- 期刊
探討居家個案非計畫拔除管路及主要照顧者對管路照護認知及學習需求
The Exploration of Home Care Patients' Unplanned Ex-tubation and the Primary Caregivers' Knowledge, and Learning Needs Related to Tubing Care
摘要
本研究目的在探討居家個案非計畫性拔除管路現況，放置管路個案之主要照顧者對管路照護相關知識瞭解程度及學習需求。研究工具採結構式問卷，透過訪談，以台北市某居家護理所居家放置管路個案，其主要照護者為研究對象，有效問卷75份，以SPSS 11.0統計軟體進行描述性及推論性統計分析，其結果顯示：1.非計畫性拔除管路以鼻胃管最多，其次為導尿管；拔除原因以病人自拔為最多，其次是管路阻塞及滑脫；非計畫性拔除鼻胃管及導尿管處理以通知居家護理師最多，而氣切套管則以自行插入為最多；2.主要照護者對鼻胃管及導尿管照護認知得分較高，而氣切套管照護認知得分最低。3.學習需求預測因子為「管路照護認知」及「管路照護經驗」，可解釋變異量為64%，其中以認知的解釋力較高，建議居家護理師對於管路照護認知得分較低及無管路照護經驗者，應加強居家管路照護護理指導，以增進管路照護照護知能，減少非計畫性拔管。
並列摘要
This study explores the unplanned ex-tubations in current home-care cases, and the cognition and learning needs on the part of primary caregivers concerning intubation patient care. A structured questionnaire, accompanied with interview, was used in this investigation. The subjects were primary caregivers from a home care center in Taipei city. Seventy-five effective questionnaires were obtained, and the results were subjected to SPSS 11.0 statistical software for descriptive and inferential statistical analysis. The results showed: 1) Mostly, unplanned ex-tubations happened to nasogastric tube, and the next was Foley catheter. The most common cause was self ex-tubation by the patient, and the next was due to tube obstruction and slipping off. Most caregivers would inform a home-care nurse when unplanned ex-tubations of nasogastric tube and foley catheter happened, but in terms of tracheotomy tubes, most would simply reinsert by themselves. 2) Primary caregivers had a better cognition on nasogastric tube and foley catheter than the cognition on tracheostomy tube. 3) The predictive factors of learning needs were ”intubation care cognition” and ”intubation care experience”. The definable variation was 64%, with the highest variation in the ability of cognitive interpretation. Therefore, we suggest that home-care nurses should provide more clinical nursing instructions for caregivers who have no experiences or poor intubation care cognition, improving their knowledge on intubation patient care and reducing the events of unplanned ex-tubation.