術前訊息需求與提供：比較病患與護理人員之觀點

中文摘要本研究目的在比較病患與護理人員對術前訊息（包括心理社會支持、術後情況訊息、病人角色、感覺訊息四層面）的接收與提供、重要程度、提供最佳時機三方面觀點之差異。此研究為描述性、比較性的研究，採方便取樣，選取高雄市一所醫學中心、兩所區域醫院為收案場所，病人及其照護之護理人員各發出問卷168份，完成之有效問卷各為148份，有效回收率為88.10%。研究工具為結構式問卷，包括術前訊息量表及基本資料表（兩者均分為病患版及護理人員版）。研究結果發現：（1）接收或提供術前訊息方面，病患與護理人員在心理社會支持及術後情況訊息兩層面約7成達顯著差異。（2）術前訊息重要程度整體的看法雙方皆介於〝普通重要〞與〝重要〞之間，只有感覺訊息層面達顯著差異。（3）兩者最常勾選的術前訊息提供時機為〝入院至術前〞，二十九個題項有5題達顯著差異。（4）護理人員認為未給予某項術前訊息最常見的3個原因依序為：「怕給太多訊息，會增加病人焦慮」、「工作太忙，無法解釋太多」、「不是護理人員的責任」。（5）有偶者之病患在心理社會支持訊息的重要程度得分高於單身、喪偶者；有過去病史者在角色訊息的重要程度得分高於無過去病史者；年齡越大者其感覺訊息、病人角色訊息兩層面重要程度的得分越高。（6）專科以下之護理人員在心理社會支持訊息、術後情況訊息、感覺訊息三層面重要程度之得分高於大學以上者；有他科經驗者之術後情況訊息的重要程度得分高於無他科經驗者；年資越高者感覺需要訊息重要程度的得分越高。研究建議未來在術前訊息提供上，能加強心理社會支持及感覺二層面之訊息，而術後情況訊息可於術前與病患討論其真正想知道的時機及內容，才能在最佳時機滿足病患的需求。關鍵字：病患、護理人員、術前訊息、訊息需求、訊息提供

關鍵字

術前訊息；訊息需求；病患；訊息提供；護理人員

並列摘要

Abstract The purpose of this study was to examin the perspective differences between patients and nurses on four domains of preoperative information—psychosocial support, post-operative situation, role of patient, and feeling. For each domain of preoperative information, patients and nurses evaluated whether the information was received /or provided before operation, their perception about the importance of receiving/or providing the information, and their perspective on the timing of receiving /or providing the information. This study was a descriptive and comparative research and took the convenience sampling consisted of patients who had received operation and the nurses caring from one medical center and two community hospitals in Kaohsiung, Taiwan. Three hundred thirty-six questionnaires were sent out with a return rate of 88.10%(N = 296). Two structured questionnaires were included in each questionnaire package, including the Preoperative Information Scale (PIS) (patients’ and nurses’ versions) and the demographic questionnaire (patients’ and nurses’ versions). Six major findings were concluded:(1) On information received and provided, about 70% of the psychosocial support and post-operative situation listed items were inconsistent between patients and nurses (tests achieved statistical significant level). (2) Most patients and nurses believed that providing preoperational information was between “moderately important” and “important” level. Patients and nurses were agreed on the importance of receiving preoperational information on three dimensions. The only disagreement was on the Feeling. (3) On the timing of providing preoperative information, most patients and nurses agreed that between hospital admission and prior surgery was the best timing of providing information. Out of the 29 listed items, patients and nurses had obvious differences on 5 listed items. (4) Three main reasons that nurses did not to provide preoperative information to patients were: worried about increasing patient's anxiousness; concerned about increase their work load; and believed that providing information was not their responsibility. (5) Several patient characteristics were related to patients’ perception of level of importance on different domains of pre-operational information. Specifically, patients who have partners scored higher on the level of importance on the Psychosocial Support domain than the patients who were single or did not have partners. Patients who had past medical history scored higher on the Role of Patients domain than the patients who did not have past medical history. Also, older patients scored higher on the Feeling and Role of Patients domains than the younger patients. (6) Several nurse characteristics were related to nurses’ perception of level of importance on different domains of pre-operational information. Specifically, nurses with less than college degree scored higher on the Psychosocial Support, Post-operative Situation, and Feeling domains than nurses with college or above college degree. Nurses with other wards experience also scored higher on the Post-operational Situation domain than the nurses without it. More experienced nurses scored higher on the Feeling domain than less experienced ones. The results on this study suggest to strengthen the importance of providing psychosocial support and feeling domains of information before operation. Also, the discussion on post-operational situations with patients prior to their operations increase patients’ satisfaction and needs. Keyword: patient, nurse, preoperative information, information needs, information providing.