護理人員對肺結核知識、態度、行為及其影響因素探討－以某市立聯合醫院為例

Study of Nurses’ Knowledge, Attitudes, Practice and Related Factors on Pulmonary Tuberculosis in the City Hospital

李曉雲(Shaio-Yun Lee)

指導教授 ： 盧美秀

共同指導教授 ： 周桂如

臺北醫學大學/護理學院/護理研究所/碩士(2007年)

https://doi.org/10.6831/TMU.2007.00023

摘要

肺結核是台灣目前發生率及死亡率最高的傳染病，因多重抗藥性患者（Multidrug Resistance, MDR）比例持續升高，容易成為隱形的病毒散播者，是我們應加以關切之問題。本研究目的是探討護理人員對肺結核之知識、態度與行為現況及其影響因素。收案期間自2006 年10月至11月，利用問卷作個別填表調查；主要內容以工作資歷、工作經驗、知識、態度為自變項，肺結核防治行為為依變項，問卷發出164份，回收162份。
本研究採橫斷式調查，以台北市立聯合醫院護理人員為母群體，採二階段分層立意取樣法選取個案，並以樣本之適合度檢定。利用S Size軟體計算樣本數，以次數分配、ANOVA 、Pearson’s correlation及複迴歸分析。統計結果聯合醫院護理人員平均32.93歲；平均年資10.50年；教育程度以專科及大學佔九成以上；77﹪表示肺結核在職教育時數夠多。獲知肺結核資訊的管道88.9﹪來自醫護書籍、其他依序為網路、雜誌期刊報紙、演講、宣導手冊海報及電視/廣播。護理人員之肺結核認知現況，知識得分平均近似80分（19.77/25）；態度平均3.3分（五分法），認同需要高品質照護、不可拒絕肺結核病患及參與在職訓練等，皆有積極正向看法；防治行為達4.5分，針對戴口罩與辨識負壓病房壓力表需進行有效管理。本研究結果發現護理人員肺結核知識與行為無關，而態度與防治行為間為正相關；護理人員的態度與曾有照護肺結核之經驗，有統計上顯著差異，二者對行為的解釋變異量為10.5﹪（R2 = .105）。在臨床上，預防肺結核首重院內感染管制之實踐，應增加實務操作機會及交叉管理，建議在職教育取消講授方式，本文可提供研擬護理人員訓練及推廣相關課程設計之參考。

關鍵詞：護理人員，肺結核，知識，態度，行為

關鍵字

護理人員 ； 肺結核 ； 知識 ； 態度 ； 行為

並列摘要

Pulmonary tuberculosis is currently the infectious disease with the highest morbidity and mortality in Taiwan. Due to the increasing multi-drug resistance rate, patients with pulmonary tuberculosis become the invisible bacterial carriers. Therefore, Pulmonary tuberculosis calls for more attention by the health professionals. The aim of this study was to explore nurses’ knowledge, attitudes, practice; and related factors on pulmonary tuberculosis.
The investigation was conducted by filling the questionnaire individually and collected from Oct. to Nov. of 2006. The major content of the questionnaire included independent variables (working history, experience, knowledge, attitude), and dependent variable (practice behavior) of pulmonary tuberculosis. A total of 162 out of 164 participants was completed with a 99% return rate.
This was a cross-sectional study desing using two stages of convenience sampling among nurses in The City Hospital. The sample size was calculated by S Size Software. The data were analyzed using descriptive statistics, ANOVA, Pearson’s correlation and multiple-regression.
The average age of nurses in this study was 32.93 years old and the average working year was 10.50 years. Ninety percent (90%) of the subjects were graduated from colleges or universities, and 77% indicated that the professional education of pulmonary tuberculosis was sufficient. Eighty-nine percent (89%) of the sources of information about pulmonary tuberculosis was from medical books.
The present status of nurses’ awareness on pulmonary tuberculosis included: Knowledge (average 80 points); Attitude (average 3.3 on a five-point scale). Subjects agreed that they would not reject the pulmonary tuberculosis patients and patients should receive high quality of care. The average score for practice is 4.5 on a 5- point Likert scale. There is a need for effective management on wearing masks and reading meters on patient wards with negative pressure.
This research indicated that nurses’ knowledge about pulmonary tuberculosis was not related to their practice behaviors. However, there was a positive correlation (p< 0.05) between the attitude and the prevention and caring practice. Nurses’ attitude was significantly affected by their past experience of caring for patients with pulmonary tuberculosis. The nurses’ attitude and past experience explained 10.5% of the variance for nurses’ practice behavior.
Clinically, the most important task on preventing pulmonary tuberculosis
is to implemnet infection control in the hospital. Meanwhile, it is
recommended to increase the actual practice opportunities and effective management. It is suggested not to use lecture modality in continuing education programs. In conclusion, this research provides important information for designing training programs for nurses on caring patients with pulmonary tuberculosis.
Key words：Nurse、Pulmonary tuberculosis、Knowledge、Attitude、Practice behavior

並列關鍵字

Nurse ； Pulmonary tuberculosis ； Knowledge ； Attitude ； Practice Behavior

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