護理人員與心臟衰竭病患對病患健康照護需求及需求滿足程度之差異及其相關因素

Comparison of health care needs and levels of needs satisfaction perceived by heart failure patients and their primary nurses

余秀珊(Hsiu-San Yu)

指導教授 ： 羅美芳

國立臺灣大學/醫學院/護理學研究所/碩士(2005年)

https://doi.org/10.6342/NTU.2005.02759

摘要

本研究目的為瞭解護理人員與心臟衰竭病患對病患健康照護需求及需求滿足程度，進一步比較兩者間差異及相關因素，研究方法為橫斷式調查法，以北部某醫學中心及某區域醫院心臟衰竭病患與護理人員為研究母群體，共收得72名病患及49名護理人員，研究工具包括個案及護理人員基本資料表、心臟衰竭病患症狀經驗量表、巴氏量表、心臟衰竭健康照護需求及需求滿足量表，結果如下：
ㄧ、護理人員與心臟衰竭病患對病患健康照護需求的評估為中度偏高度重要，需求獲得滿足程度為中度滿足，整體健康照護需求與需求滿足程度呈現顯著正相關(r =0.48, 0.56; p < 0.01)。
二、護理人員辨認病患整體健康照護需求、訊息及心理社會需求顯著高於病患(t = 2.03, 4.37, 2.54; p < 0.05)，對靈性需求的評估顯著低於病患(t =-2.40; p < 0.05)；護理人員辨認病患整體健康照護需求、心理社會層面、生理層面及靈性層面需求獲得滿足程度顯著低於病患自覺滿足程度(t = -2.08, -2.71, -2.27, -3.03; p < 0.01, 0.01, 0.05, 0.05)。
三、心臟衰竭病患健康照護需求之相關因素，包括年齡、性別、NYHA分級、抽煙習慣、症狀困擾及日常活動能力。護理人員辨認病患健康照護需求之相關因素，包括年齡、工作年資及心臟科照護經驗。
依研究結果提出以下建議：
ㄧ、加強護理人員對病患整體需求之評估能力，並適時提供介入措施。
二、對於心臟衰竭病患高需求、低滿足的項目（例如：促進睡眠及休息的照護），安排在職教育課程，增強護理人員問題之處理能力。
三、設置心臟衰竭個案管理師，並與護理人員密切合作，將病患納入個案管理照護模式，以提供更符合病患需求的護理照護。

關鍵字

心臟衰竭 ； 健康照護需求 ； 需求滿足程度

並列摘要

The purposes of this study were (1) to explore the health care needs and levels of needs satisfaction perceived by heart failure patients and their primary nurses, (2) to compare the differences between patients' and nurses' perceptions, (3) to identify the factors related to the health care needs.
This was a descriptive and cross-sectional study, using a purposive sampling method. The subjects were 72 heart failure patients and 49 nurses from a medical center and a regional teaching hospital in northern Taiwan. Four instruments were used in this study including Background Information, The Congestive Heart Failure Symptom Distress Experience Scale, Barthel’s Scale and The Heart Failure Patients’ Health Care Needs and Satisfaction Inventory.
The findings were summarized as following:
1. The levels of health care needs perceived by nurses and heart failure patients were between “important” to “very important”, and the levels of needs satisfaction were “moderate”. Health care needs were significantly related to the levels of needs satisfaction (r = 0.56, 0.48, respectively; p < 0.01).
2. Nurses overestimated patients’ needs including overall health care needs, information needs, psychosocial needs (t = 2.03, 4.37, 2.54, respectively; p < 0.05)and underestimated patients’ spiritual needs(t = -2.40; p < 0.05). On the other hand, nurses identified the levels of needs satisfaction significantly lower than patients themselves in overall health care needs, psychosocial needs(t = -2.08, -2.71, respectively; p < 0.01), physical needs and spiritual needs(t = -2.27, -3.03, respectively; p <0.05).
3. Factors related to the health care needs of heart failure patients were age, gender, NYHA classification, smoking, level of symptom distress and activities of daily living. Nurses’ age, career seniority and experiences of caring for cardiovascular patients were factors that related to the findings of needs assessment.
Based on these findings, we suggested that:
1. Nurses’ ability to assess patients’ health care needs should be improved to provide appropriate intervention.
2. Hospital in-service training programs which focused on patients’ high-important, low-satisfaction needs (e.g. management of sleep problems) should be arranged.
3. The case management program should be introduced, collaborated with nurses, to provide proper care for patients

並列關鍵字

heart failure ； health care needs ； levels of needs satisfaction

參考文獻

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