醫療照護者迷信之概念分析

Superstitious Beliefs Among Healthcare Providers: A Concept Analysis

10.6224/JN.202306_70(3).11

吳怡雯(Yi-Wen WU)；賴維淑(Wei-Shu LAI)；陳嬿今(Yen-Chin CHEN)

醫療照護者 ； 迷信 ； 概念分析 ； healthcare provider ； superstitions ； concept analysis

護理雜誌

70卷3期（2023 / 06 / 01）

85 - 93

繁體中文;英文

臨床照護係以實證科學證據為依據，當醫療照護者於照護過程中，面對病人非預期性病況改變或者無法控制的情境時，內心存有對照護過程或結果信心不足或者恐懼不安，認為有外部力量控制未知的事件，而產生迷信信念及行為表現，醫療照護者可能會產生非理性心理投射及行為，來減少對事件的責任及義務壓力，此迷信行為亦可能影響醫療人員個人身心健康及團體氛圍，間接影響照護品質。雖然迷信常見於醫療照護中，但迷信的概念容易與俗信概念混淆，導致研究偏差及無法有效運用在臨床實務中。本文依據Walker及Avant概念分析（2019）分析步驟，統整醫療照護者迷信相關文獻，並將其概念定義特徵為：（一）於醫療環境缺乏控制時，存有非理性的認知效應；（二）面對健康相關情境之間的因果關係，缺乏客觀證據的連結；（三）醫療照護者在未經事件驗證下成為其信念與行為依從規範。並且列舉典型案例、邊緣案例及相反案例，進行概念釐清後，進行影響醫療照護者迷信的前因後果與臨床研究常用的實證測量工具之確認。期望藉此概念分析，增進醫護人員了解迷信概念，進而改善醫療照護者之迷信信念與照護行為，以提升醫療照護品質。

Evidence-based practice is a problem-solving approach to healthcare delivery that reflects the best current scientific evidence. When healthcare providers face unexpected changes in a patient's condition or uncontrollable situations during care delivery, they may have less confidence or feel fearful / anxious about the care process and result. As people, healthcare providers may hold beliefs regarding the effect of external, supernatural forces on events, which may lead to superstitious beliefs and behaviors. Also, superstitious beliefs may be adopted by healthcare providers as a mechanism to cope with stress, anxiety, and uncertainty in situations where standard medical practices offer no ready solution. Although superstitious beliefs may help ease anxiety and feelings of failure in healthcare providers, this issue and the effects of these beliefs on medical staff behavior have not been adequately studied. The concept analysis strategy of Walker and Avant (2019) was applied in this study to define this concept and to examine (1) healthcare providers' loss of environment control and domination of irrationality in decision making, (2) the lack of objective evidence to explain cause-and-effect relationships in health-related situations, and (3) how unverified true or false claims become a compliance criterion among healthcare providers. Typical, borderline, and contrary cases were used to explain the concept of superstition in medical staff. The antecedents and possible consequences of healthcare providers holding superstitious beliefs were identified and the empirically addressed measurement tools were evaluated. This analysis may be used to improve the understanding of healthcare workers regarding superstitious beliefs. The results are expected to benefit clinical practice, facilitate further research, and enhance healthcare quality.

1. 俗信（無日期）． 於中文百科．2022年7月26日取自https://www.newton.com.tw/wiki/%E6%B0%91%E9%96%93%E4%BF%97%E4%BF%A1/6534576 [Custom. (n.d.). In Newton.com. Retrieved July 26, 2022, from https://www.newton.com.tw/wiki/%E6%B0%91%E9%96%93%E4%BF%97%E4%BF%A1/6534576]
2. Brookfield, C. R.,Phillips, P. P. J.,Shorten, R. J.(2019).Q fever-The superstition of avoiding the word "quiet" as a coping mechanism: Randomized controlled non-inferiority trial.BMJ,367,l6446.
3. Damisch, L.,Stoberock, B.,Mussweiler, T.(2010).Keep your fingers crossed!: How superstition improves performance.Psychological Science,21(7),1014-1020.
4. Drobatz, K. J.,Syring, R.,Reineke, E.,Meadows, C.(2009).Association of holidays, full moon, Friday the 13th, day of week, time of day, day of week, and time of year on case distribution in an urban referral small animal emergency clinic.Journal of Veterinary Emergency and Critical Care,19(5),479-483.
5. Ellis, A.(1991).The revised ABC’s of rational-emotive therapy (RET).Journal of Rational-Emotive and Cognitive-Behavior Therapy,9(3),139-172.
6. Exadaktylos, A. K.,Sclabas, G.,Siegenthaler, A.,Eggli, S.,Kohler, H. P.,Luterbacher, J.(2001).Friday the 13th and full-moon: The "worst case scenario" or only superstition?.The American Journal of Emergency Medicine,19(4),319-320.
7. Habibullayevna, I. M.(2022).Superstitious beliefs across cultures: A view from linguaculturology.Galaxy International Interdisciplinary Research Journal,10(1),61-65.
8. Huang, L.,Whitson, J.(2020).Organizational costs of compensating for mind-body dissonance through conspiracies and superstitions.Organizational Behavior and Human Decision Processes,156,1-12.
9. Kashdan, T. B.,Rottenberg, J.(2010).Psychological flexibility as a fundamental aspect of health.Clinical Psychology Review,30(7),865-878.
10. Lin, F.-Y.,Lin, H.-R.,Lee, T.-Y.(2014).Workplace beliefs about luck among Taiwanese nurses.Journal of Nursing,1(1)
11. Lu, J.,Luo, M.,Yee, A. Z. H.,Sheldenkar, A.,Lau, J.,Lwin, M. O.(2019).Do superstitious beliefs affect influenza vaccine uptake through shaping health beliefs?.Vaccine,37(8),1046-1052.
12. Mandal, F. B.(2018).Superstitions: A culturally transmitted human behavior.International Journal of Psychology and Behavioral Sciences,8(4),65-69.
13. Mandell, D. L.,Claypool, M. L.,Kay, D. J.(2005).Superstitions among perioperative nurses.AORN Journal,81(5),971-984.
14. Oxford University Press. (n.d.). Superstition. In Oxford learner’s dictionaries. Retrieved June 12, 2022, from https://www.oxfordlearnersdictionaries.com/definition/american_english/superstition#:~:text=the%20belief%20that%20particular%20events,a%20mirror%20brings%20bad%20luck
15. Pacheco, L. L.,Magbato, L. O., Jr.,Alfaras, R. S. A.(2021).Sociological factors that influence the practice of superstitions among CPSU students.Asian Journal of Behavioral Sciences,3(3),11-23.
16. Palmer, S.(2002).Cognitive and organisational models of stress that are suitable for use within workplace stress management/prevention coaching, training and counselling settings.The Rational Emotive Behaviour Therapist,10(1),15-21.
17. Sapra, R.,Dhaliwal, P.(2021).A blockchain solution for The privacy of patients’ medical data.Machine learning, big data, and IoT for medical informatics
18. Skinner, B. F. (1948). Superstition in the pigeon. Journal of Experimental Psychology, 38(2), 168-172. https://doi.org/10.1037/h0055873
19. Taher, M.,Pashaeypoor, S.,Cheraghi, M. A.,Karimy, M.,Hoseini, A. S. S.(2020).Superstition in health beliefs: Concept exploration and development.Journal of Family Medicine and Primary Care,9(3),1325-1330.
20. Thomassy, M.,Peacock, A.,Leone, A.,Hornbostel, H.,WardSmith, P.(2021).The desire to explain phenomenon: Hospital nursing staff’s familiarity and perceived relevance of superstitions.Open Journal of Social Sciences,9(9),204-218.
21. Tsai, S.-L.,Tsai, C.-H.,Hsu, Y.-C.,Hsieh, M.-H.,Kao, H.-T.,Hsu, M.-T.(2017).Taboo in the workplace: A qualitative study of Taiwanese nurses’ "not-eating pineapple" in clinical practice.Holistic Nursing Practice,31(6),384-392.
22. Vinson, D. R.(1998).Superstitions in medicine: Bad luck or bad logic?.Annals of Emergency Medicine,31(5),650-652.
23. Walker, L. O.,Avant, K. C.(2019).Strategies for theory construction in nursing.Pearson Education.
24. World Health Organization. (2019). Health professions. Retrieved October 6, 2022, from https://cdn.who.int/media/docs/default-source/health-workforce/dek/classifying-health-workers.pdf?sfvrsn=7b7a472d_3&download=true
25. Zebb, B. J.,Moore, M. C.(2003).Superstitiousness and perceived anxiety control as predictors of psychological distress.Journal of Anxiety Disorders,17(1),115-130.
26. Žeželj, I.,Lazarević, L. B.(2019).Irrational beliefs.Europe Journal of Psychology,15(1),1-7.
27. 祈睿思, C.(2019)。國立中山大學=National Sun Yat-Sen University。
28. 教育部（無日期-a）．迷信．於臺灣閩南語常用詞辭典．2022年6月14日取自https://twblg.dict.edu.tw/holodict_new/ [Ministry of Education, Taiwan, ROC. (n.d.-a). Superstition. In Dictionary of frequently-used Taiwan Minnan. Retrieved June 14, 2022, from https://twblg.dict.edu.tw/holodict_new/]
29. 教育部（無日期-b）．迷信．於國語辭典簡編本（第三版）．2022年6月14日取自https://dict.concised.moe.edu.tw/dictView.jsp?ID=4415 [Ministry of Education, Taiwan, ROC. (n.d.-b). Superstition. In Concised Mandarin Chinese dictionary (3rd ed.). Retrieved June 14, 2022, from https://dict.concised.moe.edu.tw/dictView.jsp?ID=4415]
30. 陳奇弦, C.-H.(2018)。迷信。全球科技管理與教育期刊，7(2)，18-27。
31. 簡守信, S.-H.,林俊龍, C.-L.,賴寧生, N.-S.,陳金城, J.-C.,李宜恭, Y.-K.,何旭爵, H.-C.,李丞永, C.-Y.(2012)。鳳梨的禁忌：迷思或真實。臺灣醫界，55(8)，21-23。