某教學醫院長期照護醫護人員對壓瘡處理的認知及態度調查研究

A Survey of the Knowledge and Attitude on Pressure Ulcer Management among Chronic Health Care Providers in a Teaching Hospital

陳鼎達(Ting-Tat Chan) ； 黃麗卿(Lee-Ching Hwang)

《中華民國家庭醫學雜誌》 10卷2期 (2000/06) Pp. 67-80

https://doi.org/10.7023/CJFM.200006.0067

摘要

Pressure ulcer problems are common n both acute and chronic health care settings. Along with the aging population and the increasing number of patients with chronic diseases, there has been much progress in the research of pressure ulcer management. It is important that health care providers are aware of and familiar with these new knowledge and techniques that can improve the efficacy and quality of care. In this study, we surveyed through a questionnaire, the knowledge, attitude and training in pressure ulcer management of chronic health care providers including family physicians, nurses and nursing aides in a teaching hospital. The main purpose of this study is to provide a reference for developing better training models. Our results showed that all respondents agreed that the prevention and treatment of pressure ulcer were important in their own clinical specialty. However, our clinical training system obviously neglects this entity. It showed that 67% family physicians and 70% nurses in our study admitted that they did not attend any teaching course on pressure ulcer management during medical school training. Meanwhile, 54%physicians and 79% nurses attended on an average of 2-3 times, less than 6 hours of lectures after graduation. Respectively, about 56% and 48% of them felt that they did not receive enough training and were not competent enough in managing this problem. The average knowledge test score of all respondents was 63%. Generally, they were not aware of the pressure ulcer prevention and clinical treatment guidelines published by AHCPR (Agency for Health Care Policy and Research, Public Health Service, U.S. Department of Health and Human Services). Only 63% of them read other clinical information on this topic. More than 60% of them still had outdated, evidence-lacking, ineffective and even hazardous understanding, such as using doughnut cushion, massaging skin overlying pressure points, prolonged elevation of head of bed, keeping wound dry, packing the whole undermined wound with dressing, considering wound cleansing with povidone-iodine as a must, using diluted povidone-ioding wet-dressing, applying topical antibiotics to prevent from wound infection, and obtaining swab cultures to assess wound infection. On one hand, 79% respondents agreed that family physician was the primary care provider of pressure ulcer patients. On the other hand, only 56% felf that family physicians ware actually providing care. This study revealed that chronic health care providers had insufficient knowledge in the management of pressure ulcer, whereas they had not received enough training they needed to be competent. Changes in our pre-vocational and vocational training system are needed to resolve this problem.

並列摘要

Pressure ulcer problems are common n both acute and chronic health care settings. Along with the aging population and the increasing number of patients with chronic diseases, there has been much progress in the research of pressure ulcer management. It is important that health care providers are aware of and familiar with these new knowledge and techniques that can improve the efficacy and quality of care. In this study, we surveyed through a questionnaire, the knowledge, attitude and training in pressure ulcer management of chronic health care providers including family physicians, nurses and nursing aides in a teaching hospital. The main purpose of this study is to provide a reference for developing better training models. Our results showed that all respondents agreed that the prevention and treatment of pressure ulcer were important in their own clinical specialty. However, our clinical training system obviously neglects this entity. It showed that 67% family physicians and 70% nurses in our study admitted that they did not attend any teaching course on pressure ulcer management during medical school training. Meanwhile, 54%physicians and 79% nurses attended on an average of 2-3 times, less than 6 hours of lectures after graduation. Respectively, about 56% and 48% of them felt that they did not receive enough training and were not competent enough in managing this problem. The average knowledge test score of all respondents was 63%. Generally, they were not aware of the pressure ulcer prevention and clinical treatment guidelines published by AHCPR (Agency for Health Care Policy and Research, Public Health Service, U.S. Department of Health and Human Services). Only 63% of them read other clinical information on this topic. More than 60% of them still had outdated, evidence-lacking, ineffective and even hazardous understanding, such as using doughnut cushion, massaging skin overlying pressure points, prolonged elevation of head of bed, keeping wound dry, packing the whole undermined wound with dressing, considering wound cleansing with povidone-iodine as a must, using diluted povidone-ioding wet-dressing, applying topical antibiotics to prevent from wound infection, and obtaining swab cultures to assess wound infection. On one hand, 79% respondents agreed that family physician was the primary care provider of pressure ulcer patients. On the other hand, only 56% felf that family physicians ware actually providing care. This study revealed that chronic health care providers had insufficient knowledge in the management of pressure ulcer, whereas they had not received enough training they needed to be competent. Changes in our pre-vocational and vocational training system are needed to resolve this problem.

並列關鍵字

pressure ulcer ； knowledge ； attitude of health personnel ； practice guidelines