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  • 學位論文

重症病患決策代理人醫療決策行為意向及其相關因素之探討

Behavioral Intention of Medical Decisions in the Surrogate Decision Makers for Critical Illness Patients and its’ Related Factors

指導教授 : 吳麗敏

摘要


本研究目的在探討重症病患決策代理人醫療決策行為意向及其相關因素。採橫斷式相關性之研究設計,於南部某醫學中心之6個加護病房進行收案;共收案193位決策代理人,男生107人,女生86人,平均年齡51.7歲,71.5%與重症病患的關係為兒女。研究工具採四份結構式問卷,包含基本資料、家庭關係量表(Cronbach’s α=.95)、醫療告知的認知程度量表(Cronbach’s α=.97),及醫療決策行為意向量表(Cronbach’s α=.89)。 研究結果:(1)『重症病患年齡』、『重症病患住院天數』、『重症病患是否預立遺囑』、『與重症病患的關係』與決策代理人醫療決策行為意向具顯著相關。(2)『決策代理人與重症病患的家庭關係』和『決策代理人醫療告知的認知程度』與決策代理人醫療決策行為意向無關。(3)『重症病患年齡』、『重症病患是否預立遺囑』、『重症病患住院天數』為決策代理人醫療決策行為意向之預測因子,共可解釋的變異數13.9%。 依研究結果建議臨床醫護人員除依循決策代理人醫療決策行為意向,也需了解影響決策的相關因子:病患年齡、住院天數、預立遺囑,以及決策代理人與重症病患的關係,在告知醫療相關訊息時評估病況,清楚解釋說明,方能協助決策代理人選擇合適病患的醫療處置。建議將來研究增加質性資料以了解決策過程所面臨的困難、轉變與心路歷程。

並列摘要


This study aims to explore the behavioral intension of medical decisions in surrogate decision makers for critical illness patients and its’ related factors. It was a cross-sectional correlation study design. Samples were recruited in six ICUs in a medic center in the Southern Taiwan. A total of 193 surrogate decision makers were recruited, with 107 males and 86 females. The average age was 51.7 years old and 71.5% of the surrogates were the children of the critical patients. Four structured questionnaires were used, including the demographic data, the Family Relationship Scale (Cronbach’s α=.95), the Cognitive Scale of Medical Information (Cronbach’s α=.97), and the Behavioral Intention of Medical Decisions Scale (Cronbach’s α=.89). The results of the research were: (1) “The age of the critically ill patients”, “The length of hospitalization of the critical patients”, “Whether the critical patients have established a living will” and “The relationship with the critical patients” are significantly correlated with the decision-making agents’ behavioral intention for medical decisions. (2) “The family relationship between the surrogate decision maker and the critical patient” and “The decision-making agent’s cognitive level of the medical information” are not correlated with the decision-making agents’ behavioral intention for medical decisions. (3) “The age of the critically ill patients”, “Whether the critical patients have established a living will” and “The length of hospitalization of the critical patients” were the predictive factors in the behavioral intention for medical decisions of the surrogate decision maker, explaining 13.9% of the total variances. Based on the research results, it recommended that the clinicians do not only follow the behavioral intention of the surrogate decision maker but also understand related factors influencing the decisions, including the patient age, length of hospitalization, establishment of the living will, and the relationship between the decision-making agent and the critical patient. When informing the decision-making agents of the medical information, assessment of the patient’s medical condition should be made with clear explanation so as to help the surrogate decision maker choose the right medical treatment for the patient. It is suggested that for future research, qualitative data should be added to understand the difficulty faced in the decision-making process, the transition and the mentality along the way.

參考文獻


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被引用紀錄


廖漢文(2010)。T質子治療中心營運可行性推估〔碩士論文,國立臺灣大學〕。華藝線上圖書館。https://doi.org/10.6342%2fNTU.2010.03287

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