住院愛滋病思健康照護需求量表發展之前驅研究

The Development of a Health Care Needs Scale for Hospitalized Patients with AIDS: A Pilot Study

王世麗(Shirley Shih-Li Wang) ； 林麗嬋(Li-Chan Lin) ； 郭英調(Benjamin Ing-Tiau Kuo)

《護理研究》 6卷1期 (1998/02) Pp. 69-81

https://doi.org/10.7081/NR.199802.0069

摘要

本研究目的在發展住院愛滋病患健康需求量表。研究過程分為二階段進行；第一階段為發展訪談指引，抽樣來源係台北某一家醫學中心，採立意取樣，選樣標率為衛生署指定之愛滋病防治醫療院所醫師診斷為愛滋病、年滿 12 歲以上、能以國語溝通、且目前為住院中之個案。樣本數之決定乃依據飽和原則，經受訪病息同意後進行訪談，同時錄音記錄訪談內容並轉錄謄寫，樣本數總計八名。資料分析採內容分析法，編碼員本身一致性為 0 . 81 ，編碼員問一致性為 0 . 89 。第二階段為發展住院愛滋病患需求量表，選樣標準與第一階段相同，樣本來源為台北某二家醫學中心與中途之家。第一階段之資料分析結果被編製為 79 題之住院愛滋病患需求量表。研究結果將愛滋病息的需求分為生理、心理社會、訊息、及照護品質等四大類別。而最重要的需求項目為：照護品質需求中的「期望死亡診斷書（或住院診斷書）勿寫疾病名稱」、「醫護人員不應告訴別人病情 J 、生理需求中的「減輕死亡前身體上的痛苦J。四位臨床愛滋病專家被用來檢定內容效度：百分比同意度為93 %，而Kappa同意度係數為0.23。20位愛滋病息被用來評估量表之內部一致性，Cronbach's α為0.92。本研究結果顯示此量表有初步的心理計量屬性，未來研究建議從事效標效度及建構效度的檢定，以進一步效化本量表。

關鍵字

愛滋病息 ； 健康照護需求 ； 量表發展

並列摘要

The purpose of this two-phase study was to develop a health care needs scale for hospitalized patients with AIDS. Phase One involved developing an interview guide. Purposive sampling was used for this phase, with subjects being chosen from a medical center in metropolitan Taipei based on the following criteria: (1) diagnosed with AIDS, (2) no complications such as neuropathy, psychosis, or dementia, (3) at least 12 years of age, (4) able to speak Mandarin, and (5) being hospitalized at the time of the study. Sample size was determined by the saturation principle and eight were selected for interviews, which were tape - recorded and transcribed. Analysis included content analysis in which intra - coder percentage agreement yielded 0.81, while the inter-coder percentage agreement yielded 0.89. Phase Two consisted of constructing a health care needs scale for patients with AIDS. Sampling criteria in Phase Two were the same as in Phase One. Data obtained in Phase One resulted in a 79-item Health Care Needs Scale for Hospitalized Patients with AIDS. Seventy- nine items were categorized into four categories of health care needs: physiological, psychosocial, informational and quality of care. The most important items on health care needs scale were ”don't write the diagnosis on my certificate of death”, ”don't tell others my physical situation” in quality of care needs, and ”alleviate physiological discomfort before death” in physiological needs. Four experts were used to determine content validity, yielding a percentage agreement of 0.93 and a Kappa coefficient of agreement of 0.23. Internal consistency analysis resulted in a Cronbach's α of 0.92. Findings indicate that this scale has initial psychometric properties, and it is recommended that further studies be made to determine construct and criterion related validities.

並列關鍵字

patient with AIDS ； health care needs ； development of scale