醫療照護者迷信之概念分析

Superstitious Beliefs Among Healthcare Providers: A Concept Analysis

臨床照護係以實證科學證據為依據，當醫療照護者於照護過程中，面對病人非預期性病況改變或者無法控制的情境時，內心存有對照護過程或結果信心不足或者恐懼不安，認為有外部力量控制未知的事件，而產生迷信信念及行為表現，醫療照護者可能會產生非理性心理投射及行為，來減少對事件的責任及義務壓力，此迷信行為亦可能影響醫療人員個人身心健康及團體氛圍，間接影響照護品質。雖然迷信常見於醫療照護中，但迷信的概念容易與俗信概念混淆，導致研究偏差及無法有效運用在臨床實務中。本文依據Walker及Avant概念分析（2019）分析步驟，統整醫療照護者迷信相關文獻，並將其概念定義特徵為：（一）於醫療環境缺乏控制時，存有非理性的認知效應；（二）面對健康相關情境之間的因果關係，缺乏客觀證據的連結；（三）醫療照護者在未經事件驗證下成為其信念與行為依從規範。並且列舉典型案例、邊緣案例及相反案例，進行概念釐清後，進行影響醫療照護者迷信的前因後果與臨床研究常用的實證測量工具之確認。期望藉此概念分析，增進醫護人員了解迷信概念，進而改善醫療照護者之迷信信念與照護行為，以提升醫療照護品質。

Evidence-based practice is a problem-solving approach to healthcare delivery that reflects the best current scientific evidence. When healthcare providers face unexpected changes in a patient’s condition or uncontrollable situations during care delivery, they may have less confidence or feel fearful / anxious about the care process and result. As people, healthcare providers may hold beliefs regarding the effect of external, supernatural forces on events, which may lead to superstitious beliefs and behaviors. Also, superstitious beliefs may be adopted by healthcare providers as a mechanism to cope with stress, anxiety, and uncertainty in situations where standard medical practices offer no ready solution. Although superstitious beliefs may help ease anxiety and feelings of failure in healthcare providers, this issue and the effects of these beliefs on medical staff behavior have not been adequately studied. The concept analysis strategy of Walker and Avant (2019) was applied in this study to define this concept and to examine (1) healthcare providers’loss of environment control and domination of irrationality in decision making, (2) the lack of objective evidence to explain cause-and-effect relationships in health-related situations, and (3) how unverified true or false claims become a compliance criterion among healthcare providers. Typical, borderline, and contrary cases were used to explain the concept of superstition in medical staff. The antecedents and possible consequences of healthcare providers holding superstitious beliefs were identified and the empirically addressed measurement tools were evaluated. This analysis may be used to improve the understanding of healthcare workers regarding superstitious beliefs. The results are expected to benefit clinical practice, facilitate further research, and enhance healthcare quality.