南部某醫學中心住院病人對病人自主態度與其相關因素之探討

Correlates of Inpatient Autonomy Attitudes at a Medical Center in Southern Taiwan

本研究的目的在瞭解住院病人自主態度的現況與影響其病人自主態度之相關因素。採用描述相關性研究，以自我決策、行動自主、告知同意、具有選擇四個面向的病人自主態度結構式問卷為研究工具，以簡單隨機取樣法在南部某一醫學中心同意參與本研究，年齡介於20-90歲的84名女性與110名男性住院病人進行資料收集。結果顯示：(1)病人自主態度得分由97至160(總分160分，M=124.94、SD=10.65)。(2)四個面向的得分為知情同意最高(M=3.28、SD=0.30)、自我決策(M=3.07、SD=0.32)與行動自主次之(M=3.04、SD=0.36)、具有選擇較低(M=2.89、SD=0.42)。(3)知情同意與教育程度呈正相關但與婚姻狀況呈負相關。在自我決策上年齡與婚姻狀況則呈負相關。行動自主與年齡呈負相關與教育程度呈正相關。具有選擇的面向中教育程度與住院次數呈正相關。整體顯示研究對象中，年紀輕、未婚者與教育程度高對病人自主的態度較堅決，然而多數的病人均認為病人自主應該受到尊重。希望藉由此研究結果，讓醫護人員在執行任何措施前都能充分告知，適時地提供病人相關資訊與照護的選擇，同時尊重病人所做的決定。

The purpose of this study was to investigate patient autonomy attitudes and explore the factors that influence such attitudes. A descriptive correlative study with structural questionnaire was used. Eighty four female and 110 male patients aged 20-90 were randomly sampled from a medical center in southern Taiwan. The results showed that patient autonomy attitudes scores were 97 to 160 (total scores were 160, Mean (M)=124.94, Standard Deviation (SD)=10.65), the average scores for informed consent was 3.28 (SD=0.30), for decision making 3.07 (SD=0.32), for autonomy of action 3.04 (SD=0.36), and for health care choices 2.89 (SD=0.42). A positive relationship was found between informed consent and education, while marital status was negatively correlated. A positive relationship was found between decision making and age and marital status. A negative relationship was found between autonomy of action and age, while education was positively correlated. A positive relationship was found between education, frequency of hospitalization, and health care choices. Overall this study implied that younger, unmarried patients with higher educations were more aware of patient autonomy. Most participants agreed that patient’s autonomy should be respected. This study emphasized the importance of informed consent and encouraged healthcare professions fully respect patient’s decisions.