內科加護病房護理人員對於大便失禁患者會陰部皮膚潰瘍護理行為之研究

The Nursing Behavior for Perineal Dermatitis on Patients with Fecal Incontinence in a Medical Intensive Care Unit

本研究目的了解加護病房護理人員於大便失禁患者雖勤於清潔、更換尿布，但仍然無法改善會陰部皮膚發紅潰瘍照護行為。研究採質性、田野調查法，以方便取樣，於南部某區域內科加護病房，自97 年12 月1 日至97 年12 月31 日止，觀察42 位護理人員，並使用半結構大綱訪談6 位護理人員，經過其同意後將訪談資料記錄，以內容分析法分析。結果發現護理行為：『知行不一』、『模仿學習』與『各憑本事』等三個範疇。從本研究結果了解同一疾病照護，以『知行不一』、『模仿學習』與『各憑本事』照護行為，相對就會呈現出不同護理標準與結果。護理行為影響護理專業表現，因此在推動大便失禁患者會陰部皮膚照護品質時，應先了解護理人員護理行為，進而才能提供適切及標準化照護。

The purpose of this study was to understand the nursing behavior for perineal care in regard to patients with fecal incontinence in a medical intensive care unit. A qualitative study with field investigation and convenience sampling were adopted. We observed 42 nursing staff’s behaviors and carried out a semi-structured interview with six nursing personnel from December 1st to December 20th, 2008 who gave their consent. We conducted content analysis after interview data logging. The study results showed three themes: discordance of knowledge and practice, imitation learning, all depend on the skill. Various behaviors demonstrated different nursing standards and outcomes.Good nursing behaviors resulted in professional performance. To provide optimal and standard quality care for perineal dermatitis patients with fecal incontinence, it is imperative to understand nursing care behaviors.