護理人員照護瀕死病患行為及其相關因素之研究

Study on Nursing Behaviors toward Dying Patients among Nurses and Related Factors

顧艷秋(Yan-Chiou Ku)

指導教授 ： 黃松元

國立臺灣師範大學/教育學院/衛生教育學系/博士(1999年)

摘要

本研究旨在探討護理人員照護瀕死病患行為及其相關因素，研究對象為桃園縣三所區域醫院276位護理人員，以「護理人員對瀕死病患照護行為及其相關因素調查問卷」來收集資料，研究資料以百分率、平均數、標準差、變異數分析、相關分析及複迴歸分析等方法進行資料分析。主要研究結果如下：（1）整體來看，護理人員對照護瀕死病患之照護行為以身體照護提供的最多，其次是家屬的照護，最少的是心理、靈性、溝通照護；（2）影響護理人員照護瀕死病患行為（整體性照護行為）的因素有自我效能、與同仁分享工作心得之程度、照護瀕死病患人數、工作病房別、工作醫院別、護理長對照護瀕死病患的支持度、就學期間曾否接受臨終護理課程等七項，能解釋全部變異量之57.2%；其中影響最大的二項是自我效能（可解釋全部變異量之24.2%），與同仁分享工作心得之程度（可解釋全部變異量之24.4﹪）；（3）影響身體照護行為的因素有工作病房別、照護瀕死病患之自我效能、工作醫院別、護理長對照護瀕死病患的支持度、與同仁分享工作心得之程度、宗教別等六項，能解釋總變異量之50.9%；（4）影響心理靈性溝通照護行為照護行為的因素有照護瀕死病患之自我效能、與同仁分享工作心得之程度、工作病房別等三項，能解釋總變異量之46.4%；（5）影響家屬照護行為的因素有照護瀕死病患之自我效能、與同仁分享工作心得之程度、就學期間曾否接受臨終護理課程、護理長對照護瀕死病患的支持度、照護瀕死病患人數、年齡、自覺照護瀕死病患重要之態度、工作病房別等八項，能解釋總變異量之54.5%。此外，本研究就研究結果進行討論並提出建議，在教育方面，將臨終護理列為必修課程；在臨床實務方面，有計畫的安排護理人員照護瀕死病患，以增加自我效能；在行政方面，將瀕死病患照護列為醫院品管之指標，促使護理主管重視瀕死病患照護並給與護理同仁支持及協助；未來在研究方面，可擴及到其他層級醫院工作人員之施測，並進一步探討其他之影響因素。

關鍵字

照護行為 ； 瀕死病患

並列摘要

The purpose of this study was to explore nursing behaviors of dying patients among nurses and its related factors. This is a cross-sectional descriptive and correlation research. A total of 276 nurses were recruited from 3 Tao-Yuan regional hospitals. A structure questionnaire was used to collect data. Data were statistically analyzed by means of descriptive analysis, One-way ANOVA, correlation and stepwise multiple regression. The major findings of this study were as follows :（1）General speaking, the most frequently cited nursing behaviors toward dying patients was physical care, followed by family care and mental spiritual and communication care.（2）Comprehensive nursing behaviors toward dying patients could be predicted by 7 items; i.e. self-efficacy, sharing experience with peers, the number of dying patients cared, kind of ward, kind of hospital, support of head nurse, curriculum of dying patient care in their school years. The total variance was 57.2%.（3）Physical care of dying patients could be predicted by kind of ward, self-efficacy, kind of hospital, support of head nurse, sharing experience with peers and religion. The total variance was 50.9%.（4）Mental spiritual communication in nursing care toward dying patients could be predicted by self-efficacy, sharing experience with peers and kind of ward. The total variance was 46.4%. （5）Nursing care of the families of the dying patients could be predicted by self-efficacy, sharing experience with peers, curriculum of dying patient care, support of head nurse, the number of dying patients cared, age, attitude of importance about dying patient care and kind of ward. The total variance was 54.5%. The results of this study suggest that we should take terminal nursing as required course, educate nurses, arrange nurses to care dying patients and support nurses in order to increase self-efficacy toward dying patients.

並列關鍵字

nursing behavior ； dying patient

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