居家護理師對高齡者足部照護知識、態度及照護能力相關因素探討

Exploring the Factors Related to Home Care Nurse Knowledge of, Attitudes Toward, and Care Competence for Foot Care in the Elderly

背景：隨著全球人口老化及慢性病、失能人口的增加，長期照護需求快速攀升。足部健康對高齡者的生活品質及行動能力至關重要，適當的足部護理不僅能降低跌倒和失能風險，還能有效預防因足部問題引發的健康惡化，足部照護已成為我國長照服務的重要一環。
目的：探討我國居家護理師在高齡者足部照護能力的現況及影響因素。
方法：採橫斷式設計，以全國立案居家護理所的護理師為研究對象，使用自編結構式問卷作為研究工具，內容包括個人屬性、足部照護知識、態度、實務及護理能力五個部分，並進行問卷信效度測試後，發出250份，回收有效樣本183份，使用SPSS 21.0軟體進行資料分析。
結果：受試者的平均年齡為43.1歲（SD = 9.1），在足部照護方面，有51.4%的受試者未參加過足部護理繼續教育，而曾參加者的平均訓練時數為4.7小時。整體足部照護能力的得分，以專業倫理與合作以及品質管理與實證運用得分最高，照護態度、實務經驗與受訓時數呈現正相關。經由逐步迴歸分析，態度、實務經驗及繼續教育為影響足部照護能力的主要因子，解釋力達63%。
結論：本研究結果指出態度、實務經驗及繼續教育是影響居家護理師足部照護能力的主要因素。建議未來在護理教育中納入足部護理相關課程，系統化提升學生與護理師在足部健康評估、護理措施及專業技能，應持續推動在職教育與訓練，增強居家護理師的實務能力，以因應高齡化社會下對長期照護服務的需求。

Background: Cases of chronic disease and disability and the demand for long-term care have risen in step with the steady global increase in aging populations. Foot health is critical to quality of life and mobility in older adults, and proper foot care can reduce the risks of falls and disabilities while preventing foot-issue-related health deterioration. Thus, foot care has become an integral part of long-term care services in Taiwan.
Purpose: The objective of this study was to explore the current status of older-adult foot care in Taiwan and factors influencing the competency of home care nurses in implementing this care.
Methods: This cross-sectional study targeted nurses working at nationally licensed home care institutions. The self-developed structured questionnaire used in this study covered five sections: demographics, foot care knowledge, attitudes, practices, and competencies. After testing for validity and reliability, 250 copies of the questionnaire were distributed, with 183 valid responses collected. Data were analyzed using SPSS 21.0 software.
Results: The average age of participants was 43.1 years. Regarding foot care, 51.4% of the participants had not attended any continuing education on foot care, while those who had reported an average training duration of 4.7 hours. Overall foot care competency scores were highest in the areas of professional ethics, collaboration, and quality management with evidence-based application. Positive correlations were observed between foot care attitudes, practical experience, and training hours. Stepwise regression analysis revealed attitudes, practices, and continuing education as the main predictors of foot care competency, with an explanatory power of 63%.
Conclusion: Attitudes, practical experience, and continuing education are key factors influencing foot care competency in home care nurses. Nursing education curricula should incorporate foot care to systematically enhance student foot health assessment skills, care measures, and professional expertise. Moreover, ongoing in-service education and training should be promoted to strengthen the practical capabilities of home care nurses, addressing the growing demand for long-term care in aging societies.