在人類社會中，失能老人大多由家庭來承擔照顧責任，也因此帶給照顧者相當重的負荷。在此脈絡下，家庭照顧者的相關政策與措施逐漸受到大眾的重視，期望藉由各式的措施與服務以減少照顧對生活的不利影響，進而增加照顧者的生活福祉。在心理性的支持服務中，自助團體能夠有效舒緩照顧者的身心壓力，但照顧者自助團體研究甚少，且照顧者自助團體之研究未正視團體成員先前團體參與的經驗，及既有研究忽略照顧者支持團體的延續性效益之探究，是故，本研究目的包括：一、從接觸自助團體的起源—探討照顧者參與支持團體的經驗；二、分析照顧者參與自助團體的經驗；三、以增強權能觀點探究照顧者參與自助團體的經驗；四、從自助團體成員及社工員的角度看自助團體的未來發展；五、依據研究結果，提供建議作為辦理照顧者自助團體的實務工作者及家庭照顧者相關團體之參考。 本研究使用質性取向的研究方法，以「台北縣家庭照顧者關懷協會」作為研究場域，本研究共計訪問八名受訪者，一名社工員及七位照顧者。照顧者皆為女性，年齡介於53-64歲之間。照顧狀況方面，有1位仍持續照顧中，6位已結束照顧工作。照顧者參與自助團體方面，僅有1位非團體幹部。 主要的研究結果如下： 1.照顧者參與支持團體經驗中，透過醫療單位及個人熟識者得知活動訊息。照顧者支持團體前的處境大致可區分心理壓力、生理壓力、缺乏社會支持網絡及不清楚照顧方面的資訊。照顧者實際參與支持團體的條件為能擁有自己可支配的時間，以及有人協助暫代照顧工作。支持團體活動內容包括身心成長類、藝術治療類、活動肢體類、人際學習類，其中團體領導者的角色為教育者、催化者及使能者。領導者與成員的關係會隨著時間而改變，隨著時間的發展，許多不在正式的團體中的互動行為跟關係開始產生，此互動經驗讓成員與領導者在團體之外仍保持密切互動，彼此約定舉辦定期的聚會，逐漸形成自助團體。 2.照顧者參與自助團體之經驗中，北縣家協每個月會安排一次三小時的座談分享會，座談內容偏向靜態主題如舒壓、按摩穴道等。自助團體成員的角色可區分為活動發起者、訊息傳遞者、聯繫者、支持者及追隨者。團體互動歷程包括三個階段：互動初期、關係建立期及關係維持期。成員彼此互動的情形中，共享相似的照顧經驗及用支持的力量陪伴成員走過艱辛路，此外，單身、結束照顧工作的成員與他人互動的頻率較高。 3.以增強權能觀點分析照顧者參與團體的經驗中，在個人面的改變部份，照顧者能夠「減少負面感受」、「改變認知」、「增加知能」、「增加自信」、「支配自己的生活」；在人際面的改變中，照顧者「以同理心與被照顧者互動」、「普同性的照顧經驗」、「利他性的互動」、「知識訊息分享」、「建立同儕友誼關係」及「擴大社會網絡」；在社會面的改變中，照顧者開始從事「志願服務」、「贊助協會」，對「家庭照顧者議題及政策」也有所看法。 4.從自助團體成員與社工員的角度看自助團體的未來發展：從照顧者角度看自助團體，可發現自助團體目前運作狀況為擴大服務據點至偏遠地區，北縣家協與自助團體彼此具有雙向的互動關係。照顧者建議將活動資訊發給每個社區的健康中心，透過增加資訊管道以使訊息更具有可近性。從社工員的角度看自助團體發現，照顧者喜愛輕鬆的聚餐，期待設計自助團體相關教材，並成立自助團體的關懷小組，及補助自助團體的運作經費。 / On an aging society, the disabled elderly usually cared by families that becomes a heavy load of caregivers. In this context, the policies and measures of family caregiver are valued by the general public gradually, and hope to reduce the negative effects, to increase the well-being of caregivers. Self-help groups can effectively reduce the ca-regiver physical and mental pressure, but there are few related studies. In addition, the experience of caregiver involve in previous groups few mentioned in current studies, and caregiver support groups of the continuity of the effectiveness is neglected to explore in existing studies. Accordingly, the purposes of this study are as following: first, examine the expe-rience of caregivers involved in the support group; second, consider the experience of caregivers involved in the self-help group; third, explore the experience of caregivers involved in the self-help group --analyze from the perspective of empowerment; fourth, the expectation of the future development of self-help groups of members from the self-help groups and social workers; fifth, according to research findings, provide suggestions for caregivers’ practitioners and relevant groups. This study employs a qualitative research approach, and data collection is gotten from " Family Caregivers Association in Taipei County", including semi-structured in-depth interviews with a social worker and seven caregivers, aging from 53 to 64. One caregiver who still cares her family members and one caregiver is not the cadre. The study findings are listed below: First, caregivers get information through the medical units and individuals who are familiar to them. Caregivers have psychological stress, physical stress, lack of social support networks, and lack of care information. Caregivers can involve support groups because they have their own time, or someone help to take care temporarily. Support group include physical and mental growth activities, art therapy classes, common activities and interpersonal learning classes. The role of support group leader is a educator, catalyst and enabler. The relationship between leaders and members change over time, as time goes on, members and leaders still remain in close interaction, therefore a self-help group formed gradually. Second, when caregivers involve in the self-help group, the Association arrange a three-hour discussion sharing monthly. The role of self-help group members can be divided into active sponsors, messengers, associates, supporters and followers. Group interaction process consists of three stages: the initial interaction, relationship building and relationship of the maintenance phase. Members interact with each other, sharing similar experiences and support each other .In addition, caregivers who are single, or do not have to care their family members have higher participation rates to involve in self-help group. Third, explore the experience of caregivers involved in the self-help group --analyze from the perspective of empowerment. Changes in the personal aspect include "reduce the negative feelings", "change the perception", "more knowledge", and “more confident”, “control their own life”. Changes in the interpersonal aspect include " empathy the care receivers "," same experiences in taking care "," altruistic interaction "," knowledge and information sharing "," establish peer friendships and relationship "and" expand the social network ". Changes in the social aspect include "engage in voluntary service "," contribute money to Association ", besides caregivers have ability to suggest for family caregiver issues and policy. Fourth, the perspective of self-help group members is self-help groups expand services to remote areas. The Association and self-help groups also have good interaction. Caregivers suggest activities distributed to each community's health information center, make information more accessibility. The perspectives of social workers is design teaching material about self-help group, and set up a support team, and grant funding for self-help.

家庭照顧者的照顧負荷沉重，其多表達有支持性服務的需要，故針對家庭照顧者使用支持性方案之經驗，頗值得研究加以探討。本研究目的為瞭解家庭照顧者使用支持性方案的情形為何，進而探索使用服務期間從事活動的經驗，剖析家庭照顧者在使用支持性服務期間重新回復能量之過程。 本文採質性研究法，以深度訪談法蒐集資料，訪談樣本來自台灣失智症協會，共有4位失智症照顧者接受訪談。主要研究結果如下﹕ 1.家屬使用「各項家庭照顧者支持性方案」的情形，以瑞智學堂、瑞智互助家庭、家屬聯誼會為例，進而比較上述三項服務方案之異同：(1)學堂到互助家庭，家屬「聚在一起」和「舒緩的時間」更多；家屬更懂得「釋放關心」。(2)從學堂到家屬聯誼會：「家屬未經組織的團體聚會」到「成為團體成員後的聚會」。(3)服務對象與受惠對象方面，學堂服務對象以「失智長者為主，長者受惠較多」；互助家庭以「長者和家屬為主，家屬受惠較多」；家屬聯誼會以「家屬為主，家屬受惠較多」；但其實「長者與家屬之間具有相互性」，家屬獲益之後，更能以健康的身心靈來提供長者的照顧，相對的，長者的功能得以維持或減緩退化，亦有益於家屬提供照顧。 2.家屬的需求與動力是推動支持性方案重要的推展，從學堂到互助家庭的歷程，家屬與長者有三個階段的活動經驗，包含麻將班、烹飪班以及樂樂班，其顯示家屬有時間、空間以及活動參與的需求。 3.家屬使用服務期間從事活動獲得「心理喘息」的要素，可就休閒與休息、自我效能感、團體的歸屬感、採取行動的層面進行分析，分別為(1)休閒與休息：「才能展現」、「享受說話」以及提升生活「滿意感」；(2)自我效能感：「學習」、「突破」、「成就感」的過程，增進自我效能感；(3)團體的「歸屬感」，以及(4)社會貢獻的使命和生命的「意義感」，可見家屬由照顧者蛻變成助人者的軌跡。 / The caregivers in families carry a heavy responsibility, and many of them express the need for supportive services. As such, their experience in using supportive programs warrants further study and examination. In this study, we aim to first understand how such programs are being used. Next, we examine the restorative process in which caregivers use such services to gain respite. This study used the qualitative research approach, and collected data from Taiwan Alzheimer's Disease Association and included semi-structured in-depth interviews with four caregivers of the elderly with dementia. The research findings were listed below: 1.We studied the following three supportive programs and analyzed their similarities and differences: the School of Wisdom, the Family of Wisdom, and the Family Club. (1) As the group progresses from the School of Wisdom to the Family of Wisdom, family members have more and more time to spend together and respite time; they also tend to show more care for others. (2) As the group progresses from the School of Wisdom to the Family Club, unorganized group gatherings evolve into organized gatherings for members of the group. (3) The target participants for the School, the Family and the Club are, respectively, senile seniors, seniors and their families, and families; the beneficiaries of the programs are seniors, families, and families. However, there is also an interrelation between seniors and their families: families who benefit from improved mental, physical and spiritual health are better able to care for their seniors. Vice versa, it is easier for families to care for seniors who are able to maintain or mitigate the degeneration of their daily functions. 2.The needs and motivations of families are pivotal drivers for supportive programs. Throughout the evolution from the "School" to the "Family", families and seniors go through three stages of participation in activities, namely, mahjong classes, cooking classes and hobby classes. The progress reveals the families' need for respite time and space and their levels of participation. 3.Families enjoy a restorative mental break by participating in activities. We analyzed the key elements of this mental break: leisure and rest, self-efficacy, belongingness, and level of participation. (1) Leisure and rest: display of talent, enjoyment of talking, and enhanced satisfaction toward life. (2) Self-efficacy: enhanced self-efficacy through the process of learning, breakthrough and sense of achievement. (3) Belongingness: the sense of belonging to a group. (4) Level of participation: the sense of mission to contribute to the society and meaning of life demonstrated by the families show an evolution from being the caregiver to the one who helps others.