[[alternative]]The experiences in taking care of elderly patients among older adults: from the perspectives of caring patients with hip fracture

[[abstract]]髖部骨折病患中，65歲以上老人占63% ，而老人髖部骨折術後日常活動功能常呈現嚴重依賴，出院返家後更需依賴家屬的照顧。當主要照顧者為65歲以上之老人時，除面對自己本身因老化而導致的身體功能衰退，還需承受擔任照顧者所面對之各種衝擊。 本研究在探討老年主要照顧者在面對照顧髖部骨折術後老年病患的生活經驗。採質性研究設計，以立意取樣，自99年12月至100年5月，於嘉南地區三家區域、地區教學醫院進行收案，運用深度訪談法訪談十位老年主要照顧者，受訪者年齡介於65歲至82歲。以內容分析法進行資料分析，結果共可歸納出五個主題，分別為：害怕跌倒、缺乏技能、居住兩難、身心負荷、正向面對。研究結果說明，老年主要照顧者在照顧剛出院返家之老年病人，常常擔心及害怕病人會因為自己下肢無力、行動不方便或其它各種因素導致再度跌倒而形影不離或限制老年病人活動來預防跌倒；當照顧日常活動功能嚴重依賴、傷口尚未痊癒的老年病人時，更常感受到自己缺乏照顧技巧，並對於疾病變化的不確定或發生突發狀況不知如何處理而忐忑不安；老年主要照顧者自己本身面對老化引起的身體機能衰退外，還需承受擔任照顧者的體力負擔，有時更要承受老年病人負面的情緒反應、擔心健康變化等這些心理壓力，老年照顧者在承受體力透支、經濟負擔等多重負荷下，也陷入要讓老年患者在家中接受照顧或選擇機構照顧服務的兩難情境中。然而在歷經照顧上的種種負荷後，老年主要照顧者會開始調整自己心態，並尋求支援，重新學習照顧方式，改善自己在照顧老年病人時所遇到的問題與造成之壓力。 藉由本研究結果，有助於深入了解老年主要照顧者面對照顧老年髖部骨折病患的經驗與感受，並可提供臨床護理人員於面對老年主要照顧者時，可以提供適切的個別性護理措施，以提升老年主要照顧者之生活品質。[[abstract]]Sixty-three percent among the patients who have hip fracture are over 65, as the result, they are highly depending on the others in their daily bases, and lots of assistance is required after discharge and returned for home caring. . When the main caregivers who aged more than 65 years old, they have to deal with not only their aging related body function weakening issue, but also the impacts of being a caregiver. The purpose of this study was to understand the experiences in taking care of elderly patients with hip fracture among older adults. Qualitative design and purposive sampling with in-depth interview was conducted to collect data from three districted and local teaching hospitals in Chayi and Tainan areas during December 2010 to May 2011. Ten elder caregivers aged 65 to 82 were interviewed. Content Analysis was used to analyze data. The findings revealed five themes: fear to fall down, lack of skills, living dilemma, physical and mental burden, and positive attitude. The results indicated the fact that when elder caregivers took care of older patients whom just discharged from hospitals and returned for home caring, these caregivers often worried that their patients might fall down again because of their poor mobility, thus they tend to follow their patients everywhere or by limiting their activity to prevent accident occurs. When elder caregivers had to take care of highly depending patients or who had unrecovered wounds, they often sensed of lacking the skill in care-giving and felt anxiety because of the uncertainty to the illness or not knowing how to deal with the situation that accident suddenly occurs. the. While dealing with patients’ negative reactions and health problem, elder caregivers had to face their own energy overused and the weakness of body function. As elder caregivers under health and economical pressures, they struggled in deciding whether to arrange the patients to long-term care fertilities or to take care of them by their own at home. On the other hand, after experiencing the difficulties in care-giving, elder caregivers started to adjust their attitude and searched for assistance in order to learn new caring skill, by doing so, they would be able to overcome the stress and problems of patient care. The results of this study reveal the experiences and feelings of elder caregivers when taking care of older patients with hip fracture. They also provide clinical nurses proper indication to take care of patients individually and to increase the quality of life among elder caregivers