- 期刊
南部某區域醫院醫療從業人員簽署預立醫囑之意願探討
The Health Professionals' Willingness of Signing Advance Directives in a Regional Hospital in South Taiwan
摘要
背景：我國於2000年立法通過的「安寧緩和醫療條例」，已明文規定二十歲以上具完全行爲能力者，得預立選擇安寧緩和醫療、不施行心肺復甦術意願書及醫療委任代理人委任書，但立法至今，簽署預立醫囑的比例仍相當低，除訊息宣導不足及文化差異外，醫療從業人員自身的簽署意願及對生命末期的醫療態度亦可能影響預立醫囑的推動。目的：探討醫療從業人員簽署預立醫囑的意願及影響因素。方法：本研究爲描述相關性研究設計。以南部某區域醫院之正式員工爲樣本來源，採分層隨機取樣於不同職稱人員中依比例抽取醫師30名、護理人員118名、醫事人員20名、行政人員53名，共收案221名。以研究者自擬之個案基本資料與相關經驗、對生命末期醫療行爲的期待及預立醫囑知識與意願等問卷作爲研究工具，所收集資料以SPSS12.0版統計軟體進行分析。結果：本研究發現僅3.1%爲已簽署者，而有意願簽署者佔72.9%。願意簽署預立醫囑之主因爲「避免造成家人身心或經濟上的負擔」，不願簽署主因爲「未來的日子還離我太遠，我沒考慮這些」。而自覺健康狀態、曾有親人或朋友預立醫囑、曾與他人討論過臨終時想採取的醫療措施、曾向家人提過預立醫囑、預立醫囑意願書知情與否及末期的醫療態度爲影響簽署意願之相關因素。結論：本研究爲醫療從業人員對預立醫囑認知感受及意願之初探，除建立本土性資料外，並提供醫療機構在職教育課程規劃之參考，建議未來可更深入探討相關議題。
並列摘要
Background: Advance directives allow an individual to participate indirectly in future medical care decisions if he or she becomes decisionally incapacitated. In Taiwan, the Hospice-Palliative Care Act enacted in 2000 was designed to emphasis the rights of individual autonomy, and stipulates people above 20 years old and have complete capacity can set up the choice of medical service in advance of the occurrence of serious illness. Although the legislation has already existed eight years, the completion rate of advance directives remains low. The purpose of this study was to investigate the willingness and related factors of the health professionals in signing advance directives. Methods: This was a descriptive correlational research that used stratified random sampling to collect subject from a regional hospital in south Taiwan. The anonymous self-completed questionnaire was newly developed and distributed to four categories of 221 staff members. Data were analysed by using SPSS 12.0 software. Results: Finding showed that health professionals in Taiwan had lower completion rate of advance directives. Not wanting to be a burden on their family was the major reason for completing advance directives. They believed still have plenty of time to make end of life decisions as the predominant barrier to their completion. Factors associated with advance directives completion included self-perceived health status, have friend or family who signing advance directives, ever discuss end of life care decisions with others or family, knew the formulation of advance directives, and the attitude of end of life. Conclusion: The study findings could understand health professionals' perception and willingness of advance directives, and as a result could provide institution to plan for relevant educational programming.