腦神經外科加護病房病人家屬的需求與焦慮程度之相關性

The relationship between needs and anxiety level in family members of patients of neurosurgical intensive care unit

何麗娟(Li-Chuan Ho)

指導教授 ： 張媚

國立臺灣大學/醫學院/護理學研究所/碩士(2012年)

https://doi.org/10.6342/NTU.2012.01152

摘要

中文摘要
背景 加護病房的護理人員常因較專注於照顧病情不穩定的病人，忽略或低估家
屬的需求及感受，進而影響家屬與護理人員之關係；神經外科加護病房的
病人家屬多少都有不等程度的焦慮情緒。
目的 探討腦神經外科加護病房術後病人家屬的需求與焦慮程度之相關性。
方法 本研究以立意取樣方式，採横斷式描述性相關研究，選取北部某醫學中心
神經外科加護病房122位病人家屬為施測對象。結構性問卷內容包含「病
人的基本屬性」、「家屬的基本屬性」、「腦神經外科重症病人的家屬需求量
表」及「家屬情境焦慮量表」等，將所得資料進行描述性統計與推論性統
計分析。
結果 腦神經外科加護病房病人家屬認為重要，但沒有充分被滿無足的需求依序為「有人提供我有關長期照護的資訊」、「每天可以有機會與醫師談話」、「有人教我如何和溝通有困難的病人溝通」、「瞭解照顧病人的工作人員的專業經歷」、「能有人關心我的健康」。家屬整體需求重要程度與焦慮程度呈正相關，家屬整體需求被滿足程度與焦慮程度無顯著相關。巴氏量表指數為家屬整體需求被滿足程度、保證需求被滿足程度、支持需求被滿足程度等之重要預測因子。焦慮程度的重要預測因子依序為保證需求被滿足程度、接近病人需求重要程度及病人昏迷指數，共可解釋17%之變異量。
結論 所以醫療團隊在滿足家屬需求方面仍有待努力的，可藉由適時的舉辦相關在職教育與家屬討論會，確切瞭解腦神經外科加護病房家屬的需求，增進家屬需求被滿足程度，進而降低家屬焦慮。面對昏迷指數低及巴氏量表指數低的病人家屬時，須給予家屬接受病況的時間，引導其了解病人實際狀況，幫助家屬將重心轉移到未來如何幫忙病人復原，使家屬有效地調適及有能力去面對並處理親人生病所帶來的家庭危機，減輕家屬的焦慮。

關鍵字

神經外科加護病房 ； 需求重要程度 ； 需求被滿足程度 ； 焦慮程度

並列摘要

Abstract
Background: The intensive care unit nurses tend to ignore or undervalue the needs and feeling of the patients’ families as they usually focus on taking care of the patients in unstable condition. This further affects the relationship between nurses and patients’ families. The families of the patients at the neurosurgery intensive care unit have anxious feeling to a certain degree.
Purpose: Discuss the relationship between the needs and anxiety level of the neurosurgery intensive care unit patients’ families.
Method: Through purposive sampling method, a cross-sectional descriptive study was conducted by targeting on families of 122 neurosurgery intensive care unit patients. The content of the constructive survey includes “the patient’s basic attribute”, “the attribute of the patients’ families”, “the scale of the needs required by the families of the neurosurgery patients” and “the scale of the anxiety scenario of the patients’ families” etc..The descriptive and inferential statistical analyses were conducted to analyze the data.
Results: The needs that the neurosurgery patients’ families believe necessary but can’t be satisfied are listed from the most important to the least important: “someone can provide them with long-term care information”, “they will get a chance to talk to doctor on a daily basis”, “someone can teach them how do communicate with patients who have communication problems”, “the staffs who have specialized experience in taking care of the patients”, and “someone can concern about their health”. The overall level of the needs of the patients’ families is positively correlated with the anxiety level. The satisfaction level of the needs of the patients’ families is not significantly correlated with the anxiety level. The Barthel Index refers to the key factors of the satisfaction level of the needs of the patient’s families, the guaranteed level of satisfaction of the needs, and the supported satisfaction level of the needs. The important factors of the anxiety prediction are the guaranteed level of satisfaction of needs, approaching patient’s level of needs and the Glasgow Coma Scale, which can explain 17% of the variance.
Conclusion: The nurses should spend time in guiding the families to understand the patient’s real situation and focus on patient’s recovery in the future when facing patient with low Glasgow Coma Scale, low Barthel Index and slow recovery after surgery. This will allow the patients’ families effectively adjusting their feelings and having the ability to cope with the illness and crisis, and reduce the families’ anxiety.

並列關鍵字

the neurosurgery intensive care unit ； important level of needs ； satisfaction level of needs ； anxiety level.

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