醫師與護理師專業準備度與發燒及藥物處置知識、信念及處置依據之相關

Association between Professional Readiness and Fever and Antipyretic Management in Physicians and Nurses

邱旅揚(Lu‐Yang Chiu) ； 戴玉慈(Yu‐Tzu Dai) ； 盛望徽(Wang‐Huei Sheng) ； 柯文哲(Wen‐Je Ko)

《護理暨健康照護研究》 9卷1期 (2013/03) Pp. 74-82

https://doi.org/10.6225/JNHR.09.1.74

摘要

背景：發燒為人體對抗感染之自然防禦機轉，然而此觀念並未落實於臨床退燒藥物處置，且少有研究探討醫師與護理師對成年病患發燒之看法。目的：了解醫師與護理師進階層級、年資與發燒及藥物處置的知識、信念及退燒藥物處置依據之相關。方法：採橫斷性調查，以自填結構式問卷針對北部某醫學中心醫護人員進行資料收集。收案期間2012年2月至4月，共收案78位醫師、251位護理師，總共329位醫護人員。並以SPSS 16.0版統計軟體進行描述性與推論性統計分析。結果：醫師進階層級越高，越資深，對發燒認知及退燒藥物處置信心越高，但進階層級和年資，與其發燒知識無關。而護理師進階層級高、越資深，對發燒認知與退燒處置信心越高，發燒知識總分也越高，對發燒反應的焦慮越低，認為退燒目的主要為緩解家屬與病患的焦慮及預防病患無法負荷身體代謝率的增加，不是為避免腦部或重要器官細胞受損的比率越高。而資淺醫護人員的退燒藥物處置易受同事、家屬與病患影響，以及認為高燒會使病患出現腦部受損的比率較高。結論：本研究結果可做為未來主管規劃醫護共同繼續教育及研擬發燒處置準則之參考。

關鍵字

發燒 ； 退燒藥物處置 ； 醫師 ； 護理師

並列摘要

Background: Fever is a part of the body's natural defense mechanism against infectious disease. However, this concept has not been incorporated into antipyretic practices. Nurse and physician views on caring for febrile adults have been rarely explored. Purpose: This study investigated the association of level of practice and length of practical experience with physicians' and nurses' knowledge, beliefs and rationale on fever and antipyretic management. Methods: A cross‐sectional design was used to gather data from physicians and nurses. A total of 329 self-administered, structured questionnaires were collected from 78 physicians and 251 nurses at a medical center in northern Taiwan from February to April 2012. Data were analyzed with descriptive and inferential statistical analyses using Statistical Product and Service Solutions (SPSS), version 16.0. Results: Physician participants practicing at a more advanced level and with more experience reported higher fever cognitive and antipyretic management confidence. However, fever knowledge among physician participants did not relate to either practice or length of experience. Similarly, nursing participants practicing at a more advanced level and with more experience were also more confident in their cognitive and antipyretic fever management abilities and more knowledgeable and less anxious about fever response. They believed the purpose of antipyretic therapy to be reducing family member and patient anxiety and helping patients tolerate the metabolic burden of fever rather than preventing fever‐induced brain/organ cell damage. We found the antipyretic management practices of less experienced physicians and nurses to be relatively more influenced by colleagues, patient family members, and patients. We also found that less‐experienced physician and nurse participants, in particular, believed significantly more often than their more experienced physician and nurse colleagues that high fever would cause brain damage. Conclusion: Study results offer a reference for fever‐related continuing education planning and guideline setting.

並列關鍵字

fever ； antipyretic treatment ； physicians ； nurses