安寧與非安寧居家護理型態之照顧者預立醫囑知識與簽署意向差異

Knowledge of and Intention to Engage in Advance Care Planning Among Providers of Hospice and Nonhospice Home Care

10.6142/VGHN.201712_34(4).0007

陳儀倩(Yi-Chien Chen)；杜淑文(Shu-Wen Tu)；張瑋婷(Wei-Ting Chang)

居家照顧者 ； 預立醫囑計畫 ； 安寧緩和醫療 ； 知識 ； caregivers ； advance care planning ； hospice palliative medicine ； knowledge

榮總護理

34卷4期（2017 / 12 / 01）

380 - 391

繁體中文

預立醫囑計畫與安寧緩和醫療儼然已是一項全球性、無國界的公共問題與積極推行的政策，且最能反應個人的醫療決策。本文旨在探討安寧與非安寧二種居家護理型態之照顧者在預立醫囑知識與簽署意向之差異與相關性。採橫斷式描述性研究，花蓮縣南區接受居家護理服務之照顧者，以預立醫囑之「知識」與「簽署意向」量表進行資料收集。有效問卷中接受安寧居家護理有86位，非安寧居家護理有125位。運用SPSS 21.0進行統計分析，採用描述性統計、t檢定、單因子變異數分析、皮爾森相關及複迴歸分析。知識與簽署意向呈強烈相關。安寧與非安寧二種居家護理型態之照顧者，共同影響其簽署意向的重要因子為預立醫囑之「知識」，且達統計上顯著性差異(p= .001)。精進推廣預立醫囑的知識，是政府單位須著墨的重點，以因應照顧者對於照顧對象病況惡化時，如何適當選擇治療模式及減輕照顧者做醫療決策過程中的負荷。

Advance care planning and hospice palliative medicine are global policies that can reflect patient decisions. This study analyzed the correlation between the knowledge of advance care planning and the intention to engage in it among caregivers whose family member was receiving hospice care or nonhospice home care. A cross-sectional and descriptive survey was used. The questionnaire comprised two subscales concerning knowledge of and intention to engage in advance care planning. A total of 211 participants, including 86 caregivers providing hospice home care and 125 caregivers providing nonhospice home care, were recruited from four townships in southern Hualien County through simple random sampling. Data were analyzed using descriptive statistics, the t test, one-way ANOVA, Pearson correlation, and multiple regression analysis by employing SPSS 21.0. Knowledge and intention were strongly related. Knowledge was a significant predictor of the intention to engage in advance care planning. It is crucial for policy makers to identify how to promote hospice care to the public, to help caregivers choose the correct care plan and to reduce the pressure on the caregiver during decision-making when the patient's condition has deteriorated.

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