本研究目的在探討長期臥床病患主要照顧者接受照護指導後，對其照護能力及病 患照護之影響。以台中縣內其活動能力合於柯氏量表(Karnofsky scale)第三、四級之病患， 共392名為研究對象。以病患日常活動自理能力、壓瘡情形及主照顧者照護認知、技術等能 力作為照護指導成效評值項目，由公衛護士每月觀察紀錄，持續三個月。所得資料以SPSS 套裝軟體處理，再以描述統計、Chi-square test、t-test、paired t-test 及multiple logistic regression 進行分析。結果顯示：主照顧者接受照護指導後，整體照護知識及技術顯著提昇、壓瘡個案 中1/3情況改善；經過三個月，病患日常生活活動自理能力平均得分雖有顯著改善，但無法 證實其與主照顧者能力有關。經多變項對數迴歸分析，病患之臥病期程及活動能力等級顯著 影響其日常生活活動自理能力改善與否。研究者建議應儘早對主照顧者實施照護指導介入， 以有效改善病患日常生活活動自理能力。

　　　　　The objective of this study was to investigate the effects of nursing instructions given to caregivers of long-term bedridden patients. Subjects included 392 caregivers whose patients met the criteria of grade 3-4 based on the Karnofsky scale. After caregivers were given nursing instructions, the public health nurses monitored the patients' progress once a month for three months. Three criteria were used to determine the instructions' effectiveness: degree of improvement of patients' self-care ability, change in the patient's condition with respect to pressure sores, and overall ability of caregivers (including caregiving knowledge and techniques for general care and care of pressure sores). All data were analyzed by SPSS and statistical methods including frequency, Chi-square test, t-test, paired t-test, and multiple logistic regression. Results showed a significant improvement in the overall ability after caregivers were given instructions. One third subjects with pressure sore was improved. The average score for self-care ability given to patients improved significantly over the three- month period, however this was not found to be related to the caregivers' ability. Based on a logistic egression analysis, bedridden duration and grade of mobility had a significant effect on the patient's self-care ability. The authors suggest that nursing instructions need to be provided to caregivers as early as possible in order to effectively improve the patient's self-care ability.