成人加護病房家屬不確定感及需求重要性之探討

The Study on Level of Uncertainty and Importance of Needs for Family of Patients in ICU

莊令吏(Lin-Lih Chuang)

指導教授 ： 顏文娟 ； 李選

中山醫學大學/護理學院/護理研究所/碩士(2005年)

https://doi.org/10.6834/CSMU.2005.00098

摘要

本研究目的為探討影響成人加護病房家屬不確定感的相關因子，以及瞭解不同科別的成人加護病房家屬不確定感程度與需求重要性之間的相關性。本研究以中部某醫學中心內、外科成人加護單位為研究地點，以立意方式取樣，研究對象需符合：(1)成人加護病房病患：住院天數以入院滿24小時(評估APACHEⅡ)至15天內之病人；(2)家屬：18歲以上，能以國語或閩南語溝通且與病患同住一起的人。本研究採橫斷式相關性研究設計，使用Mishel (1982) Parent Perception of Uncertainty Scale-Family Member (PPUS-FM)的家屬不確定感量表與Leske (1991) Critical Care Family Needs Inventory (CCFNI)的重症家屬需求量表，所測得CVI值為.90，Cronbach’s α分別為.91及.96，由研究者一對一訪談成人內、外科成人加護單位共140位家屬。
研究結果發現 (1)成人加護病房家屬不確定感會受到家屬年齡、性別、教育程度與病人關係與病患疾病嚴重度的影響。(2)不同科別及住院天數之成人加護病房家屬與其不確定感無顯著差異，但住院天數一至三天及四至五天與住八天以上者的不確定感與不確定感分量表中的「不可預測性」有顯著的差異。(3)成人加護病房家屬的不確定感受程度與其需求重要性沒有顯著相關。(4)成人加護病房家屬在需求類別重要性中以保證需求排序第一，其次的順序排列分別為：獲知病人訊息、陪伴病人、支持及舒適需求。(5)不同科別之成人加護病房家屬需求間沒有顯著差異，但在需求重要性之排列上有所不同。
本研究的結果將可提供護理人員瞭解不同的成人加護單位家屬的不確定感與需求，使能早期評估每個家屬有其不同的個別需要差異，進而提供個別性的照護以協助家屬減少不確定感。

關鍵字

成人加護病房 ； 家屬不確定感 ； 家屬需求

並列摘要

The purposes of this study are to exam the level of uncertainty and importance of needs for families of patients in ICU. This study was conducted in a medical center in Central Taiwan. The families of the patients in MICU and SICU were recruited in this study. Purposive sampling was conducted. The eligible including criteria were (1) The patient who is admitted in adult ICU at least 24 hours up to 15 days . (2) Family must be 18 or older, lives with this patient , and is able to speak Chinese or Taiwanese. A cross-sectional correlational research design was used. Two research instruments , Parent Perception of Uncertainty Scale-Family Member (PPUS-FM), Critical Care Family Needs Inventory(CCFNI) were utilized. The Content validity index (CVI) of the two instruments was .90. Internal consistency reliability, Cronbach’s α, were range from .91- .96. To ensure the collection of sufficient valid questionnaires, total 140 families of patients were recruited form MICU and SICU.
The findings of this study are (1) The level of uncertainty can be affected by the age of the family member, gender, education level and the severity of the patient’s illness. (2) There is no significant variation between different ICU units and the days of hospitalization, but the “Unpredictability” on PPUS-FM presented a significant change on 1-3 days , 4 to 5 days , and above 8 days of the hospitalization. (3) There is no significant association between the level of uncertainty and the importance of needs for the family. (4) The need category of assurance was ranked as the first priority, followed by receiving the patient’s update information, accompanying the patient, support and comfort. (5) There is no difference alone with the family’s needs in different ICU units, but the different order on ranking of the needs was found in MICU and SICU.
The result of this study can help the nurses realize the level of uncertainty, and family’s needs in different ICU units. According to the understanding, the nurses can provide individualized care to the patient’s family, and decrease their level of uncertainty effectively.

並列關鍵字

Adult ICU ； Family Uncertainty ； Family Needs

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