護理人員對疾病末期病人選擇維生醫療的知識、態度與行為之研究

Knowledge, Attitudes, and Behaviors of Nurses Toward the Life-Sustaining Treatment Choices of Terminally Ill Patients

陳巧宴(Chiao-Yen Chen) ； 徐宗福(Tsung-Fu Hsu) ； 裴駿(Jun Pei)

《醫務管理期刊》 17卷3期 (2016/09) Pp. 169-187

https://doi.org/10.6174/JHM2016.17(3).169

摘要

目的：瞭解護理人員對疾病末期病人選擇維生醫療知識、態度與行為及相關因素，提供有關當局擬訂策略之參考，提升醫療服務品質。方法：採橫斷研究設計，以立意取樣中部地區四家醫院護理人員，以結構式問卷調查，發出問卷564份，回收有效樣本465份，有效回收率82.4%。以SPSS 17.0統計軟體分析。結果：維生醫療知識、態度與行為間呈顯著中度正相關。護理人員在其年齡20-29歲、每年平均曾參與安寧緩和醫療在職訓練1小時、維生醫療知識及維生醫療態度對維生醫療行為有顯著相關，可解釋維生醫療行為43.5%變異量，其中以維生醫療知識有最佳相關。維生醫療知識透過維生醫療態度的部分中介效果，解釋維生醫療行為。結論：定期調查以瞭解護理人員對疾病末期病人選擇維生醫療知識、態度與行為及相關因素，教導護理人員相關在職教育，增進其對維生醫療知識與培育照護技能，增強其維生醫療正向態度，務實其對維生醫療行為的執行，以維護病人生命尊嚴，並提升疾病末期照護品質。

關鍵字

疾病末期 ； 維生醫療 ； 知識 ； 態度 ； 行為

並列摘要

Objectives: This study examined the status and factors related to nurses' knowledge, attitudes, and behaviors toward the life-sustaining treatment choices of terminally ill patients to provide a reference for the relevant authorities who formulate policies and strategies for enhancing the quality of health care services. Methods: A sample of nurses from four hospitals in central Taiwan was investigated. A purposive sampling method was used to obtain cross-sectional data through a self-administered structured questionnaire. From a total of 564 questionnaires that were administered, 465 valid questionnaires were collected; this yielded a valid response rate of 82.4%. Data were analyzed using SPSS version 17.0. Results: A significantly moderate positive correlation was observed among the nurses' knowledge, attitudes, and behaviors toward certain life-sustaining medical treatments. Of all independent variables, being 20-29 years of age, attending an average of 1-hour palliative medical service training course annually, possessing adequate knowledge of life-sustaining medical treatments, and having a positive attitude considerably correlated with nurses' behaviors toward life-sustaining medical treatments. The model explained 43.5% of the variance in nurses' behaviors toward life-sustaining medical treatments. Nurses' knowledge of life-sustaining medical treatments exhibited the highest correlation, thus explaining their behaviors through the partially mediating effect of their attitudes. Conclusions: Nurses should periodically examine the status and factors related to their knowledge, attitudes, and behaviors toward terminally ill patients' choices of life-sustaining medical treatments to increase their knowledge and skills, enhance their positive attitudes, and execute life-sustaining medical practices through on-the-job education. These efforts may protect the dignity of terminally ill patients and improve the quality of life-sustaining medical care services.

並列關鍵字

terminal disease ； life-sustaining treatment ； knowledge ； attitude ； behavior

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