Hospital Nurse Knowledge of and Approach to Dementia Care

背景　英國衛生局提倡透過一個國際性的失智症照護策略以促進急性醫院的失智症照護品質。策略其一為評估護理人員是否有適當的知識及以人為中心的照護方式，以促進醫院的失智症照護品質。目的　本研究目的在評價醫院護理人員的失智症照護知識與失智症照護方式，並探討護理人員的特性、其失智症照護知識及失智症照護方式的相關性。方法　以16題的問卷，評估台灣南部某一教學醫院內的124位護理人員的失智症照護知識；另以13題有關護理人員對晚期失智症照護方式的問卷，評估受試的護理人員提供照護的方式傾向現實導向或以人為中心。結果　護理人員的失智症照護知識平均得分為10.8分（標準差2.0），答題結果顯示，多數護理人員無法區辨失智症與瞻妄。護理人員對晚期失智症照護傾向於現實導向的照護方式。有愈多年工作經驗的護理師其失智症照護知識的得分愈高。護理人員的年齡與工作經驗皆傾向現實導向的照護方式呈負相關。結論／實務應用　多數醫院護理人員具有正確的失智症照護知識並且傾向於採現實導向的照護方式。這是一份初步瞭解南部某醫院的失智照護現況調查。未來需增進護理人員對瞻妄與失智的區辨能力，且進一步探討失智照護品質與醫院護理人員的失智照護知識及方式的相關性。

關鍵字

失智症；醫院；知識；瞻妄；以人為中心照護方式

並列摘要

Background: The U.K. Department of Health recently proposed an international dementia strategy to enhance the quality of dementia care in acute hospital care settings. To implement such a strategy, it is necessary to first assess whether nurses have the knowledge and person-centered approach essential to enhancing hospital-based dementia care quality.Purpose: The purpose of this study was to evaluate hospital nurse knowledge of and approach toward dementia care and to explore the relationship between nurse demographic characteristics and these two issues.Methods: We distributed a 16-item questionnaire on dementia care knowledge to 124 nurses at a teaching hospital in southern Taiwan. We also distributed to the same participants a 13-item questionnaire designed to assess the approach, either reality oriented or person centered, of participants in providing care to advanced dementia patients.Results: The total mean score for participant dementia care knowledge was 10.8 (SD = 2.0). Results indicated that most nurses confused dementia with delirium. The advanced dementia care questionnaire suggested care tended to be reality oriented. Licensed registered nurses with more working experience had higher dementia care knowledge scores. Age and working experience both negatively correlated with a realityoriented approach toward care.Conclusions/Implications for Practice: Most participants had accurate dementia care knowledge and tended to use a reality-oriented approach. Nurse competency in differentiating delirium from dementia should be enhanced. This study provided initial insight into the dementia care situation at a single hospital in southern Taiwan. Future studies should further explore the relationship between dementia care quality and hospital nurses’ knowledge and approaches, respectively.

並列關鍵字

dementia ； hospital ； knowledge ； delirium ； person-centered approach

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