照顧服務員對住民心理社會照護與問題行為處理能力探討

Nurse Aides in Psychosocial Care and Problematic Behavior Management for the Residents in Nursing Home

本研究以橫斷式調查法進行照顧服務員對住民心理社會層面之照顧知識、問題行為之處理態度與自我效能探討。研究對象為大台北及桃園地區已立案之護理之家與安養／養護機構之照顧服務員，共選取8家177位照顧服務員參與本調查。研究工具為自陳式結構式問卷，經信效度檢定及預試修訂後，至各機構以集體施測方式進行資料蒐集。本研究之有效問卷率為83.5％，經統計分析發現在知識層面，本國籍照顧服務員顯著高於外國籍。但是在住民心理社會需求的了解、溝通能力、照顧如餵食、給藥以及問題行為如失眠、激動、多疑、四處遊走等，無論國籍均有再訓練之必要。對住民之態度傾向正向，但處理問題行為之自我效能如幻覺與妄想等，較為不足。因此，建議在職前教育及在職教育中宜加強照顧服務員心理衛生教育，特別是有關問題行為之處理。

This cross-sectional survey investigated the knowledge of psychosocial care among nurse aides (NAs) working in long-term care institutions. Their attitudes and self-efficacy in managing problematic behaviors were also evaluated. One hundred and seventy-seven nurse aides were recruited from eight long-term care institutions in Taipei and Taoyuan areas. A structured questionnaire, after being tested for validity and reliability, was administered to the NAs. The response rate was 83.5%. The results showed that the domestic NAs had significantly higher score in knowledge about psychosocial care than the foreign NAs. However, the knowledge were insufficient in several aspects, in spite of different nationalities, including identification of psychosocial needs, skills of communication, and capabilities of managing agitated and wandering behaviors, and caring for insomnia. Their attitudes toward residents tended to be positive, while, the self-efficacy in dealing with hallucination and delusion was insufficient. Thus, we recommend that the ability of psychosocial care, especially in managing the resident’s problematic behaviors could be emphasized in pre-job and on-the-job training.