養護機構照護者對預防住民跌倒認知、歸因、自我效能與處預方式之探討

葉淑菀

指導教授 ： 郭鐘隆

國立臺灣師範大學/教育學院/健康促進與衛生教育學系/碩士(2010年)

摘要

跌倒是老年人生活中很值得重視的問題，養護機構住民因整體功能狀況較差，更易面臨跌倒風險。因此，為使住民有安全的環境與妥善的照護，探討機構住民的跌倒問題與養護機構照護者採取之預防措施有其重要意義，亦可作為日後擬訂相關計畫之參考。
本研究採立意取樣，選取台北縣市地區已立案之11所老人安養護機構，共98位護理人員、本國籍照服員和外籍照服員。以問卷調查方式，探討研究對象之社會人口學變項、認知、歸因、自我效能對處預方式的影響，並與研究對象進行面對面質性訪談，以更進一步了解養護機構照護者實務上的執行情形。
取得的資料以平均數、標準差、百分比、卡方檢定、獨立樣本t 檢定、變異數分析(analysis of variance)、相關分析 (Correlation Analysis)、階層迴歸分析(Hierarchical Regression Analysis)等方法進行分析。
本研究主要發現為：研究對象之教育程度越高，及獲證或接受過相關訓練者，認知越高；教育程度越高者，認同歸因越高，本國籍照服員的認同歸因也高於外籍照服員；接受過相關訓練者可預防歸因越高。本研究也發現：認知、可預防歸因是護理人員、本國籍照服員與外籍照服員處預方式的顯著因子；認同歸因、可預防歸因是護理人員和本國籍照服員處預方式的顯著因子；此外，研究對象的可預防歸因越高，在預防住民跌倒時會採取越多相關措施。
未來在實務工作方面，機構可考慮聘僱教育程度較高、獲證、接受過相關訓練的護理人員與照服員。平時機構可更重視護理人員與照服員的在職教育與訓練課程，增加溝通橋樑，並對高危險群的住民進行相關介入計劃。未來研究者可在本研究的基礎下，更深入探討其他與處預方式相關的因子，或擴大樣本數、地區，或採取護理人員、照服員與住民的配對研究，以更全面地了解護理人員、照服員認知、歸因、自我效能與預防住民跌倒採取處預方式的相關性。

關鍵字

養護機構 ； 護理人員 ； 照顧服務員 ； 處預方式 ； 跌倒

並列摘要

Residents in the facilities have poor physical functional status. They tend to have the risk of falls. In order to enable to residents have a safe environment and proper care. Preventing fall for residents is worthy of study. The purpose of this study is to explore the relationships among knowledge, attributes, self-efficacy and the process of preventing fall between the nurse and nurse aides. According to the finding of this study, it presents some suggestions as references for improving the preventing residents falling process between nurse and nurse aides and further research in related field.
There are 98 subjects in the study. They are nurses, the national nurse aides and foreign nurse aides from 11 registered facilities in Taipei. The data in the study is collected by the scale and qualitative interview, and analyzed by Chi-square test, independent samples t-test, analysis of variance, correlation analysis and Hierarchical regression analysis.
The results of this study are as follows: Education and training are related to the knowledge of nurse and nurse aides; education is related to approval, and the approval of national nurse aides is higher than foreign nurse aides; Training is related to preventable attribution. In addition, in the case of nurses, national nurse aides and foreign nurse aides, knowledge and preventable attribution have significant predictive effect on the process of preventing fall. For nurses and national nurse aides, approval and preventable attribution have significant predictive effect on the process of preventing fall. When having more preventable attribution, they would take more related processes.
Suggestions for employing nurses and nurse aides with higher education and well-trained, and offering relevant courses are able to prevent residents to fall. In the future researches, increasing the number of subjects and conducting paired-study of subjects and residents should be considered as the focuses of future studies. It could enhance the effect and realize its potential influence and correction of knowledge, attribution, self-efficacy and process of preventing fall.

並列關鍵字

Facility ； Nurse ； Nurse aides ； Treatment ； fall

參考文獻

周志玉(2006)。憂鬱症污名研究：可控制性歸因、危險與依賴刻板印象對歧視行為的影響。中原大學心理學研究所未出版碩士論文。桃園。

陳秀蓉、李素貞、郭憲文(1998)。台灣中部三縣市長期照顧機構護理人員工作滿意度探討。弘光學報。32。29-45。

郭鐘隆、張鈞惠、林靜兒、蔡益堅(2009)。16週跌倒預防介入對社區及安養機構老人之成效初探。健康生活與成功老化學刊。1(1)。53-67。

林淑芬、高毓秀(2008)。機構高血壓老人預防跌倒行爲相關因素之探討。衛生教育學報。29。99-117。

謝昌成、蔡坤維、劉鎮嘉(2007)。老年人的跌倒問題。基層醫學。22(10)。352-357。