兒科護理人員對兒童癌症疼痛處置之認知及學習需求

The Pediatric Nurses’ Knowledge and Education Needs about Cancer Pain Management in Children

黃庭紅(Ting-Hung Huang)

指導教授 ： 陳月枝

國立臺灣大學/醫學院/護理學研究所/碩士(2005年)

https://doi.org/10.6342/NTU.2005.10466

摘要

本研究是探討台灣地區兒科護理人員對於兒童癌症疼痛處置之認知及學習需求，了解其是否受個人屬性、個人過去經驗及環境因素的影響，並分析認知與學習需求之關係及其預測因子。研究對象為台灣地區六家醫學中心兒科護理人員，使用結構式問卷收集資料，共發出204份問卷，回收180份問卷，回收率為88.24%。所收集的資料以SPSS 12.0 for windows套裝軟體進行統計分析。
重要結果如下：
一、兒科護理人員對兒童癌症疼痛處置之認知瞭解程度平均得分為28.03 ± 4.55分，亦即平均答對28題，答錯16題。其中對於急慢性疼痛之區別、止痛劑的副作用、藥物劑量的轉換、癌症疼痛治療的目標及疼痛評估，這幾方面的知識仍有改善的空間。
二、兒科護理人員對兒童癌症疼痛處置之學習需求程度平均得分為54.82 ± 8.60分，每項平均為3.41分，屬於部分需要。其中以止痛劑的使用及疼痛理論及機轉的學習需求程度最高。
三、兒科護理人員的年齡愈大、護理教育背景為研究所畢、臨床進階制度為N4、護理工作資歷愈長、兒科工作資歷愈長、曾參加過兒童癌症護理訓練課程、曾參加與疼痛相關的在職教育、參加疼痛在職教育的次數愈多、最近一次疼痛在職教育距今時間在6個月內及親友曾經歷癌
症疼痛，其對兒童癌症疼痛處置之認知瞭解程度愈高。其中通過進階制度、參加疼痛在職教育的次數愈多、曾參加兒童癌症護理訓練課程、護理教育背景為大學畢或以上，為對兒童癌症疼痛處置認知之最佳預測因子，可解釋總變異量的16.2 %。
四、兒科護理人員的護理教育背景為專科、未參加過與疼痛相關的在職教育及親友曾經歷癌症疼痛，其對兒童癌症疼痛處置之學習需求程度愈高。其中最近一次疼痛在職教育距今時間在6個月內及護理教育背景為大學畢或以上，為對兒童癌症疼痛處置學習需求之最佳預測因子，可解釋總變異量的8%。
五、兒科護理人員其兒童癌症疼痛處置之認知及學習需求未達統計上顯著相關。

關鍵字

兒科護理人員 ； 兒童癌症疼痛處置 ； 疼痛知識

並列摘要

The purposes of this study were (1) to examine the level of knowledge and education needs about cancer pain management in children among pediatric nurses with different background characteristics、personal past experiences and environment factors from six medical centers in Taiwan, (2) to analysis and determine the relationship and predictor(s). Data was collected with structured questionnaire. One hundred and eighty of 204 subjects were completed, and returned valid rate was 88.24%. Statistical analyses were performed through the SPSS 12.0 for Window Software.
Significant results were summarized as followed：
1. The mean score of knowledge about cancer pain management was 28.03 ± 4.55, which equaled correct answers to 28 questions and wrong answers to 16 questions. Among them, knowledge on the (1) differences in acute and chronic pain, (2) side effects of narcotics, (3) conversion of drug dose, (4) goals of cancer pain treatment, (5) pain assessment still needed improving.
2. The mean score of education needs about cancer pain management was 54.82 ± 8.60. The mean score per item of 3.41 fell into the category of partial needs. Among them, the highest scores of education needs were in the areas of narcotics use and pain theories and mechanisms.
3. Results showed that pediatric nurses with higher mean correct answer scores of the knowledge about cancer pain management in children that had older age, had master degree, clinical ladder was N4, had longer experiences in
nursing field, had longer experiences in pediatric nursing, had received the childhood cancer nursing training, had participation in pain-related in-service education, the more times of participation in pain-related in-service education, the last time of participation in pain-related in-service education took place within 6 months and relatives who had experienced cancer pain. According to multiple regression analysis, had passed the clinical ladder, the more times of participation in pain-related in-service education, had received the childhood cancer nursing training, and the highest academic was bachelor or higher degrees were the optimal predictors of the knowledge about cancer pain management in children. These four variables contributed for 16.2% of total variances.
4. Results showed that pediatric nurses with higher mean scores of the education needs that the highest academic was college, never participation in pain-related in-service education, relatives who had experienced cancer pain. According to multiple regression analysis, the last time of participation in in-service education took place within 6 months, and the highest academic was bachelor or higher degrees were the optimal predictors of the education needs about cancer pain management in children. These two variables contributed for 8% of total variances.
5. There was no significant correlation between the pediatric nurses’ knowledge and education needs about cancer pain management in children.

The study results can provide reference to nursing school education, in-service education, Childhood Cancer Foundation, and the curriculum design for workshops on pain-related conferences.

並列關鍵字

Pediatric nurses ； cancer pain management in children

參考文獻

石明煌（2003）．類鴉片藥物治療非癌症慢性疼痛．慈濟護理雜誌，2（3），31-36。

李詠瑞、馬素華、史麗珠、楊靖宇（2002）．音樂治療對癌症疼痛的成效．台灣醫學，6（5），682-690。

吳幸娟、陳秀蓉（2002）．以五種疼痛評估量表探討手術後病童之疼痛程度．慈濟醫學，14（5），311-315。

林玉娟（1997）．癌症疼痛評估．護理新象，7（4），753-773。

林佳靜、陳淑如、謝麗鳳（1998）．疼痛護理．護理雜誌，44（1），37-47。