護理人員文化能力及其相關因素之探討： 以臨終照護行為為例
| 論文名稱(中/英文) | 研究生 | 指導教授 |
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護理人員文化能力及其相關因素之探討： 以臨終照護行為為例 Patients Care Behavior |
劉芳瑜 | 林梅香博士 |
| [ 摘要 ] | ||
| 生命末期照護重要的目標是協助病人善終，而家屬善別。護理人員進行臨終 照護時，因台灣風俗民情關係，應考量到文化、宗教信仰和價值觀。本研究旨在 探討護理人員文化能力及臨終照護行為之現況及相關性，探討不同人口學變項其 護理人員之文化能力及臨終照護行為差異情形，並且針對護理人員臨終照護行為 進行預測因子探討。本研究為橫斷性研究設計，採立意抽樣自北部某醫學中心內 科、腫瘤科及加護病房護理人員，應用結構式問卷進行調查。本研究共發放 263 份問卷，有效問卷數為 234 份，回收率 89.0%。經由描述性統計及 t 檢定(t-test)、 單因子變異數分析(One-way ANOVA)、皮爾遜積差相關係數(Pearson productmoment correlation coefficient)及多元線性回歸(multiple linear regression)推論性統 計方法進行分析。研究結果顯示：(一)護理人員文化能力中文化自覺和文化敏銳 度面向平均得分最高；臨終照護行為以生理照護行為面向平均得分最高。(二)不 同人口學變項中現職單位護理工作總年資、專科專長、與團隊成員談論臨終照護 感受、曾接受文化相關教育課程次數與護理人員文化能力具有顯著差異。(三)不 同人口學變項中年齡、臨床護理工作總年資、現職單位護理工作總年資、護理進 階層級、服務科別、專科專長、與團隊成員談論臨終照護感受、曾接受安寧緩和 醫療相關教育課程次數、曾接受文化相關教育課程次數、過去兩年曾照顧臨終或 瀕死病人經驗、曾照護外籍人士(含大陸人士)與護理人員之臨終照護行為有顯著 差異。(四)文化自覺、文化知識、文化敏銳度、文化技巧、整體文化能力與臨終 照護行為之生理照護行為、靈性照護行為、整體臨終照護行為呈顯著正相關。(五) 護理人員臨終照護行為之預測因子為文化技巧、進階層級、過去兩年曾照顧臨終 或瀕死病人經驗、文化敏銳度、現職單位護理工作總年資和曾接受安寧緩和醫療 相關教育課程次數，其解釋能力為 42.1%。研究結果將作為提供日後護理人員在 職教育課程規劃參考，進而提升護理人員臨終照護之品質。 | ||
| [ Abstract ] | ||
| Toward good death for the patient and families good grief is important in end-oflife care. Cultural, religious beliefs, and values, due to the customs and traditions in Taiwan, should be taken into consideration while nursing staffs doing dying care. The purposes of this study was to explore the current situation and relevance of nursing staffs’ cultural competency and dying care behavior, to explore the differences in the cultural competency and dying care behavior of nursing staffs with different demographic variables, and especially in investigating the predictors of nursing staffs’ dying care behavior. This research adopted a cross-sectional approach, by the purposive sampling, selecting internal medicine, oncology and intensive care unit nurses of one medical center from northern Taiwan, using a structured questionnaire. There were 263 questionnaires issued and 234 were returned and validated (89.0%). The result was analyzed by the descriptive statistical analysis, t-test, one-way ANOVA analysis, Pearson product-moment correlation coefficient and the multiple linear regression conclusive statistical. Study results showed: (1) The highest-scoring questionnaire item were cultural awareness and cultural sensitivity of nursing staffs’ cultural caring competence; The highest-scoring questionnaire item was physical caring behavior of nursing staffs’ dying patients care behavior. (2) In the different variables of demography, the total years of work for current division, the specialist expertise, having discussed about the end-of-life care feeling with colleagues, the times taken the cultural curriculum showed significant difference to the nursing staffs’ cultural competence. (3) In the different variables of demography, the total years of clinical nursing experience, the total years of work for current division, clinical ladder of nursing, serving division, specialist expertise, having discussed about the end-of-life care feeling with colleagues, the times of taking the hospice care curriculums, the times of taking the cultural curriculums, the experience of taking care of dying patient in past two years, and having the experience of nursing foreign patient including mainland China’s patient showed significant difference to the nursing staffs’ dying care behavior. (4) Cultural awareness, cultural knowledge, cultural sensitivity, cultural skills, and overall cultural ability have the positive correlation with physical care behavior, spiritual care behavior, and overall dying care behavior. (5) The predictors of nursing staffs’ dying care behavior were cultural skills, clinical ladder of nursing, the experience of nursing dying patient in the past two years, cultural sensitivity, the total years of work for current division, and the times of taking the hospice care curriculums, its’ multivariate linear regression accounted for 42.1%. The results of this study would give as a reference of planning the nursing staffs’ in-service training curriculums and improve the quality of the nursing staffs’ dying care. | ||