外科加護病房病患氣管內管留置期間之基本需求及其預測因子

中文摘要本研究目的在探討外科加護病房氣管內管留置期間病患基本需求及其重要預測因子，採描述相關性研究設計。研究以方便取樣，選取南部三所醫院之成人外科加護病房，曾住進外科加護病房且置放氣管內管病患為研究對象，共收集80位病患。研究工具採結構式問卷，內容包括:病患人口學特性及疾病特性、基本需求量表及溝通困難量表。本研究所得的資料以百分比、平均數、標準差、皮爾森積差相關及逐步迴歸進行統計分析，結果發現加護病房氣管內管留置病患的整體基本需求程度標準化得分為54.38分，屬於中等程度，以愛及歸屬感需求的得分最高；溝通困難程度之標準化得分為46.98分，屬於中等程度，以「整體而言，當您無法說話，您想要讓別人了解您多困難？」得分最高。溝通困難與基本需求程度成正相關。溝通困難、約束帶使用、置放氣管內管經驗及教育程度為基本需求的顯著預測因子，可解釋之總變異量為46.7%之變異數，其中以溝通困難之預測力最佳，可以解釋28.2%之變異數。本研究結果可提供醫護人員瞭解病患氣管內管留置期間病患之基本需求及溝通困難程度。建議運用本研究工具，評估病患之需求及作為溝通手冊製作的參考，並依需求程度決定優先順序，以提供適合病患需求之照護。關鍵詞：氣管內管、基本需求、溝通困難、加護病房

關鍵字

基本需求；氣管內管；溝通困難；加護病房

並列摘要

Abstract The purpose of this study was to explore the relationships between basic needs and difficulty in communicating, and to investigate the predictors of patient's needs and difficulty in communicating during the intubation patient's stay in the SICU. It was a descriptive correlational research design, where eighty patients from SICU and wards were recruited from four hospitals in southern Taiwan. Three structured questionnaires were utilized to interview the subjects including: personal demographic questionnaire, basic needs scale, and communication difficulty scale. Data were analyzed by using the descriptive statistics, Pearson's correlation , and stepwise multiple regression analysis. 54.38 standarized score of basic needs, a moderate-leveled, was found in this study. The highest scores of basic needs among intubated patients were love and belongingness. The standarized score of communication difficulty was 46.98, which indicated a moderate-leveled score. Subjects had the highest scores in “In general, how hard has it been for you to make yourself understood by other people without being able to speak? ”. Basic needs were significantly positively related to communication difficulty. The significant predicators of subjects' statistics of basic needs were communication difficulty, physical restraints, intubated experience, and educational level, which account for 46.7% of total variance. However, the best predictor was communication difficulty which account for 28.2%. These results might help health providers understand the basic needs of intubated patients, and the difficult level of communication in SICU. We suggested that nurses should assess patients' needs, and a communication booklet as instrument should be used during delivery of care period. Nurses could design appropriate needs according to priority of vulnerable patient's needs. Keywords: Endotracheal tube, basic needs, communication difficulty, intensive care unit