- 期刊
提升外籍照顧者瀕死症狀照護正確率
Improving accuracy in nursing care for pre-dying signs in patients with terminal illness by foreign caregiver
摘要
我國外籍移工人口數以印尼籍最多，服務於家庭看護占36.4%，照護生命末期病人時，無法理解瀕死徵象及妥善處理病人出現的瀕死症狀照護而引發外籍照顧者照護焦慮進而影響照護品質。期望透過指導瀕死症狀照護技巧、提升外籍照顧者知識及技能正確性，以降低照護壓力並增加照護成就感，也可使生命末期病人獲得善終；專案小組制定瀕死症狀照護標準流程，明訂瀕死症狀評估與措施介入時機、制定稽核制度，掌握技能正確性、設計雙語瀕死症狀單一護理指導彩虹小卡，助於提升瞭解程度、增設模擬教具，提供實際演練照護技巧、擬定家庭成員共同照護計畫，參與身體清潔與舒適護理，降低外籍照顧者壓力。經專案改善接受衛教後，外籍照顧者瀕死症狀照護正確率由50.35%提升至86.17%；壓力指數23.53分降至8.77分；接受護理指導滿意度55%提升至84.2%。依教學目標訂立評核項目，標準化護理指導及訂定瀕死症狀照護查核機制，使用一致性的指導內容及工具，可使照護正確率提升，建議平行推展至照護生命末期病人之病房，助達善終目標。
並列摘要
Indonesia accounts for the vast majority of foreign migrant workers in Taiwan, with 36.4% serving family care. When caring for patients at the end of life, they cannot recognize pre-dying signs and properly attend to the patient's pre-dying symptoms, which causes anxiety for foreign caregivers and affects the quality of care. It is hoped that by instructing the care techniques of pre-dying signs and improving the accuracy of foreign caregivers' knowledge and skills, the pressure of care can be reduced and the sense of achievement in care can be enhanced. It can also enable patients at the end of life to die tranquilly. The task force establishes the standard process of pre-dying signs care, clearly specifies pre-dying signs evaluation, measures the timing of intervention, formulates an audit system, and masters the correctness of skills. Moreover, it designs a bilingual rainbow card for pre-dying signs single nursing guidance in order to strengthen perception. It also adds simulation teaching aids to provide practical exercise care know-how, draws up family members' common care plan, and participates in body cleansing as well as comfort care to lessen the pressure of foreign caregivers. After the project was improved and foreign caregivers received health education, the accuracy rate of care for pre-dying signs increased from 50.35% to 86.17%; the stress index dropped to 8.77 from 23.53; the satisfaction rate of receiving nursing guidance increased from 55% to 84.2%. We establish evaluation items based on teaching objectives, standardize nursing instructions, and formulate pre-dying signs care review mechanisms, and use consistent guidance content along with tools to upgrade the preciseness of care. It is recommended to extend the guidance to the ward that cares for patients at the end of life in parallel to help achieve the target of dying peacefully.