護理人員對愛滋病照護知識需求評估之探討

A Needs Assessment of Nursing Staff AIDS Care Knowledge Needs

背景：台灣愛滋病毒感染人數直線上升，截至2009年4月底，本國籍愛滋病毒感染人數為17,979人，近五年平均年增加率達18%，不管是全球或國內情況，除了醫療問題外，其他社會、心理問題也隨著愛滋病毒感染人數的增加而日趨複雜化。因此了解護理人員對愛滋病知識及臨床照護的教育需求，辦理相關的在職教育課程，以提升護理人員照顧愛滋病患的照護知識，促進護理人員的自我成長，可有助於專業發展與提升照護品質。
目的：探討護理人員對愛滋病照護知識之需求，並探討不同個人背景變項之護理人員在愛滋病照護知識需求之差異性，以提供在職教育課程規劃之參考。
方法：本研究為描述性及相關性研究設計（descriptive and correlational study design），採橫斷式調查方法（cross-sectional survey），以自擬結構式問卷進行資料收集。發出556份問卷，回收問卷546份，回收率98.2%。
結果：護理人員愛滋病照護知識需求方面，依平均分數排序得分最高的前三項為：被害人性侵害後之後續處理、其次是預防傷害與後續處理及伺機性感染症之護理；得分需求最低的三項依序為HIV之流行病學、台灣愛滋病政策與法令及HIV傳染途徑；愛滋病照護知識需求之整體平均分數皆在4分以上。年齡越大對於愛滋病照護知識之需求越高；已婚對於知識之需求相較於未婚者為高，服務年資高者相較於服務年資低者，其知識需求較高。
結論：研究結果可作為醫院在HIV/AIDS照護在職教育課程優先順序之安排；政策擬定之參考，例如：可將預防傷害及後續處理列為所有醫療人員必修之課程以及推廣安全針具之使用，以降低臨床工作人員針扎之風險。

Background: The number of HIV infections in Taiwan has been increasingly linear in recent years. At the close of April 2009, Taiwan registered 17, 979 AIDS infections. The average annual infection rate has grown an average 18% during the most recent five year period. Apart from medical problems, the social and psychological problems associated with AIDS are becoming increasingly complicated both in Taiwan and globally with the increasing number of HIV infections. Identifying the knowledge needs of nursing staff members for providing appropriate nursing care to HIV/AIDS patients is important to planning effective in-service nursing education programs. Quality of both patient care and professional development can be promoted.
Purpose: This study investigated the HIV/AIDS educational needs of nursing staffs and variations in care knowledge needs by individual background. Results provide a reference for in-service education program planners.
Methods: This was a descriptive and correlational study design that used self-structured questionnaires to conduct a cross-sectional survey. A total of 556 structural questionnaires were distributed and 546 completed questionnaires were returned (response rate = 98.2%) and used in data analysis.
Results: The average knowledge need score for nursing staffs with regard to HIV/AIDS patient care was > 4 points. The highest three mean scores were (in rank order): follow-up treatment for victims after sexual assault, prevention of injury (e.g., sharp objects, exposure to infected body fluids) and subsequent management, and nursing care of opportunistic infection. The lowest three mean scores were (in rank order): HIV epidemiology, Taiwan HIV policies and regulations, and HIV transmission routes. Nurses who were older, married, or held senior nurse positions had more knowledge needs.
Conclusion: This study can be a reference for prioritizing the arrangement of in-service HIV/AIDS care education and for formulating hospital policies related to HIV/AIDS patients. Prevention of injury and subsequent management of patients with opportunistic infections should be made mandatory in all health care provider courses. Also, enhancing promotion of safety needles can help reduce needle stick risks for clinical staff.