兒科護理人員與病童家屬對關懷照護認知之差異性及其影響因素

Comparison of Family's and Pediatric Nurse's Perception of Caring Behaviors and Influential Factors

本研究乃比較兒科住院病童家屬及護理人員對關懷照護認知程度之差異性及其相關影響因素之探討。自年92月至11月止，選取某醫學中心小兒內科病房病童家屬及護理人員為研究對象，共收案護理人員16名，病童家屬30名，並採用Q研究法中之歸Q類法收集資料。研究結果顯示，兒科護理人員對屬於表達性關懷照護行為中「提供心理社會支持」選項的得分顯著高於病童家屬，然而病童家屬卻是對屬於操作性關懷照護行為中有關「解釋及促進」層面選項得分顯著高於護理同仁，由此結果不但印證了過去多項研究中所提，護理人員與病人對關懷照護認知程度有顯著不同的期望外，更可以讓護理同仁深思，在面對住院病童或家屬時，需要考量生、心、社會、發展及文化等不同層面的需求，適當的運用表達性或操作性的關懷照護行為，幫助他們渡過這個危機。研究者亦發現護理同仁除了對關懷照護的概念相當模糊之外，更不暸解什麼樣的行為能讓家屬感受到我們的關懷。因此建議可將研究結果與護理人員及管理者分享，將來可由護理品質促進部門制定關懷照護標準及行為指標，利用在職教育課程或手冊，宣導理念及增加同仁的認知，更積極的落實關懷照護的理念。

This descriptive has study examined the perception of caring behaviors and influential factors between pediatric patient's family and nursing staff in a pediatric medical ward. From March to November of 2003, thirty family and sixteen staff were chosen from one pediatric medical ward of a medical center in Taipei city. The instruments for this study included a list of information about the patients, family, and staff, and Caring Assessment Instrument (Care-Q) which were developed by Larson at 1984. The study compared the differences between pediatric patient family's and staff's perception of the ten most important caring behaviors, using the Caring Assessment Instrument (Care-Q) by Q methodology, demonstrating that staff stressed the importance of expressive activities of caring, whereas family stressed the importance of instrumental activities of caring. The authors concluded that family and nursing staff of pediatric patients have different cognitive perception and expectation about caring behaviors. The results suggest that patient-staff communication requires specific knowledge and skills to make staff accurately judge what is important in making patients and family feel how the patient is cared for. And we also have to make a more detailed assessment of what their need and expectations are during our caring process.