老人養護機構照護者對預防住民跌倒認知、歸因、自我效能與處預方式之探討

The Relationships among Knowledge, Attributes, Self-Efficacy and the Treatment of Preventing Fall of Long-Term Care Facility Caregivers.

葉淑菀(Su-Wang Ye) ； 黃素妃(Su-Fei Huang)

《健康生活與成功老化學刊》 4卷1期 (2012/06) Pp. 15-31

https://doi.org/10.29775/JHLSA.201206.0002

摘要

目的：本研究目的瞭解養護機構照護者在預防住民跌倒之認知、對跌倒事件的歸因，以及處理跌倒事件的自我效能與處預方式。方法：本研究以量性為主並輔以質性研究。量性部分以結構性問卷調查，以台北市及新北市2行政區立案長期照顧機構中，立意取樣11所機構共98人；質性部分，以自擬之訪談大綱，立意取樣10名照護者進行深度訪談，以了解照護者對老人跌倒之防治策略。結果：研究對象分為護理人員34位，本國籍照服員35位，外籍照服員29位，三組年齡達統計上顯著差異。護理人員在預防跌倒認知得分上高於本國籍和外籍照服員，且達統計上顯著差異。在住民跌倒後的處預方式則採取9~11項來防範日後跌倒發生。研究對象對預防住民跌倒的認知越高，並認為跌倒事件的歸因是可以預防的情況下，採取相關的防跌措施越完整，其解釋力達12％。研究對象之教育程度越高，及取得證照（或訓練）者，其預防跌倒的認知越高；教育程度越高者，其跌倒事件的認同歸因也越高。進一步分析發現：預防跌倒之認知、跌倒事件的可預防歸因是養護機構照護者在跌倒事件之處預的顯著因子；跌倒事件的認同歸因和可預防歸因是護理人員和本國籍照服員在跌倒事件之處預的顯著因子。建議：未來在實務工作方面，機構可考慮聘僱教育程度較高、已取得證照（或訓練）的護理人員與照服員。平時機構可更強化跌倒議題之相關在職教育與訓練課程，增加溝通橋樑，並對高危險群的住民進行相關介入計劃。

關鍵字

預防跌倒 ； 歸因 ； 自我效能 ； 處預方式

並列摘要

Purpose: The purpose of this study is to explore the relationships among knowledge, attributes, self-efficacy and the process of preventing fall between the nurse and nurse aides in long-term care facilities. Methods: This study method combined qualitative and quantitative. The quantitative data used a structured questionnaire survey. According to a purposive sampling method, 98 caregivers were recruited in Taipei and New Taipei City' long-term care facilities. The qualitative data were collected using a semi-structured interview format and analyzed using qualitative content analysis. Participants comprised 10 caregivers recruited from 11facilities. Result: They are 34 nurses, the 35 native nurse aides and 34 foreign nurse aides from 11 registered facilities in Taipei. Education and license (training) are related to the knowledge of nurse and nurse aides; education is related to approval, and the approval of native nurse aides is higher than foreign nurse aides; Training is related to preventable attribution. In addition, in the case of nurses, native nurse aides and foreign nurse aides, knowledge and preventable attribution have significant predictive effect on the process of preventing fall. For nurses and native nurse aides, approval and preventable attribution have significant predictive effect on the process of preventing fall. When having more preventable attribution, they would take more related processes. Suggestions: For employing nurses and nurse aides with higher education and well-trained, and offering relevant courses are able to prevent residents to fall. Long-term care facilities can strengthen in-service programs of fall prevention issues to increase care quality.

並列關鍵字

fall prevention ； attributes ； self-efficacy ； treatment