器官移植教育對護理人員器官捐贈觀念之影響

The Impact of Transplantation Education for Nursing Staffs on Their Concept of Organ Donation

器官捐贈為不可逆器官衰竭的重要治療方法；然而國內器官移植推動上，卻面臨需求量遠多於供應量的窘境。又護理人員的態度會影響其執行勸捐及影響病患及家屬捐贈器官的態度與決定。因此提昇護理人員對器官捐贈的態度、勸捐意願，將有助器官捐贈的人數。本研究的目的乃在評估器官移植及捐贈教育訓練對護理人員器官捐贈意願、認知及態度上的影響。我們於2000年1月在北部某醫學中心進行一前後測的介入研究，共30位護理人員完成訓練。結果顯示：（1）護理人員未接受此教育訓練前已簽署過器官捐贈卡的比例為13.3%；當病人生命無法挽救時，願意簽署家人同意書者前測為36.7%；執行器官勸募方面偏向於工作上有需要才勸捐（27%）。器官捐贈的認知得分為7.43±2.01，偏向中等程度的認知。態度得分為2.95±0.82，偏持正向的態度。（2）器官移植教育訓練課程介入後，器官捐贈的認知及器官捐贈態度均改善，訓練後器官捐贈的認知得分為8.57±1.65，器官捐贈的態度得分為2.43±0.53，訓練前、後認知與態度改變皆達統計上的顯著差異（p<0.01）。在簽署器官捐贈卡（16.7%）及簽署家人同意書（50%）、勸募意願（30%）雖有提升，但未達統計意義。本研究結果顯示器官移植教育訓練能提昇護理人員器官捐贈的認知及態度。因此，建議將器官移植訓練作為醫療機構訓練臨床護理人員的在職教育訓練課程，提昇人員正向的態度及強化醫療人員相關專業知識，以促使器官捐贈更加落實。

Organ transplant is the last mean to save lives in patients with organ failure. However, organ donation is uncommon in Taiwan. Nurse's attitudes towards organ procurement can affect attitudes and decisions of organ donation for potential donor or their family members. The purpose of this study was to evaluate the changes of nurses’ willingness, attitude, and knowledge after a 2-day education program about brain death, organ transplantation, care of patients with organ transplantation and donation. A before-after intervention trial was conducted at a medical center. A total of 30 nurses completed the trial in January 2000. Prior to the intervention, the proportion of nurses signing an organ donation card, signing a document for donating her family member's organs and procurement were 13.3%, 36.7% and 27%, respectively. On average, 7.43 out of 10 knowledge questions were answered correctly; a score of 2.95 was obtained in the attitude questions. After intervention, the proportion of nurses signing an organ donation card and authorizing procurement slightly increased to 16.7% and 30%, respectively, but did not reach a statistical significance. The knowledge score increased to 8.57 (p< .01) and the attitude score changed to 2.43 (p< .01). Our study shows that education program of organ donation can increase nurses’ knowledge of organ donation and affect their attitude positively. An organ donation education program is recommended to be added in nurses’ training program on a routine basis.