大學護生對癌症疼痛及麻醉性止痛藥之信念與知識及其相關因素探討

Beliefs about and knowledge of cancer pain and narcotic analgesics and related factors in undergraduate student nurses

正確的評估為有效疼痛處理的基礎，護生的疼痛信念、疼痛知識及疼痛態度會影響其日後對病人疼痛的處理。本研究目的在探討及比較三種不同學制護理象畢業班（一般學制班、二技正規班、二技在職班）護生之癌症疼痛信念及疼痛知識，並探討可以預測其癌為信念及疼痛知識之相關因素。研究採橫斷式相關設計，針對北部某醫學院護理象畢業班護生，以疼痛及麻醉性止痛藥治療信念量表--癌痛版、Ferrell 疼痛知識態度量表及基本資料表，進行問卷調查，共發出問卷220份，回收188份，回收率85.5% 。研究結果顯示： （1）整體而言，護生對癌痛及麻醉性止痛藥信念具有正向態度，但卻仍普遍地認為疼痛是癌症不可避免的症狀； （2） 護生疼痛處理的知識相當不足，三十七題的知識量表中，平均答對17.7 題，平均答對率為47.9%' 各題答對率分佈由10.6%至93.1% ； （3）來自不同學制背景的護生有明顯的癌痛信念及知識上的差異，不具臨床工作背景的護生對癌痛及麻醉性止痛劑的信念怠負向，及較差的疼痛處理知識； （4）接受護理教育年數與接受疼痛處理課程與否，皆可以預測護生的癌痛信念及疼痛知識。本研究發現護生對疼痛處理的知識相當不足，建議於教育及臨床上應積極增加疼痛處理課程時數及案例分析的演練。The purposes ofthis study were to (1) examine the be1iefs and lmow1edge regarding cancer pain management in the 1ast year undergraduate nurse students, and (2) ana1yze the factors which can best predict these student nurses' pain be1iefs and know1edge. A cross-sectiona1 survey with a structured questionnaire including 'Background Information Form, ' 'Pain and Opioid Analgesics Be1iefs Sca1es - Cancer Version' and Ferrell's 'Nurses' Know1edge and Attitudes Survey' were used. One hundred and eighty eight subjects were recruited, with a 85.5% response rate. The results showed that (1) in general, nurse students had positive beliefs regarding cancer pain and narcotic analgesics, but most of them believed cancer pain is inevitable; (2) there existed a serious know1edge deficiency in student nurses, especially in pharmacological knowledge. The correct response rate, in average, was 47.9%, and the correct response rate for each question raged from 10.6% to 93.1 % ; (3) students nurses without working experience and without nursing education background before their undergraduate program had more negative pain be1iefs and the worst pain knowledge scores ; and (4) results from stepwise regression showed that students having more years in nursing education and having received pain management class had more positive pain be!iefs and more correct knowledge of pain management. The results suggest that more cancer pain control classes should be arranged in both school education and clinical education. The content of these courses should focus more on pharmacological pain management know1edge and case analyses.