题名

建構護理人員對呼吸器依賴患者長期照護知識之在職教育需求量表

并列篇名

Constructing the Scale of Need Assessment for In-Service Education in Long-Term Care Knowledge for Ventilator-Dependent Patients

DOI

10.3966/102673012017032801002

作者

林純麗(Chun-Li Lin);謝素英(Suh-Ing Hsieh);許麗齡(Li-Ling Hsu)

关键词

長期照護 ; 呼吸器依賴 ; 在職教育 ; 需求評估 ; long-term care ; ventilator dependent ; in-service education ; need assessment

期刊名称

長庚護理

卷期/出版年月

28卷1期(2017 / 03 / 01)

页次

12 - 24

内容语文

繁體中文

中文摘要

背景:現今醫療發達,使呼吸器依賴患者逐年增加,臨床護理人員須具備呼吸器依賴的相關長期照護知能,以提升患者長期照護品質。目的:本研究旨在建構護理人員對呼吸器依賴患者長期照護知識之在職教育需求量表。方法:本研究採橫斷式調查法。研究工具為自擬的結構式問卷,發放問卷共260份,有效問卷254份,有效回收率97.69%。資料採用探索性因素分析的主軸因素分析(Principal Axis Factoring),並以斜交轉軸的promax rotation萃取因素。結果:以主軸因素分析發現八個因素分別為:常見健康問題之評估與處理;呼吸器依賴患者的相關照護需求及技巧;長期照護的相關法規及政策;醫療、社會資源運用;呼吸器依賴患者長期照護概念;呼吸器依賴長期照護安置;呼吸器依賴患者之照護措施,以及呼吸器模式相關概念,共解釋76.29%變異量。結論:本研究提出護理人員對呼吸器依賴患者長期照護知識的在職教育需求之八大因素,可做為護理人員在職教育課程規劃之參考。

英文摘要

Background: Advancements in today's medical field have resulted in a steady increase in the number of ventilator-dependent patients. Clinical nurses need to possess adequate knowledge regarding long-term care for ventilator-dependent patients in order to enhance the quality of long-term nursing care. Purpose: The purpose of this study was to construct a rating scale for measuring the needs of nurses for in-service education to enhance their knowledge regarding long-term care for ventilator-dependent patients. Methods: Self-designed structured questionnaires were used to conduct the cross-sectional survey. A total of 260 questionnaires were released, and 254 valid questionnaires were returned, registering a 97.69% return rate. Data were analyzed with exploratory factor analysis method using principal axis factoring, and factor extraction with oblique promax rotation was performed. Results: Principal axis factoring identified eight factors, including assessment and treatment of common health issues, nursing care needs for ventilator-dependent patients and the skills involved in the care of such patients, regulations and policies related to long-term care, applications of medical and social resources, concepts related to long-term care of ventilator-dependent patients, long-term care placement for ventilator-dependent patients, care measures for ventilator-dependent patients, and ventilation-related concepts, accounting for 76.29% of the variations. Conclusion: This study identified eight major factors affecting the needs of nurses for in-service education to enhance their knowledge of long-term care for ventilator-dependent patients, which might be of use to the future planning of in-service nursing education.

主题分类 醫藥衛生 > 預防保健與衛生學
醫藥衛生 > 社會醫學
参考文献
  1. 陳杏雯、許重梅、林惠釧、葉美玲(2010)。非計畫性成功拔除氣管之影響分析。醫護科技期刊,12(4),290-298。
    連結:
  2. 陳國瑚、陳麗如、蘇喜(2006)。護理人員對護理工作認知與離職傾向之探討。台灣衛誌,25(3),177-188。
    連結:
  3. Algera, M.,Francke, A. L.,Kerkstra, A.,Van Der Zee, J.(2004).Home care needs of patients with long term conditions: Literature review.Journal of Advanced Nursing,46(4),417-429.
  4. Creative Research Systems. (2012). The survey system: Sample size calculator. Retrieved from http://www.surveysystem.com/sscalc.htm
  5. De Vaus, D. A.(1986).Surveys in social research.London:Allen & Unwin.
  6. Hermans, G.,Agten, A.,Testelmans, D.,Decramer, M.,Gayan-Ramirez, G.(2010).Increased duration of mechanical ventilation is associated with decreased diaphragmatic force: A prospective observational study.Critical Care,14(4),R127.
  7. Hung, M. C.,Lu, H. M.,Chen, L.,Hu, F. C.,Chan, S. Y.,Yan, Y. H.,Yu C. J.(2011).Life expectancies and incidence rates of patients under prolonged mechanical ventilation: A population-based study during 1998-2007 in Taiwan.Critical Care,15(2),R107.
  8. MacIntyre, N. R.,Epstein, S. K.,Carson, S.,Christopher, K.,Muldoon, S.(2005).Management of patients requiring prolonged mechanical ventilation: Report of a NAMDRC consensus conference.Chest,128(6),3937-3954.
  9. Nelson, J. E.,Mercado, A. F.,Camhi, S. L.,Tandon, N.,Wallenstein, S.,August, G. I.(2007).Communication about chronic critical illness.Archives of Internal Medicine,167(22),2509-2515.
  10. Pett, M. A.,Lackey, N. R.,Sullivan, J. J.(2003).Making sense of factor analysis: The use of factor analysis for instrument development in health care research.Thousand Oaks, CA:Sage.
  11. Rose, L.,Baldwin, I.,Crawford, T.,Parke, R.(2010).Semirecumbent positioning in ventilator-dependent patients: A multicenter, observational study.American Journal of Critical Care,19(6),100-108.
  12. Tabachnick, B. G.,Fidell, L. S.(2007).Using multivariate statistics.New York, NY:Pearson.
  13. 中央健康保險署(2013).呼吸器依賴患者整合性照護試辦計畫:長期呼吸器依賴患者權益說明. 取自http://www.nhi.gov.tw/webdata/webdata.aspx?menu=8&menu_id=498&webdata_id=942 [National Health Insurance Administration, Ministry of Health and Welfare, Taiwan, ROC. (2013). Integrated delivery system: Description of rights and interests for long-term ventilator-dependent patients. Retrieved from http://www.nhi.gov.tw/webdata/webdata.aspx?menu=8&menu_id=498&webdata_id=942]
  14. 王中慧、洪秀玉、孫培蕾、伍麗珠(2012)。降低氣管內管留置措施不完整率。領導護理,13(2),103-116。
  15. 王文璀(2011)。台中=Taichung City, Taiwan, ROC.,中臺科技大學健康產業管理研究所=Central Taiwan University of Science and Technology。
  16. 王榮德(2016)。長期使用呼吸器維生之抉擇。臺灣醫界,59(3),40-43。
  17. 行政院衛生署(2000),中央健康保險局公告呼吸器依賴患者整合性照護前瞻性支付方式試辦計畫。衛生署公報,29 ,21-26。[Ministry of Health and Welfare, Taiwan, ROC. (2000). Announcement of the Integrated Delivery System from Bureau of National Health Insurance. Ministry of Health and Welfare Gazette, 29, 21-26.]
  18. 吳清平、楊式興(2011)。台灣呼吸器長期使用概況。醫療審議相關論述,1-18。
  19. 李彩緣、徐慧娟、周怡伶、陳鈺如(2012)。中部某醫學中心護理人員對老人態度及照顧意願之探討。護理暨健康照護研究,8(4),297 -305。
  20. 林四海 (2011)。不同照顧場所之中風失能老人復健照護利用及其長期照護政策意涵。健康管理學刊,9(1),1-16。
  21. 林錦儷、林惠茹、林為森(2012)。呼吸器依賴患者之主要照顧者的照顧需求探討。呼吸治療,11(2),81。
  22. 禹美君(2012)。台北=Taipei City, Taiwan, ROC.,國立陽明大學=National Yang-Ming University。
  23. 胡月娟、彭孃慧、劉新莉、劉紋妙、林麗鳳、鍾淑英、邱子易(2014)。護理研究過程與實務。新北市=New Taipei City:新文京=New Wun Ch。
  24. 范淑珍、黃月嬌、莊寶玉(2005)。置放口內氣管內管病愚臉部皮膚暨口腔黏膜組織完整性缺損改善方案。護理雜誌,52(2),39-47。
  25. 張秀琳(2006)。一位支氣管擴張症病患急性呼吸衰竭護理經驗。慈濟護理雜誌,5(4),126-136。
  26. 郭俊宏(2009)。長期照護機構整體服務品質研究 中部某照護機構為例。光田醫學雜誌,4(7),23-40。
  27. 陳慧秦、鄭文輝、林孟志(2008)。由家屬的角度探討長期呼吸器依賴患者的照護問題。呼吸治療,7,1-19。
  28. 陸敏清(2013)。淺論我國長期照護服務法草案。長期照護雜誌,17(3),283-296。
  29. 鄭婉如、古雅如、馬瑞菊(2010)。一位呼吸衰竭插管病患急性疼痛之護理經驗。領導護理,11(3),46-58。
  30. 謝景祥、李元墩、周蕙苓(2013)。不同背景之基層護理人員對繼續教育課程成效認知之探討。澄清醫護管理雜誌,9(2),33-39。