）。台北：衛生福利部。  延伸查詢new window
3.Martin, S.、Lowell, B. L.、Gozdziak, E. M.、Bump, M.、Breeding, M. E.(2009)。The Role of Migrant Care Workers in Aging Societies: Report on Research Findings in the United States。Washington, DC：Georgetown University。  new window
4.O'Shea, E.、Walsh, K.(2010)。The Role of Migrant Care Workers in Ageing Societies: Report on Research Findings in the United Kingdom, Ireland, Canada and the United States。Geneva：International Organization for Migration。  new window
5.Immigration Law Practitioners' Association(2011)。Senior Care Workers。London：ILPA。  new window
6.Huber, M.、Hennessy, P.、Organisation for Economic Co-operation and Development(2005)。Long-Term Care for Older People。Paris：OECD Publishing。  new window
7.Cook, R. J.、Lawless, J.(2007)。The Statistical Analysis of Recurrent Events。New York, NY：Springer。  new window
8.衛生福利部(2013)。老人狀況調查報告。台北：衛生福利部。  延伸查詢new window
其他
1.Day, T.。About long term care，http://www.longtermcarelink.net/eldercare/long_term_care.htm， 2015/08/01。  new window
2.脇阪紀行(2012)。外籍護士問題--大膽變革乃當務之急，http://www.nippon.com/hk/currents/d00034/， 2015/08/10。  延伸查詢new window
3.Bassett, L.。Danish's perspectives for training of senior caregivers，http://www.slideshare.net/ssuser897bf3/aging-innovation-week-taiwan， 2015/08/10。  new window
4.SOSU Nord。The social and health college in North Jutland，http://sosunord.dk/media/43528/ sosuuddannelserne_p__engelsk_juni_2012.pdf， 2015/08/10。  new window
 
 
 
 
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