護理人員對失智症的知識、態度與其處理行為問題能力之相關因素探討

研究背景失智症盛行率逐年增加，國內關於臨床護理人員對失智症患者之知識、態度及行為問題處理能力之研究咸少，因此，了解影響護理人員對於失智症照護行為問題處理能力之相關因素，是疾病照護不可忽視之健康議題。目的探討護理人員社會人口學特性、失智症照護的知識、態度對於失智症行為問題處理能力之相關性，及影響護理人員於臨床上面對失智症患者行為問題處理能力的預測因子。方法採横斷式、相關性研究設計，研究對象為中部某醫學中心病房的護理人員。以護理人員社會人口學特性、失智症照護的知識、失智症照護的態度以及行為問題處理能力等結構式問卷收集資料；方便取樣，於中部某醫學中心實際從事臨床護理工作滿三個月以上的護理人員，共收案198人；所得資料以SPSS 22.0套裝軟體進行統計分析。結果護理人員的失智症照顧知識平均得分11.71分(總分15分)，失智症照顧態度平均得分29.35分(總分45分)，失智症行為問題處理能力平均得分63.90分(總分85分)。從逐步迴歸分析結果顯示：整體迴歸模式可以解釋護理人員行為問題處理能力19.6%的變異量。護理人員曾經有照護失智症家人的經驗（4.9%）、護理進階的N1/N2（2.4%）、取得長期照護認證（2.4%）、失智症相關問題的態度（9.8%）均是影響護理人員對於失智症行為問題處理能力最主要的預測因子結論提升護理人員對於失智症照顧行為問題處理的能力，醫療機構應培訓進階能力較低之護理人員，鼓勵參與失智症相關課程，並取得長期照護認證，以提升護理人員對於失智症行為問題處理的能力。

關鍵字

護理人員；失智症；知識；態度；行為問題處理能力

並列摘要

Background The prevalence of dementia has been increasing year by year. However, there are few domestic studies on the clinical nursing practitioners’ knowledge and attitudes towards dementia, and ability to coping with behavioral problems of patients with dementia. Therefore, it is necessary to understand the relevant factors that affect the nursing staff's ability to cope with dementia behavioral problems, which is a health issue that cannot be ignored. Purpose In our study, we explore the association between nursing practitioners’ sociodemographic characteristics, knowledge and attitudes of dementia care and the ability to coping with behavioral problems in dementia, and investigate predictors that affect nursing practitioners’ ability to cope with behavioral problems in patients with dementia. Method This is a cross-sectional, correlational study. We included nurses in the wards of the medical center in Central Taiwan, and collected data with structured questionnaires including nursing practitioners’ sociodemographic characteristics, knowledge of dementia care, attitudes toward dementia care, and behavioral problem-handling abilities. In our study, convenient sampling was adopted. Nursing staff who have been engaged in clinical nursing work for more than three months in a medical center in Central Taiwan were included. The sample were expected to be 198 cases. The obtained data were analyzed by SPSS 22.0 software package. Result The average score of nursing practitioners’ knowledges of dementia care was 11.71 points (total score was 15 points), the average score of dementia care attitude was 29.35 points (total score of 45 points), and the average score of the ability to cope with dementia behavior problems was 63.90 points (total score of 85 points). The results of stepwise regression analysis showed that the overall regression model could explain 19.6% of the variation in nursing practitioners’ ability to cope with behavioral problems in patients with dementia. Having experiences in caring for family members with dementia (4.9%), having advanced nursing N1/N2 (2.4%), long-term care certification (2.4%), and nursing practitioners’ attitudes (9.8%) are the main relevant factors that affect the ability of a nursing practitioner to cope with behavioral problems from patients with dementia. Conclusion To improve nursing staff to cope with behavioral problems from dementia, medical institutions should train nursing practitioners with lack of advanced ability, encourage them to participate in dementia-related courses, and obtain long-term care certification.