護理人員接受安寧療護在職教育課程需求之探討

The Needs Assessment for Nurses Receiving the Inservice Education Program in Palliative Care

10.3966/102673012015062602001

張惠如(Hui-Ju Chang)；謝素英(Suh-Ing Hsieh)；許麗齡(Li-Ling Hsu)；朱宗藍(Tsung-Lan Chu)；余文彬(Wen-Pin Yu)

安寧療護 ； 護理人員 ； 在職教育 ； 需求評估 ； palliative care ； nursing staff ； in-service educational course ； needs assessment

長庚護理

26卷2期（2015 / 06 / 01）

125 - 136

繁體中文

護理人員在安寧療護團隊中扮演舉足輕重的角色，而現今安寧療護所提供照護對象的疾病項目逐漸擴增，但台灣各醫療院所未能提供有系統性之安寧療護在職教育課程。因此，本研究旨在探討護理人員對安寧療護在職教育之課程需求，並分析護理人員對安寧療護在職教育課程需求之預測因子。本研究為相關性研究，採用橫斷性問卷調查，依據單位護理人員之人數比例，以叢集隨機抽樣北部某醫學中心的護理人員為研究對象，發放「護理人員接受安寧療護在職教育課程需求問卷」，有效問卷數為600份，回收率為97.72%；資料分析使用描述性統計和線性迴歸的推論性統計。護理人員安寧療護課程需求整體平均得分為3.95（SD = 0.81）；需求程度由高至低依序為：「瀕死的準備與照護」、「症狀處理」與「失落、悲傷及家屬失親之痛」、「道德與倫理法律議題」、「疼痛評估與處理」與「溝通」、「護理人員於安寧療護之專業壓力、角色及功能」、「臨終照護」、「安寧療護的文化及靈性因素考量」與「安寧療護概論」。另多元線性迴歸顯示宗教信仰、臨床服務年資、工作單位及參與安寧療護課程之意願為顯著的預測因子，可解釋整體護理人員對於安寧療護在職教育課程需求10.3%變異量。護理人員有高度安寧療護在職教育課程需求，醫療院所可依據安寧療護課程需求之分佈情形與護理人員之宗教、年資、單位與意願規劃安寧療護在職教育課程。

Nurses played an important role in the palliative care team. Palliative care is provided by more and more departments in the hospitals. However, medical facilities in Taiwan have not provided systematic in-service educational courses in palliative care. This study aimed at exploring the in-service educational course needs in palliative care and analyzing the predictors of such needs among nurses. This was a correlational study using cross-sectional survey. The cluster random sampling based on the nurses' proportion of units was used to select nurses from a northern medical center. The In-Service Education Scale in Palliative Care was distributed to the participants. Valid questionnaires were returned by 600 nurses, a response rate of 97.72%. The data were analyzed using descriptive statistics and inferential statistics with linear regression. The mean score of the In-Service Education Scale in Palliative Care among nurses was 3.95 (SD=0.81). The level of needs ranked from high to low included ＂the preparation and care for dying process,＂ ＂symptom management,＂ ＂loss/grief/bereavement management,＂ ＂moral, legal, and ethical issues,＂ ＂pain assessment and intervention＂ and ＂communication,＂ ＂the professional stress, role, and function of nurses in palliative care,＂ ＂end-of-life care,＂ ＂cultural and spiritual considerations in palliative care,＂ and ＂introduction to palliative care.＂ In addition, multiple linear regression showed that the significant predictors for educational needs were religion, working experience, working unit, and willingness of participating in the in-service educational course in palliative care. This model accounted for 10.3% of the variances in nurses' needs for the in-service educational course in palliative care. This study identified a high needs in the in-service educational course in palliative care among nurses. Hence, hospitals can design and plan the in-service educational course in palliative care based on actual demand as well as the nurses' religion, working experiences, working units, and willingness.

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