醫護人員及家屬對兒童安寧緩和照護需求滿意度之探討

Preliminary Study of Needs and Satisfaction toward Hospice Palliative Care of the Medical Personnel and Family in Pediatric Wards

本研究探討癌症病童家屬對安寧療護之需求和滿意度，及兒科醫護人員對兒童安寧療護之知能需求和工作自我滿意度。研究採描述調查性研究設計，收案某醫學中心癌症病童家屬58位及醫護人員154位。結果發現69%家屬願意讓小孩接受安寧療護，僅37.3%家屬曾與病童談過死亡相關議題。病童家屬安寧療護需求程度總得分平均為152.1±24.71分，兒科護理人員安寧療護之知能需求總得分平均為148.0±20.84 分、醫師為146.2±13.32分。無論家屬或醫護人員對兒童安寧療護之需求及滿意度前五名項目多屬於生理和心理層面需求，而最不滿意的前五項，則以靈性照護層面為主，顯示目前臨床兒童安寧療護仍著重於生理層面之照護及相關護理指導。未來若要建構一個本土化的兒童安寧療護模式，首要努力的重點，除了呼籲各相關專業團體重視兒童安寧療護課題，鼓勵醫護人員繼續教育訓練外，並建議成立兒童安寧療護小組，透過醫療團隊成員的共同參與，全面提升兒童安寧療護之品質。

This study aims to explore the extent to which the family of children with disease demand and feelsatisfiedwith the hospice care provided bymedical staffmembers in the pediatric field, aswell as the extenttowhich thesemedical staffmembers knowabout pediatric hospice care and feel satisfiedwith their ownwork performances. The subjects included the families of 58 children with cancer and 154 medical staffmembers.The datawere collected through interviews and questionnaires at a pediatricward of onemedicalcenter in metropolitan Taipei fromMarch to October, 2007. The findings showed that the physiologicalaspects and nursing-teachingwere regarded asmostly demanded by the family focused on themedical staffmembers in the care they actually provided, and all the subjects received the least satisfaction in the spiritualaspect.Based on the findings, it is suggested to develop amodel ofpediatric hospice care in the local context:(1) related medical service groups attend to issues surrounding pediatric hospice care, (2) medical staffmembers are encouraged to continue participating in pediatric hospice care education programs, and (3) aspecial task group of pediatric hospice care is to be formed to enhance the quality of the pediatric hospicecare.