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護理人員接受安寧療護在職教育課程需求之探討

論文名稱(中/英文) 研究生 指導教授
護理人員接受安寧療護在職教育課程需求之探討
The study of need assessment of palliative care course for inservice education among nursing staffs		 張惠如 許麗齡博士
[  摘要  ]
背景 護理人員在安寧療護團隊中扮演舉足輕重角色，比其他健康照顧專業人員有更多時間與病人及家屬相處。因此護理人員在職教育課程中，評估安寧療護課程教育之需求更顯重要，進而規劃合宜之安寧療護課程，以提升照護品質。
目的 本研究目的在探討護理人員對於安寧療護在職教育課程內容之需求，探討不同基本屬性之護理人員對安寧療護在職教育課程內容之需求差異，並分析護理人員對安寧療護在職教育課程內容需求之預測因素。
方法 本研究是橫斷性問卷調查，以叢集隨機抽樣自北部某醫學中心不同工作單位的護理人員填寫自擬結構式安寧療護教育需求問卷表。本研究共發放614份問卷，有效問卷數為600份，有效問卷回收率為97.72%。資料分析使用描述性統計和變異數分析與線性迴歸的推論性統計。
結果 護理人員對安寧療護課程需求整體平均得分為3.95分(SD = 0.81)，平均得分最高題項為病情告知4.14分(SD = 0.80)和最低題項為安寧療護國內和國外發展史3.33分(SD = 0.86)。另探索式因素分析發現六個因素分別為：疼痛與症狀處理、臨終病患之倫理議題、臨終準備與照護、安寧照護概念、溝通與諮商、及文化與靈性因素考量，共解釋77.22%的變異量。護理人員不同的年齡、教育程度、宗教信仰、護理職級及服務年資、曾參加安寧療護研習會、有意願參加安寧療護課程、及臨床工作曾照顧末期病人，其安寧療護在職教育課程需求有顯著差異。多元線性迴歸顯示年齡、教育程度、宗教信仰、臨床服務年資、工作單位及有意願參與安寧療護課程為護理人員對安寧療護在職教育課程需求顯著預測因子，可解釋護理人員對安寧療護在職教育課程需求10.3%變異量。
結論 本結果了解安寧療護在職教育課程需求之分佈，及安寧療護在職教育課程需求六大因素。未來應著重安寧療護在職教育課程之規劃、加強護理人員之培訓、行政資源之配合、整合跨團隊合作、以期全人照護理念之落實。
[ Abstract ]
Background: Nurses are important members of palliative care teams who spend more time with patients and families than other healthcare professionals. Thus, the assessment of palliative care education needs is very important for nurses’ in-service education program. Additionally, design and plan of an appropriate palliative care educational program is to promote quality of care.
Aims: To investigate needs for the essential content of the palliative care inservice education program for nurses; to explore mean need differences of the palliative care in-service education program content in nurses with diverse background; and to analyze predictors of the palliative care in-service education program content for nurses.
Methods: The study was a cross-sectional survey. The nurses, from different working units a medical center in northern Taiwan using cluster random sampling, filled out the self-development structured questionnaires. The study distributed 614 questionnaires and 600 valid questionnaires were returned with 97.72% of returned rate. The data was analyzed by descriptive statistics and inferential statistics, such as 1-way ANOVA and linear regression.
Results: The total mean score of palliative care education program needs for nurses was 3.95 (SD = 0.81). The highest mean score was disclosure of medical condition (mean = 4.14, SD = 0.80) and lowest mean score was developmental history of Taiwan and abroad hospice and palliative care (mean = 3.33, SD = 0.86). Six factors were found using exploratory factor analysis, including pain and symptom management, ethical issues for dying patients, preparation and care for dying, palliative care concept, communication and consultation, and cultural and spiritual factors, and explained 77.22% of variance. There were significant mean palliative care education program need differences in diverse ages, education degrees, religion, clinical ladders, and working years, attendance of palliative care seminars, willingness of attending palliative care programs, and care for terminal patients in clinical settings. Age, education degree, religion, clinical service years, working units, and willingness of attending palliative care programs were significant predictors of nurses’ palliative care education program needs and accounted for 10.3% variances of nurses’ palliative care education program needs.
Conclusions: This study understand the distribution of nurses’ palliative care education program needs and six major factors of nurses’ palliative care in-service education program needs. The design and plan of palliative care in-service education program should be emphasized, nurses cultivation should be strengthen, administrative resources should be cooperated, multidisplinary collaboration should be integrated in the future for achievement of belief of the total man care.