公共衛生護理人員對失智症照護的知識、態度與執行信心

Knowledge, Attitude, and Confidence of Public Health Nurses in Dementia Care

江筱璇(Hsiao-Hsuan Chiang)

指導教授 ： 張媚

國立臺灣大學/醫學院/護理學研究所/碩士(2005年)

https://doi.org/10.6342/NTU.2005.02949

摘要

隨著老年人口的增加，失智症將會是未來醫療照護及社會福利的重要課題，而基層照顧團隊在失智症照護工作上扮演重要的地位，公共衛生護理人員即是其中重要的一群。故本研究旨在探討台北縣的公共衛生護理人員對失智症照護的知識、態度及執行信心之現況與其影響因素; 採橫斷式調查研究法，以自擬式問卷為研究工具，運用郵寄問卷方式進行資料收集，共計回收有效問卷225份，重要結果為：
一、公共衛生護理人員對失智症照護知識量表平均得分18.95(SD=3.41)(滿分為25分);而各分項中以「失智症的定義」、「盛行率」、「病程發展」和「失智症患者及其家屬可利用的社會資源與對照顧者的支持」等層面的知識普遍不足，且有將近一半的公共衛生護理人員低估了失智症的發生率也不知如何使用認知功能評估量表。影響因素分析發現：公共衛生護理人員對失智症照護態度愈正向、年齡較小、對公共衛生護理工作愈有興趣及曾照顧過失智症患者，其失智症照護知識愈好，這些因素共可解釋失智症照護知識總變異量的28.1% 。
二、公共衛生護理人員對失智症照護的態度為中立偏正向，且大部分的公共衛生護理人員能同理失智症患者家屬所承受的壓力，並願意為其再接受在職教育並給予協助。影響因素分析發現：失智症照護執行信心得分愈高、失智症照護知識得分愈高及對公共衛生護理工作愈有興趣者，對失智症照護的態度愈正向，這些因素共可解釋態度總變異量的48.3%。
三、公共衛生護理人員在執行失智症照護工作時是「只有部分信心」的，而轉介疑似失智症患者接受檢查是公共衛生護理人員最有信心去執行的;但若遇到疑似失智症患者，要使用MMSE量表來對其做篩檢或是未來要將失智症患者收案管理並定期追蹤則是公共衛生護理人員最沒有信心去執行的部分。影響因素分析發現：公共衛生護理人員對失智症照護的態度愈正向及曾有精神科護理經驗者對失智症照護執行信心愈高這些因素共可解釋執行信心總變異量的42.7%。
故建議未來在護理養成教育及護理人員的在職訓練課程中將失智症照護議題納入，並將失智症照護列入衛生所的考核指標中，而實務工作上則建議發展合適的失智症患者社區照護模式。

關鍵字

公共衛生護理人員 ； 失智症照護 ； 知識 ； 態度 ； 信心

並列摘要

As the increasing of elderly population, dementia will be an important issue about its medical care and social welfare in the future. The primary care team has an important place in dementia care. Public health nurses form important part of the team. The purpose of the study is to investigate Taipei county’s public health nurses’ knowledge, attitude, and confidence toward dementia care and their relevant influence factors. A cross-sectional study design was conducted via self questionnaire collected by mail. 225 questionnaire were returned. Significant results were:
1.The results of this study indicated that the average score of public health nurses’ knowledge toward dementia care is 18.95(SD=3.41)(total score is 25).Their knowledge regarding “the definition of dementia”, “the prevalence of dementia”, “progress of dementia”, and “the social welfare resource for the demented patients and their family, and providing caregivers with support” are not sufficient. Almost 50% public health nurses think the prevalence rate of dementia is low. They also do not know that how to use a memory test. The analysis of the influence factors revealed that the nurses having a more positive attitude towards dementia care , taking more interest in public health nursing , having experience in caring the demented patients and younger nurses have better knowledge in dementia care. These predictable factors can explain 28.1% of the total variations.
2.The public health nurses’ attitude toward dementia care is tended to positive. Public health nurses can understand families’ stress, be willing to participate in continuing education about dementia, and provide service. The analysis of the influence factors revealed that having higher confidence of dementia care, having higher knowledge of dementia care, and taking more interest in public health nursing have a more positive attitude towards dementia care. These predictable factors can explain 48.3% of the total variations.
3.The public health nurses have a little confidence in dementia care . Public health nurses have confidence in referring possible demented patients to hospital. But they have not confidence in using MMSE to detect possible demented patients and managing demented patients. The analysis of the influence factors finds that having a more positive attitude towards dementia care, and having psychiatric nursing experience have higher confidence of dementia care. These predictable factors can explain 42.7% of total variables.

Based on the results of this study, we suggested that the issue of dementia care should be incorporated into nurse education and in-service training. Also, dementia care should be become one of the auditing indicators for community health centers. A community based dementia care model need to be developed.

並列關鍵字

Public health nurses ； Dementia care ； Knowledge ； Attitude ； Confidence

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