台北地區國小校護照護糖尿病學童之 知識、態度、行為傾向及其影響因素探討

A study of Knowledge, Attitude, Behavior Intention and Associated Factors Concerning Taking Care of Students with Diabetes by Elementary School Nurses in Taipei

李慧芬(Hui-fen Lee)

指導教授 ： 陳月枝

國立臺灣大學/醫學院/護理學研究所/碩士(2004年)

https://doi.org/10.6342/NTU.2004.01086

摘要

本研究旨在了解並探討台北地區國小校護對照護糖尿病學童之知識、態度、行為傾向及其相關因素。採橫斷式調查法，以自擬結構式問卷為研究工具，運用郵寄問卷方式進行資料收集，選擇台北地區360所公私立國民小學校護共387人(包括27所國小設置校護2名)為研究對象。共回收有效問卷218份，回收率56.33%。所收集之資料以SPSS11.0 for Windows統計套裝軟體依據研究假設進行描述性及推論性統計分析。重要結果如下：
一、兩百一十八位校護服務於208個學校，其學生與校護之人數比值平均為1298。研究對象中，214位沒有糖尿病，有4位不知道自己是否有糖尿病。58.72%有患糖尿病的親友，51.0%有直接照護糖尿病親友或病人的經驗，38.99%在擔任校護期間曾接觸過糖尿病學童。
二、台北地區校護關於糖尿病之主要知識來源依次為「護理養成教育」、「在職教育或訓練」、「書籍」及「醫護專業期刊」。
三、知識量表平均得分為14.18(答對率70.9%)。平均答對率較好的項目為「日常生活指導」，較差的為「病因與流行病學」、「急性併發症及其處理」。關於高血糖與酮酸中毒症狀的區別，只有不到一成的校護答對。
四、態度量表平均得分為75.77(得分可能範圍20-100分)。整體而言，研究對象對照護糖尿病學童之態度趨於正向。且對提供糖尿病童及教師相關的知識有很高的認同。
五、行為傾向量表平均得分為56.35(得分百分比為70.44%)。平均得分較高的題目為「能主動蒐集並閱讀糖尿病新知，以增進照護的能力」、「當發現有疑似糖尿病學童時，能做適當轉介並追蹤」、以及「教導糖尿病學童有關合併症的預防之知識」。平均得分較低的題目為「準備並管理糖尿病學童所需的緊急用藥及器材」、「召開糖尿病學童個案討論會」、以及「與校外醫療照顧人員溝通」。
六、與知識量表得分達統計上顯著差異的變項為「近五年內是否曾參加糖尿病相關之研習」，且「最高學歷」與知識量表得分成正相關。
七、與態度量表得分達統計上顯著差異的變項皆為「學校班級數」、「學生人數和校護人數比值」、「最高學歷」與「近五年內是否曾參加糖尿病相關之研習」。其中「學校班級數」、「學生校護人數比值」與量表得分成負相關，而「最高學歷」與量表得分成正相關。
八、與行為傾向量表得分達統計上顯著差異的變項皆為「學校班級數」、「學生人數和校護人數比值」、「最高學歷」、「年齡」與「近五年內是否曾參加糖尿病相關之研習」，其中「學校班級數」、「學生校護人數比值」與量表得分成負相關，而「最高學歷」與量表得分成正相關。
九、台北縣、市國民小學校護對於照護糖尿病學童之行為傾向與其對知識與態度間均成正相關。至於糖尿病之知識與態度間，則無顯著的相關。
根據研究結果，本研究建議：
一、校護：主動爭取進修機會，積極參與學校衛生護理專業團體。
二、學校衛生護理專業團體：發展校園糖尿病管理之標準程序及管理工具，定期舉辦個案管理及糖尿病照護研習。
三、教育及衛生當局：推動及建立學校護理專科證照制度，建構學校、醫療機構、社區的糖尿病照護資源網路。

關鍵字

學校護士 ； 知識 ； 行為傾向 ； 態度 ； 糖尿病學童

並列摘要

The purpose of this study was to explore the level of knowledge, attitude, behavior intention and their related factors concerning taking care of students with diabetes by elementary school nurses in Taipei City and Taipei County. A cross-sectional study design was conducted via structured questionnaire collected by mail. The elementary school nurses were from 360 public and private primary schools in Taipei. Total subjects were 387. Two hundred and eighteen valid questionnaires were returned (56.33%) and used for data analysis. Data were analyzed by descriptive and inferential statistics through the SPSS 11.0 for Window Software.

Significant results were summarized as followed：
1. Among 208 schools that 218 school health nurses came from, the students and nurses were in the average ratio of 1298 to 1. Among 218 school health nurses, 214 nurses have no diabetes and 4 nurses don’t know if they had diabetes or not. 58.72% of study subjects have diabetic family members or friends. 51.0% of them had took care their family members or patients with diabetes directly. 38.99% of them had or had ever had diabetic students when they served in school.
2. The main resource that study subjects got diabetes knowledge was “ nursing education in school ”, ” continuing education or training on-the-job ”, ” books ”, “medical or nursing journals ”.
3. The mean diabetes knowledge score was 14.18 out of a possible 20 (the percentage of correct answer was 70.9). The study subjects scored the highest on “direction for diabetic patients’ every day life”. The lower score that subjects attained was in two categories of “etiology and prevalence of diabetes” and “the acute complication and treatment”. More than 90% of study subjects confused hyperglycemia and ketoacidosis.
4. The mean diabetes attitude score was 75.77 out of a possible 100. On the whole, the attitude tendency of subjects toward the management and caring for school children with diabetes was positive. And the school nurses were willing to provide health consultation and guidance for the diabetic students and their teachers.
5. The mean score of behavior intention scale was 56.35 out of a possible 80. The study subjects scored the higher on ”acquiring and maintaining the knowledge and skills necessary to provide comprehensive care”, “referring and following up properly when finding a suspect case of diabetes” and ”providing health education about complication of diabetes for the diabetic students”. The lower score that subjects attained was in three categories of ”managing the medicine and equipment for diabetes emergencies”, “conducting a case conference of diabetic student” and “communicating with staff of the hospital or institution”.
6. The variables that impacted on the levels of knowledge were “whether or no subjects had attended diabetes seminars in 5 years”. “The highest level of nursing education” and the scores of diabetes knowledge were statistically significantly positive correlated.
7.The variables that impacted on the attitude were ”number of classes in the school”, “ratio of students and nurses”, “the highest level of nursing education” and “whether or no subjects had attended diabetes seminars in 5 years”. The first two were statistically significantly negative correlated with the scores of diabetes attitude, “the highest level of nursing education” was statistically significantly positive correlated with the scores of diabetes attitude.
8.The variables that impacted on the behavior intention were ”number of classes in the school”, “ratio of students and nurses”, “the highest level of nursing education”, “age” and “whether or no subjects had attended diabetes seminars in 5 years”. The first two were statistically significantly negative correlated with the scores of behavior intention scale, “the highest level of nursing education” was statistically significantly positive correlated with the scores of behavior intention scale.
9. There was a significant positive correlation between behavior intention and knowledge. There was a significant positive correlation between behavior intention and attitude. There was no significant correlation between knowledge and attitude.

According to the results of this study, we propose the followings:
1. For school health nurses：expanding opportunities in continuing education actively, taking part in the professional groups of school nursing.
2. For professional groups of school nursing：developing the practicing standards and tools for school diabetes management, directing periodical diabetes seminars for school nurses.
3. For the Administrations of Education and Public health：making a professional license system for specialist nurse of school health, constructing a network of diabetes care resources among schools, medical institution and community.

並列關鍵字

attitude ； knowledge ； school children with diabetes ； behavior intention ； school health nurse

參考文獻

吳齊殷譯(1999)。量表的發展：理論與應用。台北：國立編譯館。

李燕晉(1999)。胰島素治療。中華民國內分泌暨糖尿病學會會訊，12 (附刊1)，45-50。

郭清輝(1999)。糖尿病的併發症。中華民國內分泌暨糖尿病學會會訊，12(附刊1)，55-60。

林宏達(1998)。糖尿病的診斷與分類。中華民國內分泌暨糖尿病學會會訊，11，1-8。

李亭儀、林宏達(1999)。低血糖與糖尿病。中華民國內分泌暨糖尿病學會會訊，12 (附刊1)，79-82。