護理人員提供病患性衛教時面臨的問題及其頻率、困擾與需要協助程度之探討

Problems and Their Frequency, and Emotional Disturbances and Needs among Nurses Providing Sexual Health Education

本研究探討護理人員提供病患性衛教時面臨的問題及其頻率、困擾與需要協助程度以及影響因素。本敘述性橫斷式研究立意取樣選取六所北部準醫學或醫學中心泌尿科女性護理人員90名為研究對象，研究工具「護理人員提供病患性衛教時面臨的問題與需要協助程度」經因素分析萃取出「病患反應」、「環境互動」與「護理人員準備度」三層面共26題。研究結果發現護理人員提供性衛教平均面臨23項（89%）問題，問題發生的頻率介於「一半」～「經常」，困擾及需要協助程度為「中等程度」。整體而言，「環境互動」層面是護理人員最常面臨、最為困擾，且最需要協助部分。發生頻率最高及困擾程度最高的問題均為「性衛教成效不易評值或追蹤」，需要協助程度最高的問題為「缺乏足夠或適當的性衛教教材」；以逐步迴歸分析發現問題的發生頻率之預測變項為「性衛教因應能力」、「護理工作總年資」與「性衛教積極程度」，解釋變異量21%；困擾程度預測變項為「性衛教因應能力」，解釋變異量6%；需要協助程度預測變項為「性衛教因應能力」及「護理工作總年資」，解釋變異量11%。根據以上結果，提昇護理人員性衛教的因應能力及積極程度，加強資深護理人員性衛教相關教育或資源以協助護理人員勝任臨床病患性衛教的需要。

This study investigated the problems encountered by nurses delivering sexual health education, the frequency of occurrence of such problems, the types of emotional disturbances experienced by such nurses, and the needs of such nurses. Ninety urology nurses from six hospitals in northern Taiwan participated in this cross-sectional survey by completing a Problems and Needs in Sexual Health Education (PNSHE) questionnaire. Factor analysis showed that the PNSHE consisted of three dimensions: patient's response, environmental interaction, and nurses' self-preparation. Among 26 items listed as ”difficult,” nurses faced 23 (89%), at frequencies ranging from ”half the time” to ”often”. They faced ”moderate” degrees of emotional disturbance and ”moderate” needs for assistance. Over all, Environmental interaction was the dimension which arose most frequently, caused the greatest degree of disturbance and prompted the greatest need for assistance among nurses. Nurses were frequently disturbed by the problem of ”evaluating effects of sexual health education,” and most needed assistance for ”lacking suitable materials.” Stepwise multiple regressions demonstrated that ability in providing sexual health education, years of nursing experience, and pro-activeness in providing sexual health education were significant variables related to the frequency of the problems, accounting for 21% of the variance. Ability in providing sexual health education was significantly related to the degree of emotional disturbance, accounting for 6% of the variance. Ability in providing sexual health education and years of nursing experience were related to nurses' needs while providing sexual health education, accounting for 6% of the variance. The findings of this study provide information of problems and needs encountered by nurses while delivering sexual health education, and should also assist senior nurses in. identifying educational courses and resources to develop competency in providing sexual education.