臨終醫療抉擇：民眾對簽署DNR聲明的認知、態度與意圖研究

本研究旨在探討臺灣地區民眾對於簽署「不施行心肺復甦術」（DNR）文件的認知、態度和意圖行為，並分析這些因素與人口學背景的相關性。本研究採網路便利抽樣，以結構式問卷針對527名受訪者進行問卷調查。問卷內容有人口學資料、健康狀況和簽署DNR的KAP構面等問題共33題。結果顯示，受訪者的DNR知識整體表現中等，對於DNR的態度普遍積極，且簽署DNR的意圖也呈現相對高的水準。然而，不同人口學背景（性別、年齡與教育程度）的受訪者在KAP構面存在顯著差異，女性對於DNR有較積極的態度，而不同年齡層和教育程度的人在知識和態度上也有所不同。另外簽署DNR的意圖對於簽署DNR的行為有顯著預測力（p<.05），即對於個人有簽署DNR意圖者有助於形成積極的簽署行為。而簽署DNR的態度在認知和意圖之間扮演著部份中介角色，即態度不僅直接影響簽署意圖，同時透過影響認知而產生中介效果。這強調了態度在影響公眾對於DNR簽署意向的過程中的複雜作用機制。研究建議加強簽署DNR知識的宣導，提高對於DNR的全面理解。醫療機構也應該加強醫護人員的培訓，提升與患者溝通的能力，以確保患者能夠清晰地理解DNR的相關資訊。同時，社會和政府應該加大對於DNR的公共教育，減少社會文化對DNR的誤解。

關鍵字

不施行心肺復甦術；知識態度行為模式；簽署行為；中介效果

並列摘要

This study aimed to explore the Taiwanese public's knowledge, attitudes, and intentions toward signing 'Do Not Resuscitate' (DNR) orders and analyze the correlation of these factors with demographic backgrounds. The research adopted a convenient online sampling method and conducted a structured questionnaire survey with 527 participants. The questionnaire covered demographic information, health conditions, and the KAP dimensions of signing DNR, totaling 33 questions. The results revealed that participants had a moderate overall level of DNR knowledge, generally positive attitudes towards DNR, and relatively high levels of intention to sign DNR. However, participants with different demographic backgrounds showed significant differences in the KAP dimensions. Females exhibited a more positive attitude towards DNR, and individuals of various age groups and education levels varied in knowledge and attitudes. Furthermore, the intention to sign DNR significantly predicted the actual signing behavior (p<.05), indicating that individuals with the intention to sign DNR were more likely to engage in positive signing behavior. The attitude towards signing DNR played a partial mediating role between cognition and intention, highlighting the complex mechanism of how attitudes influence the public's intention to sign DNR. The study recommends strengthening the promotion of DNR knowledge to enhance a comprehensive understanding of DNR. Medical institutions should intensify training for healthcare personnel to improve patient communication skills, ensuring a clear understanding of DNR-related information. Additionally, society and the government should increase public education on DNR to reduce societal and cultural misunderstandings.