台灣安寧及腫瘤病房護理人員疼痛認知與疼痛控制知識之比較

The Comparison of Nurses’ Pain Perception and Knowledge of Pain Management between Hospice Ward Unit and Tumor Ward Unit in Taiwan

林葦青(Lin Wei Chin)

指導教授 ： 張明正 ； 楊志良

亞洲大學/健康學院/健康管理研究所/碩士(2004年)

摘要

有些癌症病患認為癌症疼痛是非常劇烈難耐，而且會因疼痛而呈現出睡眠障礙、憂鬱及易怒、情緒不穩等負面反應；由此可見疼痛對癌症病患生活有著極大影響，所以疼痛控制對癌症病患非常重要。
本研究的目的主要探討醫院安寧病房及腫瘤病房之護理人員，在護理癌症疼痛病人的認知與知識，做法是透過個案分析與全面性調查，以瞭解護理人員對癌症疼痛的認知以及疼痛控制的知識，此研究結果如被採納，就可提升癌症疼痛患者的生活品質及生命尊嚴。
分析結果顯示，從個案研究發現，疼痛認知及疼痛控制知識答對率高的護理人員比疼痛認知及疼痛控制知識答對率低的護理人員，使用疼痛評估量表的頻率較高。另一方面，在一般研究指出安寧病房的護理人員疼痛認知及疼痛控制知識方面比腫瘤病房的護理人員答對率高，但所有的研究對象在兩方面答題正確率僅六至七成，顯示護理人員對於疼痛認知及疼痛控制知識仍有改善空間，在疼痛控制知識方面，安寧與腫瘤病房的護理人員有達到顯著性差異（p＜0.001），顯示出安寧病房的護理人員有較好的疼痛控制知識；在控制其他重要變項後，發現研究對象是否曾接受癌痛評估之相關課程，以及工作單位是否有舉辦癌痛臨床個案討論會等變項對於答對與否更是重要，顯示出上課程及臨床個案討論會，會對護理人員的疼痛認知及疼痛控制知識會有影響。

關鍵字

安寧病房 ； 腫瘤病房 ； 疼痛認知 ； 疼痛控制知識

並列摘要

Many cancer patients regard cancer pains as acute and unbearable. The pains will usually result in some side effects such as dyssomnia, melancholy, being irascible, and being moody. Accordingly, the pains have great influences on the life of the cancer patients and pain management is especially important to the cancer patients.
The main purpose of this study is to examine the nurses'' pain perception and knowledge of pain management about cancer patients in the hospice ward unit and the tumor ward unit. A case study together with a general survey are conducted to collect the relevant data. Hopefully, the suggestions of this study can be adopted, and the cancer patients'' quality of life and dignity can be upgraded.
The results of the case study show that nurses with a higher percentage of correct answers about knowledge of pain management are more likely to use the pain evaluation form than those with a lower percentage. On the other hand, the data from the general survey indicate that nurses of the hospice ward unit have a higher percentage of correct answers about pain perception and knowledge of pain management than those of the tumor ward unit. The percentage of correct answers among all of the research objects are only sixty to seventy percent, manifesting that the nurses’ pain perception and knowledge of pain management leave much to be improved. With regard to knowledge of pain management, nurses of the hospice ward unit and those of the tumor ward unit show a significant difference (p＜0.001), displaying that nurses of the hospice ward unit have more knowledge of pain management. After controlling other important variables, I found that whether the research objects have ever taken the relevant curricula for evaluation of cancer pains and whether the work unit has held clinical case conferences for cancer pains are influential for the percentage of correct answers. It is shown that the curricula and the clinical case conferences can affect the nurses’ pain perception and knowledge of pain management.

並列關鍵字

hospice ward unit ； tumor ward unit ； pain perception ； knowledge of pain management

參考文獻

李筱苓(2001)：子宮頸癌末期病患安寧護理經驗。榮總護理，18(4)：369-379。

林佳靜(1996)：癌症疼痛處理的護理倫理。護理雜誌，43(1)：36-38。

林佳靜、陳淑如、謝麗鳳(1997)：疼痛護理。護理雜誌，44(1)：37-47。

胡文郁(1997)：癌症末期病人的疼痛護理。台灣醫學，1(6)：758-763。

根秀欽(1997)：癌末病患疼痛評估及護理。安寧療護雜誌，6：3-16。