舒缓治疗科的家庭照顾者心理健康测量表之评定

East Asian Arch Psychiatry 2010;20:109-15Original Article Development of a Psychological Well-being Scale

for Family Caregivers in Palliative Care

舒緩治療科的家庭照顧者心理健康測量表之評定

KK Wu, VW Cho, A Li, WT Chen, DM Tse

胡潔瑩、曹韻芝、李愛娜、陳煒嬋、謝文華

Abstract

Objective: A Psychological Well-being Scale for Caregivers (PWS-C) was developed to screen for

psychological distress among family caregivers in a Palliative Care Unit for patients with advanced

cancer.

Methods: To study the psychometric properties of the 11-item PWS-C which consisted of 5 subscales; 132

family caregivers completed the PWS-C, of whom 70 also answered the Hospital Anxiety and Depression

Scale (HADS) questionnaire. Results of 15 caregivers who had received psychological intervention and

completed the PWS-C before and after treatment were compared.

Results: The internal consistency and test-retest reliability of the scale were found to be satisfactory. A 4-factor

structure was identified. Items for Life Meaning and Social Support subscales were accounted for by 1 factor.

The subscales of Emotional Distress, Caregiving Inadequacy, and Hospital Care were accounted for by 3

other factors. The PWS-C subscale scores were moderately correlated with HADS scores. Significant changes

in the subscales of Social Support and Life Meaning of the PWS-C were identified in pre-post treatment

comparisons, which indicated the potential utility of the scale as an outcome measure.

Conclusions: The PWS-C could be a reliable and valid tool useful for screening and measuring the

outcome of psychological interventions for psychological well-being / distress reduction, for caregivers

of patients receiving palliative care.

Key words: Caregivers; Mental health; Palliative care

摘要

目的：以一個針對照顧者的心理健康測量表（PWS-C）檢視在舒緩治療科內末期癌症患者的家

庭照顧者所面對的心理困擾。

方法：為了檢視包含11個項目共5項次量表的PWS-C的心理測量特性，研究共邀請132名家庭照

顧者完成PWS-C評估，當中70名也完成醫院焦慮抑鬱量表（HADS）問卷調查，並比較15名曾

接受心理干預並完成PWS-C的照顧者其治療前後的結果。

結果：內部相容性和可靠性測試皆令人滿意，並建立4項因子結構：第1項包含生活意義和社會

支持因素，其餘3項包括情緒困擾、照顧不足和醫院護理。PWS-C次量表比分與HADS比分呈適

度相關。當比較治療前後結果時，PWS-C的社會支持和生活意義次量表比分有顯著變化，顯示

其作為結果測量的潛在效用。

結論：PWS-C是可靠和有效的評估工具，有助檢視和量度接受舒緩治療的家庭照顧者在接受心

理干預後其心理健康或困擾改善的程度。

關鍵詞：照顧者、精神健康、舒緩治療

Dr Kitty K. Wu, PhD, MSocSc (Clin. Psy.), FHKPS, MAPS, Clinical Psychology Department, Caritas Medical Centre, Shamshuipo, Hong Kong SAR, China. Ms Valda W Cho, MSSc (Clin. Psy.), BSSc, Clinical Psychology Department, Caritas Medical Centre, Shamshuipo, Hong Kong SAR, China.

Ms Anna Li, BH (Nursing), Palliative Care Unit, Caritas Medical Centre, Shamshuipo, Hong Kong SAR, China.

W. T. Chen, MBBS (HK), MRCP (UK), FHKAM (Medicine), FHKCP, Palliative Care Unit, Caritas Medical Centre, Shamshuipo, Hong Kong SAR, China.

Dr Doris M. Tse, MBBS (HK), MRCP (UK), FHKAM (Medicine), FHKCP, FRCP (Lond), FRCP (Edin), Palliative Care Unit, Caritas Medical Centre, Shamshuipo, Hong Kong SAR, China.

Address for correspondence: Dr Kitty K. Wu, Clinical Psychology Services, Kwai Chung Hospital, New Territories. Hong Kong SAR, China.

Tel: (852) 2959 8022; Fax: (852) 2959 8717; Email: wukyk@.hk Submitted: 1 March 2010; Accepted: 27 April 2010 Introduction

Psychological Well-being of Caregivers in Palliative Care

Since the beginning of the modern hospice movement,