專科護生照護瀕死病患之意願探討

Willingness of Junior College Nursing Students to Care for Dying Patients

林惠賢(Huey-Shyan Lin) ； 黃慧莉(Huei-Lih Hwang)

《Journal of Medical Education》 5卷4期 (2001/12) Pp. 291-301

https://doi.org/10.6145/jme.200112_5(4).0004

摘要

本研究從人口特性、情境經驗及死亡態度三方面探討可能影響護生照護瀕死病患意願的因素，並由累積機率邏輯模型(cumulative logits model)預測護生的瀕死照護意願，計算各類特質護生頻死照護意願之累積機率優勢比(odds ratio)。以南部某技術學院附設專科部381名護理科學生為研究對象，以結構式問卷進行調查，回收有效問卷370份，回收率97.1%。由等比優勢模型分析結果顯示人口特性、情境經驗及死亡態度三類解釋變項皆能有效預測瀕死照護意願；另外，以逐步法對19個解釋變項求整體等比優勢模型得到僅3個變項可顯著預測專科生的瀕死照護意願，以死亡態度量表中的排斥死亡程度之預測力最高（標準化迴歸係數為-0.280），其次為曾與他人討論過死亡（標準化迴歸係數為0.132），再其次為年級（標準化迴歸係數為0.111）。因此，未來護理教育者可藉由適當設計生死相關課程之內容及調整教學方式以改善護生排斥死亡程度、促進護生與他人討論死亡並給予情緒上的支持，在護理專業課程及實習中確實嚴格執行學習評量來加強護生在照護瀕死病患所需的護理專業知識和技能，以及在實習中協助護生面對死亡的事實，使其能從經驗中學習，進而提升他們對瀕死照護的信心與意願。其他變項之分析結果亦可日後研究參考。

關鍵字

護生 ； 瀕死照護意願

並列摘要

The purpose of this study was (1) to explore factors which may affect nursing student willingness to care for dying patients in three areas-nursing student demographics, situational experiences and attitudes towards death, ; (2) to predict willingness using the constructed cumulative logits model. A total of 370 junior college nursing students from southern Taiwan completed constructed questionnaires. The data were analyzed with the statistical software package SAS for Windows V.6.12. Proportional odds model analysis showed that variables in each area could effectively predict willingness. A stepwise cumulative logistic regression indicated that rejection of death, previous discussion of death with others and grade could significantly predict willingness. In addition, a model using these three variables alone to predict willingness did not differ significantly from the model using all 19 variables. Implications for junior college nursing education, changing nursing students’ attitudes towards death, increasing discussion about death with others and increasing professional knowledge and skills for the care of dying patients are discussed. The other variables remain as areas for further research.

並列關鍵字

nursing students ； willingness to care for dying patients