重症單位老年病人照護需求量表之發展與驗證

當老年人面臨重大疾病接受重症治療時，會產生多面向的壓力源，需要重症護理人員辨識其個別性的照護需求，進而提供適切的照護滿足其需求。本研究目的為發展「重症單位老年病人照護需求量表」，統整重症單位老年病人照護需求之相關文獻，擬定28題之初量表，度量種類包括照護需求重要程度及需求被滿足程度。經兩階段的內容效度專家檢定新增題項後，共為32題。正式施測採方便取樣，研究對象為221位中部某醫學中心重症單位65歲以上的老年病人。研究資料首先採用矯正的項目總分相關係數及極端值比較法進行項目分析，刪除9題後，所餘之23題接著進行因素分析，共萃取出四個因素，分別命名為「舒適和安心」、「訊息告知」、「寧靜環境」及「支持和尊重」，可解釋的總變異量為55.0%。總量表之重要程度內在一致性為.86，被滿足程度之內在一致性為.83。以組內相關係數檢定再測信度，在照護需求重要程度及被滿足程度之組內相關係數，分別為.78及.98。本研究結果顯示，重症單位老年病人照護需求量表具有可接受之信效度，且適合重症老年病人之測量工具。

關鍵字

重症單位老年病人；照護需求；量表發展；信度；效度

並列摘要

Multiple stressors have been identified in older adults with severe diseases and receiving intensive treatment; therefore, caregivers must identify their individual care needs before providing appropriate care. This study developed the Care Needs Scale for Older Adults in Intensive Care Units. The 28-item original scale was developed on the basis of a literature review and qualitative data obtained from a study that explored the care needs of older patients in intensive care units (ICUs). The scale consists of two parts: the importance of needs and the needs met by the staff. Three more items were added after two rounds of expert reviews, and the scale was administered to a convenience sample of 221 older patients in medical centers in Central Taiwan. Data analysis was performed using corrected item-total correlation and the comparison of extreme groups. Nine items were deleted, and factor analysis was performed for the remaining 23 items. The analysis yielded a 4-factor final solution, with an explained variance of 55.0%. These four factors were named comfort and ease, information providing, low-noise environment, and support and respect. Internal consistency reliability was assessed using Cronbach's alpha. The Cronbach's alpha values for the importance of needs and the needs met by the staff were .86 and .83, respectively. Test-retest reliability was assessed using intraclass correlation coefficient, which was .78 and .98 for the importance of needs and the needs met by the staff, respectively. The results indicated the acceptable validity and reliability of the scale. Therefore, the scale can be used for the identification of individual care needs, thereby improving the quality of care for older adults in ICUs.

並列關鍵字

older adults in the intensive care units ； care needs ； scale development ； reliability ； validity

參考文獻

李佳純、馮翠霞(2020)．急重症病人之焦慮、憂鬱與創傷後壓力症候群．護理雜誌，67(3)，23-29。

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