Title

影響護理之家護理人員對安寧緩和醫療條例認知與不施行心肺復甦術態度之因素

Translated Titles

Factors Associated with the Awareness of Natural Death Act and Attitudes towards Do Not Resuscitation of the Nurses in Nursing Homes

Authors

卓運晴

Key Words

護理之家護理人員 ; 不施行心肺復甦術 ; 認知與態度 ; Nurses in Nursing Homes ; DNR(Do Not Resuscitation) ; Awareness ; Attitudes

PublicationName

中國醫藥大學醫務管理學系碩士班學位論文

Volume or Term/Year and Month of Publication

2013年

Academic Degree Category

碩士

Advisor

謝淑惠

Content Language

繁體中文

Chinese Abstract

目的:台灣護理之家服務對象,多為疾病末期且失能的老人群體,生命末期住民之善終需求需要被正視。臨床照護上,護理人員是住民第一線接觸的工作人員,對住民之善終有其影響且扮演重要角色,因此,本研究將探討影響護理之家護理人員對安寧緩和醫療條例認知與不施行心肺復甦術態度之因素。 方法:本研究為橫斷式調查研究,以結構式問卷為研究工具。以北、中、南地區已立案,且評鑑為甲等(含)以上之護理之家護理人員為研究對象,共發出問卷400份,回收有效問卷301份,回收率75.3%。研究資料以描述性統計及推論性統計分析外,再以複迴歸探討護理之家護理人員對安寧緩和醫療條例認知與不施行心肺復甦術態度之重要影響因素。 結果:有53.8%的護理人員表示服務機構有推廣DNR政策,有72.1%曾參加安寧療護及DNR相關教育訓練課程。護理人員對安寧緩和醫療條例答對率為60.4%,平均得分為13.3分(滿分22分)。護理人員對不施行心肺復甦術之態度平均得分為3.4分(滿分4分),普遍呈正向態度。影響護理人員對安寧緩和醫療條例認知之因素有「職別」、「護理工作總年資」、「機構型態」、「是否接受安寧療護及DNR相關教育訓練」、「機構有無推廣DNR政策」 (p=0.026;p=0.010;p<0.001;p<0.001;p=0.028);而影響護理人員對不施行心肺復甦術態度之因素有「機構型態」及「機構有無推廣DNR政策」(p=0.041;p=0.017)。 結論:整體而言,職別、護理工作總年資、醫院附設型護理之家、曾接受安寧療護及DNR相關教育訓練、服務機構有推廣DNR政策等因素,會影響護理人員對安寧緩和醫療條例認知程度,而醫院附設型護理之家及服務機構有推廣DNR政策會直接影響到護理人員對不施行心肺復甦術之態度。本研究結果可供政府及相關單位在推動長期照護與DNR政策之參考,亦作為長期照護護理實務教育內容之依據。

English Abstract

Objectives:Most of the service subjects in nursing homes (NHs) are the groups of terminal patients and disabled elder citizens whose good death should be emphasized. In clinical care, nurses are the first-line personnel for the residents that they play the important role in the good death of such residents in NHs. This study aims to explore factors associated with the awareness of Natural Death Act and attitudes towards Do Not Resuscitation (DNR) of the nursing home nurses. Methods:This study is a cross-sectional survey; structured questionnaires were utilized for this study. With convenient sampling, the nurses in NHs, which are registered to the Department of Health and assessed as Grade A faculties, in northern, central, southern Taiwan are selected as the research subjects. Totally, 400 questionnaires were dispatched. The number of valid questionnaires was 301 and the returned rate was 75.3%. In addition to descriptive analysis and bivariate analysis, multiple regression was also applied for data analysis. Result:Among the respondents, 53.8% nurses said NHs had promoted the policy of DNR, and 72.1% have attended related educational courses. As nurses’ Natural Death Act knowledge, the mean rate of correct answered items was 60.4%, the mean average score was 13.3 (total score=22). The mean score of nurses’ agreement with DNR was 3.4 (total score=4), showing nurse’s positive attitudes to DNR in general. According to the consequences of multiple regression analysis, 5 main factors influence on nurses’s cognition are:“Position”,“Length of practice”, “NH type”,“did or did not attend DNR related training courses”,“NH have or have not promoted the DNR policy”(p=0.026;p=0.010;p<0.001;p<0.001;p=0.028). The major factors that impact on nurses’ attitudes towards DNR are“NH type”and “NH have or have not promoted the DNR policy”(p=0.041;p=0.017). Conclusions:Over all, the factors impact on nurses’ cognition of Natural Death Act are“Position”,“Length of practice”, “Hospital-Based NHs”,“DNR education courses”,“DNR policy”; and the direct factors impact on nurses’ attitudes towards DNR are “Hospital-Based NHs”and“DNR policy”. The research outcomes may be the reference for nursing practice, nursing administration, and nursing education; and used by the managers of nursing homes to design the in-service education. Also, it could be used for the further development of relative policies related to long-term care and DNR in the future.

Topic Category 醫藥衛生 > 醫院管理與醫事行政
管理學院 > 醫務管理學系碩士班
社會科學 > 管理學
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