探討護理人員對癌末病人使用安寧療護認知與阻礙因素

Exploring Nursing Staff Awareness of and Analyzing Barriers to Hospice Care for Terminal Cancer Patients

目的：針對護理人員對癌末病人使用安寧療護之認知及對癌末病人使用安寧療護阻礙因素作探討，以提供臨床照護癌末病患之參考。方法：在中部某醫院隨機抽取215位護理人員，採結構性問卷調查，內容包含基本資料、認知、阻礙三部份，收案期間為民國100年12月到101年1月止，問卷回收率100%，以SPSS 18.0軟體統計分析。結果：結果：(1)有「照顧末期病人之經驗」、「親友為疾病末期之病患」及「修習過安寧療護相關課程」之護理人員，安寧療護認知較高；(2)有「修過生死學相關課程」或自認「認識安寧緩和醫療」者，對安寧療護之阻礙因素得分較無此經驗者高；(3)安寧療護認知得分與阻礙因素得分成正相關(r=0.652，p＜0.001)。結論：本研究顯示安寧療護認知越高，護理人員更能瞭解癌末病人可能面臨的阻礙因素，應加強護理人員對安寧療護的認知，針對阻礙因素加以改善，以提升病患之照護品質。

Purposes: The aim of this study was to explore nursing staff awareness about issues in hospice care in terms of barriers experienced by terminal cancer patients in or about to undergo that care. Methods: We polled a random sample of 215 nurses from the nursing staff of a central Taiwan hospital using structured questionnaires that elicited information about background, awareness of issues in hospice care, and barriers to hospice care. Results: (1) Hospice care awareness scores were higher among nursing staff who had experience caring for terminal patients, had relatives with terminal illnesses, or had taken courses related to hospice care. (2) Scores for identifying barriers to hospice care were higher among nursing staff who had taken courses in life-and-death studies or who stated an awareness of hospice or palliative care issues, than among those who did not. (3) Hospice care awareness and barrier scores were positively correlated (r=0.652, p <0.001). Conclusions: The greater the awareness of hospice care issues, the greater the understanding of possible barriers encountered by terminal cancer patients. We suggest enhancing awareness of hospice care issues among nursing staff, and lowering potential barriers in order to improve the level of care.