影響外科住院老人自覺需要與感受護理人員瞭解程度之因素

The Impact of Selfperceived Needs of Geriatric Surgical Inpatients and Perception of Nurses'Understanding Their Needs

本研究是探討外科住院老人自覺需要及其影響因素，並感受護理人員對其自覺需要瞭解程度。本研究採方便取樣深度會談問卷方式進行調查。研究對象為南部某醫學中心年滿65歲的外科住院老人，共收案121位。研究資料以SPSS/PC軟體進行統計分析。研究結果顯示：1.外科住院老人的自覺需要平均得分3.46分(SD=0.63)(總分為5分），介於「需要」與「普通」之間，其中有6個需要項目：知道病情進展和治療結果、知道病情預期結果和應注意事項、聯繫醫師前來探訪、安靜的環境、安全的環境、清潔的衛浴設備，其平均值在4.02-4.24分之間，是介於「非常需要」與「需要」之間；2.外科住院老人感受護理人員對其自覺需要瞭解情形平均得分3.30分(SD=0.77)(總分為5分），介於「瞭解」與「普通瞭解」之間；3.外科住院老人自覺需要程度會因有無健保、婚姻狀況、年齡、主要照顧者、目前工作狀況等之不同而有顯著差異(p<.05) ；4.外科住院老人感受護理人員對其需要瞭解會因有無給予生活照顧及罹患其他疾病等之不同有差異(p<.05) ； 5.老人自覺心理部份與感受護理人員暸解程度之生理、心理、社經、環境等呈正相關(r=0.36)、老人自覺環境部份與感受護理人員暸解程度之情形呈正相關(r=0.38)。本研究結果能提供臨床護理人員照護住院老人之參考，進而提升老人照護之品質。The aim of this questionnaire-based study was to investigate the self-perceived needs of geriatric surgical inpatients and the factors affecting their decisions. Moreover, their perception of the degree of understanding such needs by the nursing staff was also evaluated. One hundred and twenty-one inpatients in the surgical wards aged over 65 were chosen for this study. Statistical analysis was achieved by SPSS/PC software. The results of this study showed that: 1. The average score of self-perceived needs was 3.46 (SD=0.63) that fell between 'needed' and 'moderately needed'. Regarding the 6 specific items reflecting their needs: (i) Knowledge of disease progress and treatment outcome; (ii) Understanding of disease prognosis and treatment plan; (iii) Physician visits; (iv) Quiet hospital atmosphere; (v) A safe environment; and (vi) Cleaniness of toilets and cleaning facilities, the average score was between 4.02 - 4.24 located between 'needed' and 'desperately needed'. 2. Their perception of the degree of understanding of their needs by the nursing staff was 3.30 (SD=0.77), between 'understood' and 'moderately understood'. 3. The factors that affected their self-perceived needs included (i) Health insurance, (ii) Marital status, (iii) Age, (iv) The difference of major care providers; and (v) Current occupation. 4. The factors influencing the perception of geriatric patients toward the understanding of their needs by the nursing staff included the presence of a chief care provider and co-existing diseases. 5. The psychological part of self-perception in geriatric patients was directly to their perception of understanding their physiological psychological socioeconomical environmental and medical needs by the nursing staffs. The environmental part of self-perception in geriatric patients was positively correlated to the understanding by the nursing staffs. The results of this study could serve as a useful reference in the care of geriatric inpatients by nursing staffs to provide a better quality geriatric patient care.