護理人員對病人善終醫療自主權認知及在職教育的需求

研究目的：瞭解護理人員對安寧緩和醫療條例及病人自主權利法的認知和此項議題在職教育的需求。醫療院所可依研究結果提供在職教育參考，達到強化護理人員對此議題的認知，並增加參與在職教育的意願，方可在面對病人及家屬詢問相關議題時，給予恰當的解釋及衛教指導。材料與方法：以北部某區域教學醫院臨床護理師為對象，依安寧緩和醫療條例及病人自主權利法設計認知問卷，共發出270份，回收264份，扣除無效問卷6份後，實得有效問卷258份，有效回收率95.6%。結果：護理人員對安寧緩和醫療條例答對率64.0%、病人自主權利法為60.8%，學歷副學士於安寧緩和醫療條例答對率高於學士層級以上，但在病人自主權利法則呈現相反，課程內容需求以「保障病人善終權益」及「促進醫病關係和諧──溝通」需求得分最高，「影響自主權的文化及靈性需求」得分最低。課程安排方面，安寧緩和醫療條例認知越高，對於在職教育需求越高，病人自主權利法認知越低，對於在職教育需求越高。結論：本研究瞭解護理人員對善終醫療自主權的認知答對率以及課程規劃之需求，以提升護理人員對於病人善終醫療自主權的解釋及衛教指導。

關鍵字

在職教育；善終；醫療自主權

並列摘要

Research objective: To understand nursing personnel's knowledge of the Hospice Palliative Care Act and Patient Right to Autonomy Act and on-the-job training demands regarding this topic. Healthcare facilities can provide on-the-job training references based on the results of this study to achieve enhanced understanding of this topic in nursing personnel and increase their willingness to participate in on-the-job training. This will enable nursing personnel to offer adequate explanations and healthcare instructions when patients and their families inquire about related issues. Materials and methodology: 270 questionnaires designed based on knowledge of the Hospice Palliative Care Act and Patient Right to Autonomy Act were distributed to the clinical nursing practitioners of a regional teaching hospital in Northern Taiwan. A total of 264 questionnaires were recovered, of which 6 were invalid and 258 were valid with a valid recovery rate of 95.6%. Results: Response accuracy of nursing personnel on the Hospice Palliative Care Act and Patient Right to Autonomy Act was 64.0% and 60.8% respectively. Responders with associate degrees responded to questions on the Hospice Palliative Care Act with higher accuracy than those with bachelor's degrees or higher, but opposite results were obtained for questions on the Patient Right to Autonomy Act. ＂Protecting Patient's Right to End-of-life Autonomy＂ and ＂Enhancing the Harmony of Doctor-patient Relationships--Communication＂ were the course topics that earned the highest points in terms of demand, while ＂Cultural and Spiritual Needs Impacting Autonomy＂ received the lowest points. Regarding course arrangement, better knowledge of the Hospice Palliative Care Act was associated with greater demand for on-the-job training, while lesser knowledge of the Patient Right to Autonomy Act was associated with greater demand for on-the-job training. Conclusions: The study seeks to understand nursing personnel's response accuracy rate regarding knowledge of end-of-life medical autonomy and course planning demands so as to improve nursing personnel's ability to explain issues pertaining to patients' right to end-of-life care autonomy and provide adequate healthcare instructions.

並列關鍵字

On-the-job training ； End-of-life ； Medical autonomy

參考文獻

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方俊凱、林子涵、畢世萱、李閏華、李佩怡（2017）．癌症末期病人的善終觀點．安寧療護雜誌，22(3)， 288-309。https://doi.org/10.6537/TJHPC.201711_22(3).003

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護理人員對病人善終醫療自主權認知及在職教育的需求

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