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研究背景：在手術室內執行細胞減積手術（CRS）和腹腔內溫熱化療（HIPEC），涉及的安全議題包含CRS時產生的煙霧、HIPEC期間的化學治療藥物暴露風險、手術室內的化療表面污染及手術後加護病房以及病房的化療表面污染情形等。必須制定安全作業指引，並由教育提升手術團隊的準備度，包含外科醫護人員、麻醉科人員等。
研究目的：本研究旨在發展「細胞減積手術合併腹腔内溫熱化學治療知識量表」並檢測其信效度，進而了解手術室醫護人員對HIPEC併CRS的知識程度與相關影響因素。
研究方法：本研究採橫斷式研究設計，以方便取樣方式，於2021年五月至六月，針對北部某醫學中心執業之外科、婦科及麻醉科醫師、手術室與麻醉科護理師進行問卷調查。知識量表經五位專家之兩回合德菲法修訂，預試後以Rasch模式檢測其適配度與信效度。
研究結果：本量表之Infit、Outfit均介於0.7至1.3之間，顯示題目達適配，整份量表之信度係數為 .95，具良好的內部一致性，試題難度為中等偏易，鑑別度良好，但知識得分無法預測手術室醫護人員對HIPEC手術之接受度。回收156份問卷，回收率91.67%，知識得分平均為68.2±13.9分(滿分100)，在量表的五個面向中，答對率最高的為HIPEC防護裝備，最低的為HIPEC手術情境判斷。醫護人員的職類(F=5.78, p < .01)、化療作業年資(F=2.19, p < .05)、HIPEC教育訓練(F=4.21, p < .05)於HIPEC併CRS知識得分有統計上顯著差異。
結論與建議：本研究結果顯示手術室醫護人員對HIPEC併CRS的知識尚待提升，未來在職教育可依據職類、年資分別設計教育訓練課程，並運用本量表做為成效評量工具，以了解人員的知識變化。
關鍵字：腹腔內熱化療、知識量表、Rasch模式、醫護人員
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Objectives: Cytoreductive surgery (CRS) combined with intraperitoneal hyperthermic chemotherapy (HIPEC) in the operating room (OR) involved the following safety issues: the smoke generated during CRS, the risk of exposure to chemotherapy drugs during HIPEC, the surface contamination of chemotherapy in OR, and surface contamination of chemotherapy in intensive care units and wards after surgery. Safety guidelines for operation must be formulated, and the preparation of the surgical team must be improved by education, including surgical medical staff and anesthesiologists.
Background: This study aims to develop the "Knowledge scale of cytoreductive surgery combined with intraperitoneal hyperthermic chemotherapy" and test its reliability and validity, in order to understand the degree of knowledge of HIPEC and CRS and related factors among medical staff in OR.
Methods: This study adopted a cross-sectional research design, and a convenient sample was recruited from a medical center in Taipei. A questionnaire survey was conducted in May to June 2021 among surgeons, gynecologists, anesthesiologists, and nurses who are practicing in OR. The research tool was developed through two-round Delphi method and was validated its appropriateness and reliability by using the Rasch model.
Results: The Rasch model analysis reveals the scale’s Infit and Outfit between 0.7 and 1.3, indicating that 20 items are suitable, and the items have good internal consistency, and the reliability of the entire scale coefficient is .95, but the criterion related validity of the scale to the HIPEC acceptance is low. A total of 156 questionnaires were returned, (returned rate 91.67%). The mean score is 68.2±13.9 points (out of 100). Among the five domains of the scale, the HIPEC protective equipment has the highest correct answer rate, and HIPEC surgical situation judgment has the lowest. The title of medical staff (F=5.78, p <.01), the experience of chemotherapy (F=2.19, p <.05), HIPEC education and training (F=4.21, p <.05) have significant difference in knowledge scores.
Conclusions: The results of this study show that knowledge of CRS and HIPEC on OR medical staff needs to be improved. It is suggested that clinical educators could design on-the-job training courses based on staff’ job title and chemotherapy experience, and use this scale as an effective evaluation tool to understand their progress of knowledge.
Keywords: Hyperthermic intraperitoneal chemotherapy, Knowledge scale, Rasch model, Healthcare professionals
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