醫院護理人員對家庭照顧者出院準備需求知能探討

背景:出院準備服務是以病人為中心，提供急性醫療住院端延伸到社區居家的個別整合性照顧服務，家庭照顧者為照顧病人很重要的一個角色，醫院護理人員為照顧病人第一線人員，須能為病人進行整體評估並提早為失能家庭做出院前準備與服務。目的:探討醫院護理人員對家庭照顧者出院準備需求知能相關因素探討。方法:採橫斷式調查並以立意取樣的資料收集，選取南部某準醫學中心符合收案之護理人員為對象，問卷內容含護理人員對高風險家庭照顧者的辨識能力量表及護理人員對照顧者出院需求處理自信量表。結果:護理人員之高風險家庭照顧者辨識能力項目中，最高得分項目為「觀察家庭照顧者的年紀大於65歲」；家庭照顧者出院準備需求處理自信總平均得分為69.02分，以「人力支持服務之處理自信」之的平均分數最高20.73 (±6.68)。辨識能力及處理自信度之Pearson積差相關結果均呈正向顯著相關(p<.001)，表示人員之辨識能力越高，提供家庭照顧者出院準備需求處理自信度就越高；家庭照顧者出院準備需求處理自信以「本院總年資、課程是否增進出院準備與長照需求能力」為預測變項，對出院準備需求處理自信總解釋變異量為12.9%。結論:建議醫院日後提升護理人員出院準備的專業知識、長期照護專業及面對家庭照顧者出院準備需求處理自信程度，讓醫院照護品質更好，亦能增進醫院護理人員未來面對台灣超高齡社會的照護需求。

關鍵字

醫院護理人員；家庭照顧者；出院準備服務；知能需求

並列摘要

Background: The discharge preparation service is providing integrating extension care services for the patients from acute medical hospitalization into community home cares, moreover, discussing with the patient and home carers to draft discharge care plans. The family caregivers play an important role in caring for patients. Staff nurses of hospital are the first-lined of caring patients and should be capable to conduct the overall assessment and make the pre-discharge preparation services for the disabled families. Purpose Explore the Knowledge of Clinical Nursing Staff About the Needs of　Family　Caregivers’ Discharge Planning Method:Collecting data by using cross-sectional survey sampling and selecting a would-be medical center hospital in southern Taiwan as a target. The content of the questionnaire includes the identification ability of high risk family carers and confidence in cares of carers after discharged Result The nursing staff's high-risk family caregiver identification ability project is 「The age of observing home carers are above 65 years old」; The average of the confidence of the home carers tackle discharge preparation demands is 69.02, and the highest average is 20.73(±6.68) which is「The confidence handling of human support」. Pearson's product-related correlations with the discernment ability and confidence handling were positively correlated (p<.001) and that means the higher the discernment ability of the staff, the higher the confidence handling in demands for the family caregivers; the predictive variable for the family caregiver discharge preparation demands is "the total years of service of the hospital, whether the curriculum improves the ability to discharge and long-term needs", and the total explanatory variance for the discharge preparation demand processing confidence is 12.9%. Conclusion:Suggesting the hospital to increase the professional knowledge, long term care and the confidence with dealing with home caregivers’ demands handling and make hospital care quality better, also enhance the care demands of senior people for the hospital staff nurses in the future.