比較安寧病房與一般內科病房護理人員對癌症疼痛處理知識之差異

Knowledge about Cancer Pain Management-the Comparison between Nurses Working in Hospice and Intemal Medicine Inpatient Wards

本研究目的為：（1）探討安寧病房護理人員的癌症疼痛知識；（2）探討一般內科病房護理人員的癌症疼痛知識；（3）比較安寧病房與一般內科病房護理人員疼痛知識之差異。研究採橫斷式相關性設計，以方便取樣於北部二所教學醫院之內科病房及安寧病房，針對單位之護理人員以護理人員疼痛知識量表及基本資料表，進行問卷調查，共發出問卷150份，回收有效問卷安寧病房71份，一般內科病房70份，共141份，有效率為94.0%，資料以SPSS套裝軟體進行平均值、標準差、百分比、卡方檢定及獨立樣本t檢定分析等統計分析。研究結果：（1）安寧病房與一般內科病房護理人員在疼痛處理知識方面，對於麻醉性止痛劑有錯誤的觀念，擔心麻醉性止痛劑的副作用；（2）安寧病房與一般內科病房護理人員疼痛處理知識前十項得分最高中以疼痛評估最高，最欠缺為案例分析之情境題的處理能力；（3）安寧病房護理人員（74%）的答對率明顯高於一般內科病房護理人員（47.1%），但仍不足，其中一般內科病房護理人員疼痛處理之知識相當缺乏。本研究結果建議護理人員的疼痛處理知識仍需要被強化，尤其以非癌症照護單位之一般內科病房，藉由案例分析討論臨床情境處理之決策，以提昇護理人員在疼痛處理方面的知識。The purposes of this study were to (1) examine the level of knowledge about cancer pain management in nurses working in hospices; (2) examine the level of knowledge about cancer pain management in nurses working in internal medicine; (3) compare the level of knowledge about cancer pain management in nurses working in both settings. The Nurses’ Pain Knowledge and Attitudes Survey — Chinese version was used cross-sectionally with convenience sampling to assess nurses’ knowledge about pain. Of 150 surveys distributed, 141 were returned with complete responses (70 from hospice nurses and 71 from internal medicine nurses; 94.0% response rate) . Data were analyzed by descriptive analysis, chi-square and independent t-test. The results showed that (1) nurses working in both settings had insufficient knowledge of pain management, and, in particular, had misconceptions and lack of knowledge about opioids; (2) nurses in both groups had better knowledge about pain assessment than about pain management, and had more problems handling questions related to case studies; and (3) nurses working in hospices had a significantly higher correct answer rate to survey items (74%) than did nurses working in internal medicine wards (47.1%). The results strongly suggest that nurses, knowledge about pain management still needs to be strengthened; especially for nurses working in non-cancer care specific internal medicine wards. More discussions of case studies about pain management are suggested to enhance nurses’ abilities in integrating pain knowledge into a complex pain management situation.