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護理人員照顧末期病人的情緒困擾與死亡因應自我效能之關聯-以北部某醫學中心為例

The Relationship Between Emotional Distress and Death Coping Self-efficacy of Nursing Staff When They Take Care of Terminally Ill Patients: Examples From a Northern Medical Center.

摘要


研究目的:探討安寧共同照護單位護理人員照顧末期病人之情緒困擾和死亡因應自 我效能之間的關聯性及預測因子。材料與方法:運用橫斷式調查,採情緒困擾量表與死 亡因應自我效能量表,立意取樣北部某醫學中心腫瘤科、胸腔內科、大腸直腸外科、胃 腸內科工作滿半年以上之護理人員。結果:(1)178位護理人員情緒困擾平均得分38.33分(18~50分),自我效能總平均得分103.33分(80~145分)。(2)年紀輕、年資淺之護理人員情緒困擾較高,有照顧意願的護理人員情緒困擾偏低。(3)年齡、年資與死亡準備呈負相關,有照顧意願與臨終關懷及死亡準備有顯著差異。(4)情緒困擾與自我效能呈負相關。(5)年資與照顧意願是情緒困擾的預測因子,能解釋12.7%之變異量( p < .001)。(6)照顧意願與情緒困擾是死亡因應自我效能之預測因子,能解釋9.3%變異量( p < .001)。結論:具有照顧意願的態度最為重要,此結果可提供行政單位調派人員及在職教育課程設計之參考。

並列摘要


Purpose: The purpose of this research is to study the relationship of the non-hospice share care nurse's emotional dilemma, self-efficacy condition and predictor when they are faced with death of patients with last stage cancer. Methods: This study is a cross-sectional design, with clinical nurses selected from a northern medical center's oncology department, chest medicine department, colorectal surgical department, gastrointestinal medicine department and cancer center department. The questionnaire included personal background information,「"emotional dilemma assessment scale"」and 「"death coping self-efficacy scale"」. Results: (1) The average score of 178 nurses in emotional predicament is 38.33 points (18 to 50 points). The overall average of self-efficacy score is 103.33 points (80 to 145 points). (2) Nursing staff who are younger and inexperience in their work tend to have higher emotional dilemma, and significantly lower willingness to take care of terminally ill patients. (3) There is negative correlation in death preparation compared to age and work experience. There is positive correlation in willingness of taking care, hospice care and death preparation. (4) There is negative correlation between emotional dilemma and self-efficacy. (5) Seniority and willingness to take care are the predictors of emotional dilemma. The explained variance was 12.7% (p <.001). (6) The willingness to take care and emotional distress are the most important predictors of self-efficacy(p <.001). Conclusion: The willingness to take care is the most important factor when it comes to addressing emotional dilemma. The results may provide helpful information to administrative units deployed staff and in-service education courses.

參考文獻


行政院衛福部。103 年國人死因統計結果。2015 年 11 月 09 日,取自http://www.mohw.gov.tw/news/531349778
Craig C, Earle ER, Park B, et al. Identifying potential indicators of the quality of end-of-life cancer care from administrative data. American Society of Clinical Onco 2003; 21: 1133-1138.
翁芝爾、陳淑賢、廖美南、王正旭。非安寧病房護理人員對安寧療護知識及態度之初探。長庚護理 2005;16(1):12-22。
Boyd D, Merkh K, Rutledge DN, & Randall V. Nurses' perceptions and experiences with end-of-life communication and care. Oncol Nurs Forum 2011; 38(3) : E229-E239.
Martens ML. A comparison of stress factors in home and inpatient hospice nurses.J Hosp Palliat Nurs 2009; 11(3): 144-153.

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