護理師對患者善終的態度以及對臨終關懷患者的照護能力

Nurses’ Attitudes towards a Good Death for Patients and Competence in Caring for End-of-Life Patients

目的：加強病患臨終關懷（end-of-life，EOL）及提供善終照護服務態度，對於年輕護理師的專業技能及社會心理健康非常重要。本研究旨在評估護理師於照護過程中影響的相關因素。方法：本橫斷研究採用了有目的性的抽樣設計，於臺灣北部某教學醫院共招募104名至少具備三個月工作經驗的醫療內、外科及加護病房護理師。本研究以描述統計和推論統計分析資料數據，包含：t檢定、Pearson相關係數、單因子變異數分析和多元線性回歸分析。結果：104名護理師的平均年齡為28.87（±5.77）歲，平均工作時間為6.99（±5.49）年。護理師在善終和處理臨終患者的能力分別為170.50（±16.56）和134.13（±23.07）；在回歸分析中，對於善終具有完備的理解、具有急診部門實踐經驗，或對於臨終患者具備良好的臨床溝通技巧的護理師，在處理臨終問題方面均展現出良好的能力。結論：本研究結果可以為醫療保健專業人員在設計護理專業內的繼續教育提供參考。作者建議，參與安寧緩和療護的護理師應該廣泛理解善終的意涵，以及在與患者討論和患者死亡相關議題時，須具備良好的溝通技巧。

 

Objective The attitude towards enabling a good death for patients and handling end-of-life (EOL) care is important for young nurses in terms of their professionalism and personal psychosocial health. The aim of the current prospective study was to assess factors associated with these caring practices in nurses. Methods This cross-sectional study used a purposive sampling design. A total of 104 medical, surgical and intensive care unit (ICU) nurses with at least 3 months of work experience were recruited from a teaching hospital in northern Taiwan. Descriptive and inferential statistics were used for data analysis, including the Student’s t-test, Pearson’s correlation coefficient, one-way analysis of variance, and multiple linear regression. Results The mean age of the 104 nurses was 28.87 (±5.77) years and they had worked for an average of 6.99 (±5.49) years. The attitude of good death and competence in handling end-of-life patients were 170.50 (±16.56) and 134.13 (±23.07), respectively. In the regression analysis, nurses with a good understanding of a good death, with practical experience at an emergency department, or with good patient-nurse communication skills regarding death and dying, showed good competence in handling end-of-life issues. Conclusion These findings may guide other healthcare professionals in providing references for continuing education within the nursing specialty. The authors recommend that nurses involved in hospice palliative care should have a broad knowledge of a good death and good communication skills for discussing the issues surrounding death and dying with their patients.