醫療照護人員對撤除生命末期病人維生醫療之意向及相關因素之探討

本研究利用行為計畫理論為架構，探討醫療照護人員的態度、主觀規範、知覺行為控制對撤除生命末期病人維生醫療之意向及影響因素。為橫斷式研究設計，以方便取樣方式，選取北部一家區域教學醫院進行研究，使用自擬結構式問卷進行資料收集，問卷內容包括態度8題、主觀規範7題、知覺行為控制10題及行為意向2題等四部份。研究結果顯示：醫療照護人員對於撤除生命末期病人維生醫療的行為意向與態度、主觀規範、知覺行為控制皆達顯著相關。利用邏輯式迴歸，找出影響行為意向的重要因素，而在控制干擾變項後，僅「態度」對行為意向之影響達統計上顯著水準（OR = 1.12, p = 0.02），對於醫療照護人員在撤除維生醫療行為意向影響最大。建議未來可經由安寧相關教育訓練，照顧末期病人經驗提升醫療人員對撤除維生醫療的態度。臨床上及早與家屬進行溝通，提供家屬正確資訊，將能夠共同討論做出最符合病人利益及需求之決策。

關鍵字

計畫行為理論；醫療照護人員；生命末期；撤除維生醫療

並列摘要

This study used a theory of planned behavior as a framework to explore the effect of health care providers' attitudes, subjective norms and perceived behavioral control on their intention to withdraw life-sustaining treatment of end-of-life patients. This research is a cross-sectional research design. Convenience sampling was performed at a regional teaching hospital in northern Taiwan. A self-devised structured questionnaire on attitudes (8 items), subjective norms (7 items), perceived behavioral control (10 items), and behavioral intention (2 items) was used to collect data. The results are shown as follows: Health care providers had a significant correlation with the behavioral intentions and attitudes, subjective norms, and perceived behavioral control for the withdrawal of life sustaining treatment. Logistic regression analysis was conducted to determine crucial factors affecting behavioral intention. After intervening variables were under control, statistical significance was observed only in the effect of attitudes on behavioral intention (OR = 1.12, p = .02), implying that attitudes had the greatest influence on health care providers' behavioral intention to withdraw life-sustaining treatment. It is recommended that the future education and training on palliative care emphasizes on the attitude of health care providers towards withdrawing life sustaining treatment. Early communication with the patient's family members and provide them with correct information. Discuss and make decisions mutually to best meet patient's interests and needs.

並列關鍵字

Theory of planned behavior ； health care provider ； end of life ； withdrawal of life sustaining treatment

參考文獻

洪培豪、蔡宏斌、鐘應欽、黃政文、洪冠予（2014）．「不施行」與「終止或撤除」透析治療之憲法爭議．腎臟與透析，26（1），11-16。https://doi.org/10.6340/KD.2014(1).03

馬瑞菊、鄭婉如、李佳欣、林佩璇、蘇珉一（2015）．加護病房生命末期病人撤除氣管內管之經驗分析．安寧療護雜誌，20（2），120-132。https://doi.org/10.6537/TJHPC.2015.20(2).2

陳榮基（2015）．我國安寧緩和照護之相關政策的過去發展與未來展望．護理雜誌，62（2），13-17。https://doi.org/10.6224/JN.62.2.13

陳婉君、潘雪幸、劉淑皎、洪東源、張芳維、歐淑華（2020）．某離島醫護人員對末期病人撤除維生醫療行為意向及其相關因素探討．安寧療護雜誌，24（2），112-126。https://doi.org/10.6537/TJHPC.202006_24(2).02

謝雅琪、蔡佩渝、楊鈺雯、林益卿、黃馨葆（2014）．無最近親屬者之生命末期醫療抉擇．安寧療護雜誌，19（1），33-46。http://doi.org/10.6537/TJHPC.2014.19(1).3

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醫療照護人員對撤除生命末期病人維生醫療之意向及相關因素之探討

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