婦女接受骨盆檢查中之照護需求與感受被護理人員照護差異之探討

Discrepancy between Women’s Perceived Needs for and Perceptions of Nurses?Assistant Practices regarding Pelvic Examination

護理人員可能影響婦女接受骨盆腔檢查之經驗，然而台灣探討此議題的研究較少。因此本研究旨在骨盆腔檢查中婦女對護理人員的照護需求與感受被照護差異之探討。方法採為橫斷面、描述性研究設計，採方便取樣，以結構式問卷調查20項婦女經歷骨盆腔檢查程序對護理人員的照護需求以及感受其被照護。研究對象為中部某醫學中心婦產科門診接受骨盆腔檢查婦女300人，並以配對t檢定檢測婦女對護理人員的照護需求與感受被照護之差異。研究結果骨盆腔檢查中婦女對護理人員的照護需求，其平均值±標準差為3.18± .71 - 3.58± .50。而且，87.0%以上的婦女需要護理人員提供這20項照護程序。婦女對護理人員的照護需求與感受被照護差異最大的前三項依序為「在檢查前，會告知您檢查過程時的步驟」、「會提供您小被單覆蓋」、「會詢問您是否圍上內診台上的小布幔」。此三項是婦女需要護理人員照護但卻感受有50.0%以上的護理人員未提供照護。而差異最小的五項依序為會「保密您的醫療資料」、「個人隱私資料」、「會使用您能懂的用語」、「檢查結束時，會告知您可以起身」、「會指導您臀部靠近內診台的下緣」。此五項是婦女需護理人員照護且感受至少有90.0%以上的護理人員有提供照護。研究結果也可做為護理人員執行最佳實務—骨盆腔檢查的指引，亦可納入婦產科護理教育課程，以及專科護理師婦產科教育訓練之參考。

Women with positive and negative experiences about pelvic examination (PE) are related to nurse’s behavior. However, little research has focused on this issue in Taiwan. The purpose of this study was to examine the discrepancy between women’s perceived need for and perceptions of nurses?assistant practices regarding pelvic examination. A cross-sectional and descriptive survey was used in this study. Data were collected from 300 women with a structured questionnaire on the perceived need for and perceptions of the nurse’s assistant practices regarding 20 PE procedures. A total of 300 women were recruited by purposive sampling from a medical center in central Taiwan. A paired t-test was used to examine the discrepancies between women’s perceived need for and perceptions of the nurse’s assistant practices regarding 20 PE procedures. Women’s average perceived need scores ranged from 3.18 (SD= .71) to 3.58 (SD= .50), and at least 87% women perceived all 20 PE procedures as needed. The three top-ranking differences were “nurse explains procedure to you before exam”, “nurse asks you whether use the PE curtain or not”, and “nurse offers drape sheet to cover your body” These three procedures were perceived as needed by women but at least 50% nurses did not assist in these procedures. In addition, the five lowest-ranking differences were “nurse protects the privacy of your medical records”, “nurse protects the privacy of your personal information”, “nurse uses general terminology (layman’s language) to communicate with you”, “nurse tells you to get out of bed when physician has finished the exam”, and “nurse instructs you how do your buttocks extending slightly beyond the edge of the examining table”. These five procedures were perceived as needed by women and at least 90% nurses did assist in these procedures. The results are regarded as best practice guidelines in an obstetric and gynecological outpatient department. These findings also can be incorporated into nursing education and used as a valuable reference for those training to become nurse practitioners.