呼吸治療師對不施行心肺復甦術及終止或撤除人工氣道態度及其相關因素探討

The Attitudes of the Respiratory Therapists and Associated Factors toward to the Care of DNR and Terminal Extubation Patients

蕭秀鳳(Hsiu-Feng Hsiao) ； 林蕙鈴(Hue-Ling Lin) ； 周蘭娣(Lan-Ti Cho) ； 高國晉(Kuo-Chin Kao) ； 蔡熒煌(Ying-Huang Tsai) ； 許光宏(Kuang-Hung Hsu)

《呼吸治療》 13卷2期 (2014/07) Pp. 1-10

https://doi.org/10.6269/JRT.2014.13.2.01

摘要

呼吸治療師主要工作場所是在加護病房中，但呼吸治療師訓練過程卻很少涵蓋到緩和醫療的概念。本研究藉由探討呼吸治療師對不施行心肺復甦術（do-not-resuscitate, DNR）瞭解、及對臨終拔管以及照顧DNR病人之態度的相關影響因素。本研究採橫斷式設計，對呼吸治療師進行問卷調查。問卷包括五大部分：呼吸治療師之基本資料、呼吸治療師對臨終拔管之意向、呼吸治療師對臨終照護之態度、呼吸治療師對照顧臨終病人之態度與呼吸治療師對臨終病人之呼吸治療專業態度。80%回收率結果顯示：受試呼吸治療師主要年齡為31-40歲、大學畢業者、臨床年資11-20年、執業於醫學中心及區域醫院。問卷結果分析，「呼吸治療師對臨終拔管之意向」以及「對臨終病人之呼吸治療專業態度」平均分數高（3.7~3.9）；而「對臨終照護之態度」及「對照護臨終病人之態度」平均分數低（1.6~1.9）。受訪者部份基本特性與年齡、工作年資、工作場所、宗教活動參與度、有無閱讀「新安寧緩和醫療條例」、及有無相關在職教育之態度呈顯著相關。本研究歸納會影響呼吸治療師對臨終病人照護態度的因素，建議整合呼吸治療師學校教育與醫院、公、學會在職教育，以增加安寧緩和相關議題與討論。

關鍵字

呼吸治療師 ； 不施行心肺復甦術 ； 終止或撤除氣管內管 ； 臨終拔管

並列摘要

Most of the respiratory therapists (RTs) work in intensive care units, and have experienced of caring dying patients during their daily practice. However, insufficient training on hospice and palliative care was found either in their formal education or continue education. The purpose of this study was to disuse perspectives on DNR issues among RTs and their attitudes toward to care of DNR and terminal extubation patients. A cross-sectional survey was conducted to the licensed RTs. The questionnaire included 5 dimensions: demographics, knowledge of RTs on terminal extubation, attitudes toward to dying patients, attitudes of caring dying patients, and attitudes of professional respiratory care to dying patients. Eighty percent samples were collected. Majority of respondents were aged between 31-40 years old, with baccalaureate, with 11-20 years of clinical experience, and working in medical centers and district hospitals. The results showed that average scores on ＂RT's perspectives on terminal extubation＂ and ＂attitudes toward to professional respiratory care on dying patients＂ were 3.7~3.9, and scores of the attitudes towards to the care of dying and DNR patients were 1.6~1.9. The correlation analysis showed a significantly different among all dimensions. The study demonstrated that factors influenced RT's attitudes toward to caring dying patients. Extending intensity of continues education on hospice and palliative care patients is recommended.

並列關鍵字

respiratory therapist ； do-not-resuscitate ； DNR ； terminal extubation ； withhold andwithdrawal artificial airways