本研究目的為瞭解醫護人員對癌末病情告知之行為意向及所遇到的困擾,採立意取樣,結構式問卷調查法,研究對象為北部某醫學中心及腫瘤專科醫院的醫師及護理人員,醫師及護理人員回收率為46.3%及74.3%,最後共收案29位醫師及139位護理人員。主要研究結果為:1)醫護人員於癌末病情告知之「態度」與「行為意向」均傾向正向告知。2)醫師及護理人員於癌末病情告知的「態度」與「行為意向」無顯著差異(P>0.05)。3)醫師在告知癌末病情時主要考慮的因素是「家屬的意願」及「病患的情緒穩定度」,護理人員則較重視「病患的意願」及「病患的情緒穩定度」。4)醫護人員於告知癌末病情過程以「家屬意見不一」的困擾程度最高,其中又以「簽署及說明不急救同意書」為最難說明的。5)護理人員在「面對不知病情病患的照顧困擾」程度高於醫師。6)「安寧緩和醫療課程(β=0.64)」及「癌末病情告知的壞處(β=0.475)」為醫師於癌末病情告知行為意向的重要影響因素(p<0.001;R2=56.3%)。7)「癌末病情告知的好處(β=0.506)」及「是否避諱和病患談論死亡問題(β=-0.152)」為護理人員於癌末病情告知行為意向的重要影響因素(p<0.001;R2=27.6%),有效解釋變異量為27.6%。總之「安寧緩和醫療課程」是非常重要的,可以促進醫護人員於癌末病情告知的行為意向。
The purpose of this study was to investigate physicians and nurses’ intention behavior for truth telling and distress that they often encountered when executing it. The subjects of this study are 29 physicians and 139 nurses recruited from a medical center and an oncology specialized hospital in Taipei. The research method of this study is questionnaire survey. The major results of this study are 1) the physicians and nurses’ attitude are positive toward truth telling; 2) There is no significant difference between the physicians’ and the nurses’s attitude and intention behaviors toward truth telling (p>0.05); 3) When deciding whether or not telling the truth, the physicians are most influenced by family members’ willingness and the patient’s steadiness of emotion, while the nurses are most influenced by the patient’s willingness and steadiness of emotion; 4) The most difficult situation that the physicians and nurses encountered is of different opinions from different family members, especially during the time making the decision on whether or not signing the consent form of “executing no CPR.”; 5) The nurses have more distress at facing a patient who does not know his/her terminal situation than the physicians do; 6) For the physicians, “The hospice training course”(β=0.64) and “Weakness of truth telling”(β=0.475)are both the predictors of doctors’ intention and behaviors for truth telling. 56% of the variances are explained; 7) For the nurses, “The benefits of truth telling” (β=0.506) and “Whether or not avoid discussing death issue with patients” (β=-0.125)are the most important factors of nurses’ intention behaviors for truth telling (p<0.001;R2=27.6%). 27% of the variances are explained. This research reveals that the hospice training course is an important factors to improve the physicians and nurses’ intention behavior.