非安寧病房護理人員對安寧療護知識及態度之初探

Preliminary Study of Knowledge and Attitude toward Hospice Care among Nurses in Non-Hospice Ward

本研究目的主要探討非安寧病房護理人員對安寧療護的知識、態度及其相關，採橫斷式研究設計，以結構式問卷調查北部某區域醫院內科病房護理人員，所得有效問卷為122份，結果發現：(1)有94.3％護理人員曾照顧過「不施行心肺復甦術 (Do Not Resuscitate, DNR)」病患，33.8％未曾接受過安寧療護照顧訓練，會主動向病患或家屬說明DNR有58.2％。(2)面對簽署DNR病患的心情，包括無力感(76.3％)、擔心(63.2％)、想哭(56.6％)、害怕面對(58.2％)、不知所措(55.8％)。(3)護理人員對安寧療護的知識及態度平均得分：7.51(SD=1.61)、87.2分。(4)工作年資、職級與安寧療護知識在統計上有顯著差異(F=2.38，p＜.05；F=2.43，p＜.05)。(5)職級、曾照顧DNR病患、主動向病患或家屬說明DNR照護與安寧療護態度在統計上有顯著差異(F=2.42，p＜.05；t=2.76，p＜.05，t=2.34，p＜.05)。(6)照顧接受DNR病患情緒反應中，與安寧療護態度在統計上有顯著差異(r=0.29，p＜.05） 。本研究結果顯示，護理人員對安寧療護的知識有明顯不足且面對簽署DNR病患有無力感等現象，擬結果納入安寧療護在職教育規劃參考。

The purpose of the study was to explore the knowledge and attitude toward hospice care among nurses in non-hospice ward. This cross-sectional study was consisted of 122 nurses from a regional hospital in northern Taiwan. Data were collected by a self-administered questionnaire. The results of the study showed that: (1) about 94.3% of the nurses had experience of taking care of Do Not Resuscitate (DNR) patients. In addition, 33.8% of the nurses never received training on hospice care and 58.2% of the subjects would explain DNR to patients or families. (2) Emotional responses of caring DNR patients included powerlessness (76.3%), worrisome (63.2%), sorrow (56.6%), fear (58.2%), and bewilderment (55.8%). (3) The average scores for knowledge and attitude of the hospice care were 7.51 and 87.2, respectively. (4) The knowledge about hospice care was associated with clinical ladder and working experience. (5)The attitude toward hospice care was associated with nursing clinical ladder, experience of caring DNR patients, and whether explaining DNR to patients or families actively. (5) The emotional response of facing DNR patients and the attitude of hospice care was also correlated (r=0.29, p<.05). Our study indicated that the knowledge of hospice care for nurses of non-hospice ward was insufficient and they felt powerless when facing DNR patients. Routine training on hospice care should be provided to nurses from non-hospice wards.