台灣職能治療師對安寧療護的知識態度與參與意願

Occupational Therapist' knowledge, Attitude and willingness toward Hospice in Taiwan

張瑄瑄(Hsuan-Hsuan Chang)

指導教授 ： 陳家玉

中山醫學大學/醫學院/醫學研究所/碩士(2007年)

https://doi.org/10.6834/CSMU.2007.00087

摘要

各種疾病末期病患的照護與臨終關懷之實施情況與品質，近年來已在世界各國，特別是已開發國家中成為先進的醫療指標之一。安寧緩和醫療的哲學與目的 —-藉由提供給末期患者最大化生命的尊嚴及有生活品質的生活功能之全人醫療照護模式與職能治療的所倡導的哲學與精神不謀而合。因此在先進國家，職能治療師是安寧緩和醫療團隊的成員之一。國內有關安寧療護設置的相關法令都有增列職能治療師的角色，將職能治療師視為安寧團隊的成員之一。但是目前國內職能治療師對安寧緩和醫療的瞭解程度為何，及抱持怎樣的態度，仍不清楚。
本研究的目的在瞭解台灣職能治療師對安寧療護的知識、態度及參與意願。研究方法以橫斷式描述性研究為主，以自擬之問卷做為研究工具及在台灣各縣市衛生局（直轄市除外）有執業登記的職能治療師為研究對象。有效問卷共336份。用SPSS10.0進行t檢定、單因子變異數分析、皮爾森積差相關、對數邏輯司特回歸等統計分析。
研究結果顯示：（一）受測者的平均年齡為30.07歲，平均工作年資6.34年，以在區域醫院執業居多；94.3％的受測者有聽過安寧緩和醫療，53.9％的人沒有上過安寧相關課程，77.1％沒有參與照顧過臨終病患。（二）知識方面答對率為74.4％，態度偏正向，而有73.5％的職能治療師願意從事安寧療護工作。（三）有末期病人照顧經驗、未來有意願參與相關課程等因素，和知識的得分相關。（四）性別、婚姻經驗、執業年資、有上過相關課程、未來有意願上課、照顧末期病人時間的長短等因素，和正向態度有關。（五）知識、態度及參與意願三者間呈正相關；有照顧經驗、未來有意願參與相關課程、及態度正向對未來願意參與安寧療護具解釋力。
因此本研究建議：1.在學校教育中納入有關安寧療護相關課程，2.在執業後繼續教育中，建立相關的專業知識技能之課程規劃及認證，3.在執行面上，應建立一套職能治療介入安寧療護的標準作業程序，讓職能治療師能有所依循，4.在居家療護部分，政府部門如要推廣社區居家安寧職能治療，應可整合其他相關資源，如各縣市政府的居家復健計畫，或各輔具中心的專案計畫，以擴充經費來源，提高參與率，5.本研究結果可做為未來在職能治療界推廣安寧療護的參考。

關鍵字

職能治療 ； 安寧療護 ； 知識 ； 態度

並列摘要

Care for the patients of terminal disease has been considered one of the achievements for the developed country in recent years.The philosophy and the goals of the hospice are parallel with the philosophy and principles of occupational therapy (OT); both of them aim to increase the dignity and quality of life. An ideal hospice team almost nowadays incorporates occupational therapist. Although the role of occupational therapist in the hospice team is now considered necessary by the Taiwanese hospice academy, the knowledge of and the attitude toward hospice of occupational therapist in Taiwan is still unknown. This research studied the Taiwanese occupational therapists’ knowledge and attitude toward hospice and their willing to participate in a hospice team.
The study tool was a cross-sectional, constructional questionnaire. All occupational therapists registered in the country were enrolled. Among all test, 336 respondents who filled in the questionnaire completely were analyzed. By using SPSS the significance of differences observed in proportions was tested mainly by independent t test, one-way ANOVA, Pearson correlation coefficient and logistic regression. All tests were two-tailed with a significance level of 0.05.
The results showed the average age of respondents was 30.07, with average clinical experience for 6.34 years. There are 94.3 % of the respondents had heard about hospice care, and 53.9 % of the respondents had never attended any lesson related to hospice care. 77.1 % of the respondents had no experience of taking care of terminal patients. Among the all respondents 74.4% were with positive attitude. 73.5 % of the respondents were willing to participate the hospice care. Those with experience of taking care for terminal patients, the willing to attend hospice lessons in the future, were related to their knowledge about hospice. Sex, marital status, academic background, credit of hospice lesson, the willing to attend hospice lesson, duration of taking care of terminal patients were all related to their attitude toward participating hospice care. Knowledge of and attitude toward hospice and the willing to participate hospice care were all related.
This pilot study implicate the followings: 1 increasing hospice related curriculum in the university; 2 establishing the system of advanced practice credential about hospice care post graduated; 3 establishing the standard operation procedure of hospice for occupational therapist. 4 promoting hospice home care assisted by the occupational therapist through sharing the resource with other community projects supported by the government such as Assistance Technology Center.

並列關鍵字

occupational therapy ； hospice ； knowledge ； attitude

參考文獻

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