病患與護理人員對病患自主權態度與經驗之比較

A Comparative Study of Patient Autonomy Attitude and Experience Between Patients and Nurses

伍碧琦(Wu, Pichi)

指導教授 ： 吳麗珍

長榮大學/健康科學學院/護理學研究所/碩士(2009年)

https://doi.org/10.6833/CJCU.2009.00072

摘要

中文摘要
本研究的目的在瞭解病患與護理人員對病患自主權態度與經驗的現況並探討兩者之間的差異。採用比較性研究，以結構式問卷為研究工具，研究對象來自台灣南部某一醫學中心，同意參與本研究的內、外科住院病患與領有執業執照的護理人員。採取簡單隨機取樣法進行資料收集，研究樣本數為194名住院病患及258名護理人員，病患問卷的回收率為94.71%、護理人員問卷的回收率為98.11%。以SPSS軟體For Window 12.0檢測，依次數分佈、百分比、平均值、標準差及排序等進行描述性資料分析，以t檢定來檢定類別變項作推論統計與分析。研究的結果發現：(一)病患與護理人員對病患自主權的態度在「行動自主（t=-3.88, p< 0.001）」、「知情同意（t=-4.42, p< 0.001）」有顯著差異，在「自我決策」、「具有選擇」面向統計上則無差異。(二)病患與護理人員對病患自主權的經驗在「行動自主（t=7.05, p< 0.001）」、「具有選擇（t=-4.04, p< 0.001）」均有顯著的差異，在「自我決策」、「知情同意」的面向兩者並沒有統計的差異。(三)病患面對家屬對他們的疾病有所隱瞞時，病患會希望照顧的醫護人員告知實情，兩者間有顯著差異。病患與護理人員均「非常同意」護理人員應該提供所有相關的資訊，來幫助病患作出正確的決定。(四)病患與護理人員均「同意」當病患與家屬對治療的選擇意見不同時，應該由病患做最後的決定。(五)在照護方式的選擇上，病患與護理人員均傾向「同意」應該由病患來決定，兩者之間無差異。(六)在病患自主權的經驗裡病患在的得分比護理人員低，顯示病患實際感受到病患自主權的經驗，比護理人員自認有給予的少。希望藉由本研究的結果激發護理人員重視與尊重病患的自主權。也期望能提供護理主管在倫理教育訓練課程安排的參考，讓醫護人員在執行任何措施前都能充分告知，適時地提供病患相關資訊與照護的選擇，同時尊重病患所做的決定。

關鍵字

病患自主權 ； 態度 ； 經驗 ； 病患 ； 護理人員

並列摘要

Abstract
The purposes of this proposed study is: 1.) To compare patients’ and nurses’ attitudes toward patient autonomy; 2.) To investigate patients’ experiences of patient autonomy; 3.) To examine nurses’ practice of patient autonomy; 4.) To compare patients’ experiences of patient autonomy and nurses’ practice of patient autonomy. The target samplings are of adult patients in a medical center in Southern Taiwan, and a random sample of 194 patients and 258 nurses selected from hospital records. The four-point structured survey questionnaire included Attitude of Patient Autonomy and Experiences of Patient Autonomy. The questionnaire asked about autonomy of action, informed consent, choices in health care, and decision-making. The descriptive statistics included frequency, percentage, mean, and standard deviation. T-tests were used for comparison between the two groups.
The results concluded that:
1.) The patients’ and nurses’ attitudes toward patient autonomy in action was t = -3.88 (p< 0.001), informed consent was t = -4.42 (p< 0.001). Health care choices and decision-making results were not significant.
2.) The patients’ and nurses’ experiences toward patient autonomy of action was t = 7.05 (p< 0.001), health care choices were t = -4.04 (p< 0.001). Decision-making and informed consent were not significant.
3.) There were significant results in situations where the patients’ families did not want to discuss the true nature of the patients’ conditions. Where the patients cannot receive sufficient treatment they still wish to discuss the facts of their condition, if not with family then with the nursing staff. Patients and nurses surveyed agreed that all information should be given to help the patients make their own decisions.
4.) Patients and nurses surveyed agreed that the patients should have final treatment decisions regardless of what opinions the families may have.
5.) Patients and nurses surveyed agreed that the patients should make their own decision about their care.
6.) Overall, the patient autonomy score was lower than the nurses’ score, indicating that the patients considered their autonomy less respected than what the nurses thought about patient autonomy.
This study should provide health care professionals with further insight into patients’ attitudes and experiences during hospitalization. In addition, intervention could be developed to help nurses and other health care providers act with regard for patient autonomy in their care.

並列關鍵字

attitudes ； experience ； patient ； nurses.

參考文獻

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