運用簡易多屬性分析於傳染性疾病照護壓力之研究-以南部某區域教學醫院為例

Using simple multi-attribute analysis to study the stress of infectious disease care – south A regional teaching hospital as an example

余麗貞(Yu Li-Chen)

指導教授 ： 黃怡詔

國立屏東科技大學/管理學院/高階經營管理碩士在職專班/碩士(2019年)

https://doi.org/10.6346/NPUST201900117

摘要

護理人員於照護病人時必需面對各種不同疾病照護與被傳染性疾病感染之風險與壓力，本研究以簡易多屬性評等技術為研究工具，探討面對傳染性疾病人時臨床護理人員之照護壓力因素，研究對象為南區某區域教學醫院之隔離病房及曾有相關照顧經驗之護理人員共計17位。經由彙集文獻並整理預先設計訪談範圍後與有相關照護經驗之護理人員進行訪談，透過訪談所得之資料彙整出照護傳染性疾病病人之壓力評估屬性共計有15項，由研究對象依重要性對各項屬性進行排序後再依各屬性之重要程度經由公式計算出其相對權重，研究結果得知照護傳染性疾病病人壓力之前十項屬性依序為：無法密切追蹤住在隔離病房病人臨床症狀、護理人員進入隔離病房時有其他病人按呼叫鈴會無法及時處理、做治療的時間被拉長覺得工作負荷量變重、穿戴防護裝備花時間會影響處理病人問題的時效性、擔心在照護傳染病病人的過程中被感染、擔心目前的防護裝備是否能夠保護自己、家人/同事的支持、與病人單獨處在隔離病房時會擔心自己的身安全的問題、對沒有照護過的傳染性疾病不熟悉有照護上的壓力、對通報傳染病送驗的檢體採檢不熟悉。
研究結果建議除了可透過教育及演練來強化護理人員照護能力、提供多家產品選擇以改善配戴防護裝備不適感之外，可透過設備改善克服病人病情監控與護理人員人身安全問題，並依病人照護之困難度及風險性適時調整護理人力之配置，以改善護理人員照護傳染性疾病病人之壓力，以提升照顧意願與護理品質。

關鍵字

簡易多屬性分析 ； 傳染性疾病 ； 照護壓力

並列摘要

Nursing staff caring for patients suffering from various illnesses and infectious diseases must face the associated risks and stresses while providing such care. This study uses the simple multi-attribute rating technique as a research tool to explore the factors of stress among nursing staff providing clinical care to patients with infectious diseases. The study focuses on 17 nursing personnel with related experience at an isolation ward in a teaching hospital in Southern Taiwan. After the related literature was collected and the scope of the pre-designed interviews was arranged, the interviews were conducted with the experienced nursing staff members. With the information obtained through the interviews, 15 attributes related to the stresses that stem from providing care to patients suffering from infectious disease were identified. The participants organized each attribute in the order of importance. Then, based on the level of importance, a formula was applied to determine their weightings. From the results it was found that with respect to the stress factors associated with providing care to patients suffering infectious disease, the top 10 attributes in order were: inability to closely track the clinical symptoms of the patients in the isolation wards; if another patient presses the call bell while the nurses are inside the isolation ward, they are not able to deal with the situation in a timely manner; when treatment times are extended, nurses feel like their work load is becoming heavier; time spent putting on protective gear affects the efficiency of handling patient problems; concern that in the processes of treating the patients, they will contract the disease; concern as to whether or not their safety gear will be able to protect them; family/co-worker support; when alone with a patient in the isolation ward, fear for personal safety; stresses associated with uncertainty when caring for a patient with a disease that they have never encountered before; unfamiliarity with the sample inspection of infectious disease in the bulletin.
Based on the research results, it is recommended that education and simulation exercises should be used to strengthen the skills of the nursing staff. They should also be provided with a greater variety of protective product options to choose from. Additionally, better equipment should be used to monitor the conditions of the patients and the personal safety of the nursing staff. Furthermore, based on the difficulty level and the related risk of the diseases, timely reconfigurations of the nursing personnel should be conducted to reduce pressures related to treating patients suffering from infectious disease, increase the nurses’ wiliness to provide care, and improve the quality of the care provided.

並列關鍵字

Simple Multi‐Attribute Rating Technique(SMART) ； Infectious disease ； care provider stress

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