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臺灣職能治療人員對實證職能治療的觀感與相關因素分析

Perceptions of and Factors Related to Evidence- Based Practice Among OccupationalTherapy Practitioners in Taiwan

摘要


目的:實證職能治療引進臺灣多年,但探討臺灣職能治療人員的實證觀以及影響因素的研究仍有限。本研究探討目前臺灣職能治療人員對實證職能治療的認知,並探索與認知觀點相關的因素,以形成克服推展障礙的策略。方法:發放實證職能治療觀點的自填問卷(含21題項、6個次量表),由出席2008年第三屆職能治療師公會全國聯合會學術研討會的會員填答,回收率53.7%。本研究以描述性統計記錄人口學資料,並以逐步線性複迴歸分析探討8個潛在預測因子是否與6個次量表分數具顯著關聯,另以t 檢定比對臺灣與美國職能治療人員的實證觀。結果:我國職能治療人員之問卷總分平均為69.01(SD = 8.49,N = 173, 範圍為43-94),6個次量表之平均分數為3.03-3.44 分。40%的填答者非常不同意或不同意有足夠的權威、影響力去改變現有的治療程序。問卷填寫最高學歷為學士者,相較於碩士或博士者,對執行實證職能治療較乏信心。其它推行實證職能治療障礙的因子包括行政支持不符期待、認為臨床經驗比研究更有價值、繼續教育報名費的考量,以及評析應用研究的技能不足。結論:本研究結果顯示目前職能治療人員對於實證職能治療的態度為中等程度,最大影響因素為行政支持度。為推展我國實證職能治療,應尋求克服障礙的有效策略,如:向管理階層宣導實證職能治療的價值、普及實證職能治療的教育、強調實證研究發現的臨床意義等。

並列摘要


Objective: Although Evidence-based practice (EBP) has been promoted in Taiwan for many years, the study of the viewpoint among occupational therapy practitioners in Taiwan towards EBP and the factors related to it remains insufficient. In order to develop strategies to overcome the barriers of implementing EBP, this study surveyed how occupational therapy practitioners perceived EBP and investigated the factors related to the perceptions. Methods: A total of 173 delegates of the 3rd Occupational Therapists' Union of Taiwan (53.7% response rate) completed a questionnaire that included 21 items of perceptions of EBP (6 subscales). The demographic data was analyzed using descriptive statistics. Stepwise multiple regression analyses were used to identify the demographic variables significantly associated with scores of the 6 subscales, respectively. In addition, the t-test was used to compare the score profiles to the responses of US occupational therapists who were surveyed on an English version of this questionnaire. Results: The mean total score was 69.01( = 8.49, = 173, ranging from 43 to 94), and the six subscale scores ranged from 3.03 to 3.44. Two fifths (40%) of the respondents strongly disagreed or disagreed to the statement that they had enough authority to change established therapeutic procedures. Compared to respondents with a master's degree or a doctorate, those with a bachelor's degree felt less confident to execute EBP. Other barriers to implement EBP included insufficient administrative support, placing higher value on clinical experience over research, the high cost of continuing education, and insufficient research and application skills. Conclusion: These findings suggest that occupational therapy practitioners are currently engaging in a moderate amount of EBP. The major barrier to implementing EBP pertains to administrative support. Strategies that may be used to remove the barriers include advocating the ideas of EBP to the administrative authority, promoting professional and continuing education for EBP, and communicating the relevance of research findings to clinical practice.

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