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護理人員推行預立醫囑之知識、態度、經驗與自信

Nurse Knowledge, Attitude, Practice and Confidence in Promoting Advance Directives

Abstracts


背景 提昇末期照護品質是國際潮流所關切之議題,預立醫囑即以尊重病人自主及重視末期生活品質為主要考量,而在推動預立醫囑的過程,護理人員扮演著獨特且重要的角色。 目的 探討護理人員預立醫囑知識、態度、經驗與自信及其影響因素。 方法 採描述相關性研究設計,選取南部某區域醫院護理人員為研究對象,共收案545位。研究工具包含基本屬性及預立醫囑知識、態度、經驗與自信之問卷。所得資料以SPSS13.0軟體建檔,並以描述性及推論性統計如t檢定、單因子變異數分析及皮爾森積差相關進行。 結果 預立醫囑知識以簽署文件形式最為缺乏;態度偏向正向;實務經驗偏低;對熟悉預立醫囑法律最無自信。年紀大、年資深、曾與他人討論臨終決策者之預立醫囑知識得分較高,教育程度為大學以上及曾與他人討論臨終決策者之態度較正向,內科與加護單位護理人員、自身已簽署預立醫囑及曾與他人討論臨終決策者有較多的預立醫囑推行經驗與自信,且男性護理人員推行預立醫囑自信高於女性護理人員。而知識與態度、經驗及自信皆呈正相關,態度、經驗與自信亦呈正相關。 結論 研究結果顯示護理人員預立醫囑知識及經驗仍相當不足,對預立醫囑法律最不熟悉而缺乏信心,建議能依不足處規劃在職教育內容,除提升護理人員正確認知,引領其重視末期照護議題,進而能有效落實預立醫囑的推動。

Keywords

預立醫囑 知識 態度 經驗 自信

Parallel abstracts


Background: Improving patient end of life quality is a high profile issue worldwide. Advance directives (ADs) are one way to respect patient autonomy and help ensure end of life quality. In the process of decision making, nurses play a unique and vital role in encouraging patients to complete ADs. Purpose: The purpose of this study was to explore the knowledge, attitudes, practices, and confidence of nurses in discussing ADs with patients and to identify key factors influencing the effectiveness of such. Methods: This was a descriptive-correlational research that targeted 545 nurses working in a regional hospital in southern Taiwan. Structured questionnaires gathered basic demographic data and surveyed knowledge, attitudes, practices, and confidence with regard to advance directives. Data were managed using SPSS 13.0 software and analysed with descriptive and deductive statistics such as the independent t test, one-way ANOVA and Pearson correlation. Results: Nurses were relatively less knowledgeable about the various types of ADs, held positive attitudes toward ADs, had less AD practices, and lacked confidence with regard to current regulations related to ADs. Older and senior nursing staff, as well as those who had previously discussed end of life care decisions with others, had relatively greater knowledge. Higher education level (college degree or above) and previous experience discussing end of life care decisions with others were found to be factors positively influencing attitudes toward ADs. Medical and intensive care unit nurses, nurses who had completed their own ADs, and nurses who had previously discussed end of life care decisions with others had relatively more practices and greater confidence. Confidence was also highly influenced by gender. Knowledge and attitudes were found to correlate positively with both practices and confidence. Attitudes, practices and confidence were also positively correlated. Conclusions: Findings showed that nurses had insufficient knowledge, inadequate practices and lacked confidence regarding AD regulations. Such indicates the need for institutions to plan and provide relevant educational programming to provide appropriate knowledge, encourage nurses to value end of life issues and enhance AD facilitation effectiveness.

Parallel keywords

advance directives knowledge attitudes practices confidence

Cited by


劉怡伶(2012)。護理人員與照顧服務員簽署預立醫療指示之差異性探討-以南部某區域教學醫院為例〔碩士論文,長榮大學〕。華藝線上圖書館。https://doi.org/10.6833/CJCU.2012.00129
顧艶秋、林麗英、蔣秀容、陳惠鈴、高紀雅(2018)。全人照護結合安寧療護之教育訓練對提升全人照護之成效高雄護理雜誌35(3),12-24。https://doi.org/10.6692/KJN.201812_35(3).0002
洪麗琴、張美玉、張碧華、廖玟君(2022)。緩和療護教育方案介入對護理人員知識、態度之成效榮總護理39(1),24-34。https://doi.org/10.6142/VGHN.202203_39(1).0003

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