護理人員對呼吸器依賴患者長期照護知識之在職教育需求評估研究
The study of in-service need assessment for ventilator dependent patients with long-term care

knowledge among nursing staffs

本研究旨在探討(1)護理人員對呼吸器依賴患者長期照護知識的在職教育需求情 形、(2)不同個人背景變項之護理人員對呼吸器依賴患者長期照護知識在職教育 需求之差異性，以及(3)護理人員對呼吸器依賴患者長期照護知識在職教育需求 之預測因子。研究採橫斷式問卷調查，方便取樣自北部某三家醫院之內、外科加 護病房、呼吸照護中心，及慢性呼吸照護病房護理人員，以自擬結構式問卷收集 護理人員對呼吸器依賴患者長期照護知識之在職教育需求，發放問卷共 260 份， 有效問卷 254 份，有效回收率 97.69%。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。研究結果顯示：(1)護理人員對呼吸器依賴患者長期 照護知識需求整體平均得分為 4.10 分(SD=0.83)，平均得分最高題項為人工氣道

管路清潔與照護 4.30 分(SD= 0.83)和最低題項為求助 119 的時機 3.60 分(SD=1.12)。 (2)呼吸器依賴患者長期照護知識在職教育課程需求之差異性分析，在單位層級 方面，發現在常見健康問題之評估與處理方面，醫學中心層級受試者需求最大。 在呼吸器依賴患者之照護措施和呼吸器相關概念兩方面，地區醫院層級受試者均 高於醫學中心及區域醫院層級受試者。在工作單位方面，發現在呼吸器依賴患者 之照護措施課程項目，慢性呼吸照護病房受試者顯然高於內科病房受試者及加護

病房受試者。在曾照顧過需呼吸器依賴長期照護患者方面，發現在呼吸器相關概

i

念課程項目有顯著差異存在(p＜.001)。在雙變項迴歸分析中，只有年齡變項會影

響整體呼吸器依賴患者長期照護知識課程需求；由 t 檢定結果顯示達顯著水準有

「年齡 25-29 歲相對於 20-24 歲」(b=5.96，p=.045)及「年齡 30-34 歲相對於 20-24 歲」(b=6.22，p=.038)受試者對於呼吸器依賴患者長期照護知識在職教育需求較 高。本研究結果可做為護理人員對呼吸器依賴患者長期照護知識在職教育課程規 劃之參考，及培訓長期照護護理人員人員能力之指標依據，並可提升行政資源對 於長期照護人才培育之支持、加強跨團隊合作及落實全人照護之理念。

關鍵字：長期照護、呼吸器依賴、在職教育、需求評估

This study was designed to investigate (1) nurses’ needs for in-service education in order to acquire knowledge required to provide long-term care for patients dependent on respirators, (2) the differences in needs for the aforementioned in-service education among nurses with different personal background variables, and (3) predictors for nurses’ needs for in-service education in order to acquire knowledge required to provide long-term care for patients dependent on respirators. A cross-sectional survey was performed on convenience samples of nurses currently working at medical intensive care units, surgical intensive care units, respiratory care centers, or chronic respiratory wards at any one of the three hospitals in northern Taiwan. A self-developed structured questionnaire was used for data collection. A total of 260 questionnaires were released, and 254 valid questionnaires were returned, registering a 97.69% return rate. Data analysis included calculation of descriptive statistics and inferential statistics as well as analyses of variance (ANOVA) and linear regression. As shown in the results: (1) The mean score of the nurses’ needs for long-term care knowledge regarding respirator-dependent patients was 4.10 (SD=0.83). The highest-scoring questionnaire item was cleaning and care of artificial airways (4.30 points, SD= 0.83), and the lowest-scoring questionnaire item was the right timing to make calls to 119 (3.60 points, SD=1.12). (2) Regarding the differences in needs for

in-service education, nurses working at academic medical centers were found to have

the greatest demand for knowledge regarding assessment and treatment of common health issues. Nurses working at local community hospitals were found to have a greater need for knowledge regarding care strategies for respirator-dependent patients and respirator-related concepts than nurses working at academic medical centers and metropolitan hospitals. In addition, nurses working as chronic respiratory wards were found to have a significantly higher demand for in-service education regarding respirator-dependent patient care strategies than nurses working at medical wards and

intensive care wards. A significant difference (p＜.001) was observed in the needs for

in-service education on respirator-related concepts among nurses with previous experience in providing long-term care for respirator-dependent patients. Bivariate linear regression analysis indicated that only the variable of the nurses’ age would cause significant differences in the needs for in-service education regarding long-term care for respirator-dependent patients. T-test results indicated that nurses ages 25-29 were found to have a significantly higher need for in-service education than nurses ages 20-24 (b=5.96, p=.045), and nurse ages 30-24 were found to have a significantly higher need for in-service education than nurses ages 20-24 (b=6.22, p=.038). The findings of this study would be useful in future planning of in-service nursing education on long-term care for respirator-dependent patients and in future assessments of core nursing competencies for long-term care nurses. It is hoped that

the findings of this study would raise the awareness of the importance of making more

investments in the training of long-term care workers, of enhancing interdisciplinary cooperation, and of pushing for holistic health care.

Key   Words:   long-term  care,   respirator-dependent,   in-service   education,   needs assessment