| 中文摘要 |
長期照護機構隨著人口老化的趨勢快速成長，照顧服務員是機構提供照顧的主力，為滿足機構住民的日常生活照顧需求，照顧服務員與住民的接觸極為頻繁，而落實照顧服務員的手部衛生行為是預防感染的不二法門。本研究運用PRECEDE（Predisposing, Reinforcing, Enabling Constructs in Educational／environmental Diagnosis and Evaluation）模式，探討養護機構的照顧服務員手部衛生行為的現況及其影響因素。採橫斷式研究，針對某市乙等以上評鑑等級之養護機構，有意願參與本研究的機構進行等比例抽樣，總共調查34家養護機構的131位照顧服務員。研究工具為問卷收集，內容包括：基本資料、手部衛生知識、態度及信念、設施設備及工作規範、支持及回饋與手部衛生行為等。照顧服務員手部衛生之傾向、使能及增強三因素與手部衛生行為得分皆屬於中上程度；傾向因素與行為呈低度正相關（r＝.380，p＜.05），而傾向因素之態度、信念與手部衛生行為則有低度正相關（r＝.397，r＝.296，p＜.05）；增強因素與手部衛生行為呈中度正相關（r＝.411，p＜.05）；傾向及增強因素對於手部衛生行為的顯著解釋力分別為16.5％及16.9％；PRECEDE模式的傾向及增強因素為照服員手部衛生行為之影響因素。建議持續加強照顧服務員的正確洗手觀念，強化機構主管及同儕的支持與回饋，並持續增設足夠便利的洗手設備，以提升照顧服務員手部衛生行為遵從性，減少感染的發生，確保照護品質。 |
| 英文摘要 |
Background: The number of long-term care institutions is growing rapidly due to the aging population. Nurse assistants are the main personnel employed by these institutions. To satisfy residents' care needs for daily living, frequent contact between nurse assistants and the residents is inevitable. Therefore, ensuring the hand hygiene practice of nurse assistants is crucial for maintaining residents' health and preventing infection. The purpose of the study was to investigate the current situation of and factors influencing the hand hygiene behavior of nurse assistants in long-term care institutions. Methods: The PRECEDE model was employed in the present study, and the predisposing, enabling, and reinforcing factors of the model were used as the research framework. A cross-sectional study design and proportionate sampling were employed to recruit 131 nurse aides in 34 institutions with Class 2 and above accreditation in a county. The research instruments utilized were questionnaires regarding nurse assistant demographics; knowledge, attitudes, and beliefs related to hand hygiene; institutional facilities and materials; work norm; and support and feedback regarding hand hygiene behavior. Results: The results of the study revealed that higher than average scores were obtained for three factors (predisposing, enabling, and reinforcing) and hand hygiene. Weak positive correlation was noted between the predisposing factor and hand hygiene behavior (r = .380, p < .05), and weak positive correlations were identified between two predisposing factors (attitudes and beliefs) and hand hygiene behavior (r = .397 for attitudes, r = .296 for beliefs, p < 0.05). Moderate positive correlation was found between reinforcing factors and hand hygiene behavior (r = .411, p < .05). In the hand hygiene behavior prediction model, predisposing and reinforcing factors were significant predictors, explaining a total of 16.5% and 16.9% variance, respectively. Conclusions: We recommend that the correct concept of hand washing and administrative support be emphasized and that sufficient and convenient hand washing facilities must be provided in long-term care institutions to increase the compliance of nurse assistants with respect to hand hygiene behavior, reduce the risk of infection, and ensure high-quality care. |
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