影響中部地區基層護理人員對麻醉性止痛藥物的使用意願－ 以嗎啡為例

Influences the related factors of the will of using narcotic analgesics agents to nurses in the community in central Taiwan- nstance of morphine

張巧靜(chang ch'iao ching)

指導教授 ： 朱僑麗 ； 周希諴

亞洲大學/健康學院/長期照護研究所/碩士(2006年)

摘要

近年來癌症死亡率一直高居十大死因之首，癌症疼痛控制議題逐漸受到
重視；為有效控制癌痛，世界衛生組織(WHO)以鴉片類藥品作為癌症疼痛控
制主流；然而，因大眾對該類藥品之使用產生誤解，導致疼痛控制成效不顯，
甚至影響病患及家屬生活品質；未來癌症照顧以居家及社區式為發展，因此
基層醫療服務人員在醫療資源網絡中，更凸顯其地位之重要。本研究目的為
探討基層護理人員對使用麻醉性止痛藥物的認知、癌症疼痛評估能力之情形
，及其對使用意願之影響，以了解影響麻醉性止痛藥物使用意願之因素。
採描述相關性研究，研究對象為中部地區台中市、台中縣、彰化縣等三
縣市57 家衛生所之護理人員，採用結構式問卷，內容包含人口學基本資料、
麻醉性止痛藥物認知、疼痛評估能力、使用嗎啡意願，量表專家效度達80％
以上，Cronbach’s α值介於0.754-0.958 間。統計方法採描述性統計、獨立
樣本t 檢定、單因子變異數分析、皮爾森積差相關檢定、迴歸分析、邏輯迴歸
分析等進行相關性分析。
研究結果發現：（1）麻醉性止痛藥物認知方面：在職教育時數、有無參
與相關疼痛處理之課程，及自認為對疼痛控制用藥的專業知識足夠與否等變
項，具有顯著影響力，迴歸方程式為Y＝9.544＋1.771X1＋0.657X2＋13.130X3
＋12.430X4＋12.300X5，可預測基層護理人員麻醉性止痛藥物認知的解釋力
為17.3％，X1 為在職教育時數每年5 小時以下，X2 為曾參與相關疼痛處理
之課程，X3 為非常不贊成自己對疼痛控制用藥的專業知識足夠，X4 為不贊
成自己對疼痛控制用藥的專業知識足夠，X5 為不贊成自己對疼痛控制用藥的
專業知識足夠。（2）疼痛評估能力方面：教育程度、有無宗教信仰、在職教
育時數、參與相關疼痛處理之課程，及自認為對疼痛控制用藥的專業知識足
夠與否等變項，具有顯著影響力，基層護理人員對疼痛評估能力的解釋力為
17％，可得以下迴歸方程式：Y＝10.250＋0.805X1＋0.738X2＋1.429X3＋
0.837X4＋9.469X5＋9.164X6＋8.376X7，X1 為教育程度，X2 為有無宗教信
仰，X3 為在職教育時數，X4 為參與相關疼痛處理之課程，X5 為非常不贊成
自己對疼痛控制用藥的專業知識足夠，X6 為不贊成自己對疼痛控制用藥的專
業知識足夠，X7 為贊成自己對疼痛控制用藥的專業知識足夠。（3）使用嗎啡
意願方面：麻醉性止痛藥物認知及疼痛評估能力不足，而使用嗎啡意願高。
65.4％ -90.1％ 之基層護理人員同意使用麻醉性止痛藥物，然而缺乏面對情境
案例分析之處理能力；年齡、護理年資及麻醉性止痛藥物認知為顯著影響因
素；年齡愈低、護理年資愈高及麻醉性止痛藥物認知愈佳，其使用嗎啡意願
愈高。
依據本研究結果建議：疼痛控制教育尚須加強，後續可納入課後評量於
相關疼痛課程教育上。

關鍵字

麻醉性止痛藥物認知、疼痛評估能力、使用嗎啡意願

並列摘要

The cancer mortality has been the first killer among the ten major causes of
death in recent years, the topic of the cancer pain control has paid more attention.
In order to control the cancer pain effectively, the mainstream of the cancer pain
control as using opiods analgesics in World Health Organization (WHO ).
However, this kind of medicines often misunderstands in amount of people, and
induces the pain control effects poorly, even influence the quality of life with the
patient and their families. Because of cancer-caring develops and regards at home
care and community care mode, The basic medical attendants are more importance
of the medical resource network. The objection of this study was to explore the
knowledge of narcotic analgesics agents of the nursing staff in the community, the
ability of pain assessment, and the influence of the will of using narcotic analgesics
agents.
A descriptive correlational design study, the research object is the nursing
staff of 57 health stations in the central Taiwan of Taichung city, Taichung county,
and Changhua county. Structurally formulated questionnaires which contains:
personal data, the knowledge of narcotic analgesics agents, the ability of pain
assessment, and the will of using morphine. Validity is more than 80％,
Cronbach’s α among 0.754-0.958. Adopted the independent t test, one way anova,
pearson correlation , regression ,and logistic regression to statistics.
The result of study: ( 1) narcotic analgesics agents’ knowledge : the unit’
education hours , participated the pain control program , and beliving enough
knowledge of pain control could predict 17.3﹪narcotic analgesics
agents ’knowledge . The regression formula : Y＝9.544＋1.771X1＋0.657X2＋
13.1 30X3＋12.430X4＋12.300X5 . X1：the unit’ education hours. X2：participated
the pain control program . X3：very not agree of beliving enough knowledge of
pain control. X4：not agree of beliving enough knowledge of pain control . X5：
agree of beliving enough knowledge of pain control. (2) The ability of pain
assessment : education degree, religion , the unit’ education hours , participated the
pain control program , and beliving enough knowledge of pain control could
predict 17﹪the ability of pain assessment. The regression formula : Y＝10.250＋
0.805X1＋0.738X2＋1.429X3＋0.837X4＋9.469X5＋9.164X6＋8.376X7. X1：
education degree . X2：religion .X3：the unit’ education hours . X4：participated the
pain control program. X5：very not agree of beliving enough knowledge of pain
control. X6：not agree of beliving enough knowledge of pain control .X6：agree of
beliving enough knowledge of pain control. (3) The will of using narcotic
analgesics agents : narcotic analgesics agents’ knowledge and the ability of pain
assessment was poor , and the will of using narcotic analgesics agents was high .
65.4％ -90.1％ was agreed to use narcotic analgesics agents , but lack the ability
of case analyze . Age, the year of nursing job , and narcotic analgesics agents’
knowledge could influence of the will of using narcotic analgesics agents.The
younger , the longer of the nursing job’year , and the better narcotic analgesics
agents’ knowledge , the more will of using narcotic analgesics agents.
The study suggestion : the education of pain control training should
augment .And add to test after the pain control program in the future.
Key words：narcotic analgesics agents knowledge, the ability of cancer pain
asse ssment , the will of using narcotic analgesics agents.1

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