探討護理之家照顧服務員對失智住民之照顧經驗

Exploration of Nursing Assistants' Experience in Caring for Residents with Dementia in a Nursing Home

曾月霞(Yueh-Hsia Tseng) ； 楊其璇(Chi-Hsuan Yang) ； 石又敏(Yu-Min Shin) ； 饒瑞玉(Jui-Yu Jao)

《榮總護理》 37卷3期 (2020/09) Pp. 232-243

https://doi.org/10.6142/VGHN.202009_37(3).0002

摘要

照顧服務員是長照機構中主要的照顧人力，與住民互動密切，然而研究發現國內照服員職前教育中缺少失智症照護訓練，以致於照服員的失智症照顧知識及能力有所不足，他們能否妥善照顧失智住民，攸關住民之照顧品質，需要加以探討。本研究以質性研究進行一對一深度訪談，探討長照機構中照服員照顧失智住民的經驗。採立意取樣，共有15位護理之家照服員參與本研究，以內容分析法進行資料的分析與歸納。研究結果顯示照服員之照顧經驗有六個類別：（一）要耐心回應和技巧性溝通；（二）要安撫情緒；（三）工作有三怕；（四）使用約束的兩難；（五）不易兼顧住民的照顧工作；及（六）學理知識應用有限，需做中學。本研究結果建議發展預防和處理躁動的有效策略，提升約束使用的合宜性及照顧，改善照服員人力配置的問題，及照服員失智症臨床照護能力的養成是需要的，以提升失智住民的照顧品質。

關鍵字

照顧服務員 ； 失智 ； 照顧經驗 ； 護理之家

並列摘要

Nursing assistants serve as the major givers in long-term care facilities and interact closely with residents. However, studies have revealed that the dementia care knowledge and skills of domestic nursing assistants are inadequate because of the lack of preoccupational training in this domain. Whether nursing assistants are capable of providing quality care to residents with dementia must be further explored. This study employed qualitative research and one-on-one in-depth interviews to explore nursing assistants' experience in caring for residents with dementia in long-term care facilities. Purposive sampling was used, and 15 nursing assistants participated in this study. Content analysis was used to analyze and categorize the data. Our findings revealed 6 categories of care experience: (1) patient to respond and skilled communication, (2) appeasing emotions, (3) 3 fears at work, (4) dilemma of whether to use restraints, (5) difficulty achieving balanced care for residents, and (6) need to learn-by-doing due to limited application of knowledge. The results suggest that effective strategies for nursing assistants should cover agitation prevention and management, enhancement of adequate use of restraint and care, improvement of nursing assistant allocation, and competence in dementia care among to improve the quality of care for residents with dementia.

並列關鍵字

nursing assistant ； dementia ； care experience ； nursing home

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