题名

長照服務老人家庭照顧者之安寧緩和療護知識與態度及其影響因素

并列篇名

Exploring the Knowledge and Attitudes Regarding Palliative Care among Family Caregivers of Elders Receiving Long Term Care

DOI

10.6540/NTJN.202303_25(1).0005

作者

呂欣怡(Shin-Yi Lu)；林碧珠(Pi-Chu Lin)；陳逸卉(I-Hui Chen)

关键词

長期照護 ； 家庭照顧者 ； 安寧緩和療護知識 ； 安寧緩和療護態度 ； long term care ； family caregiver ； knowledge of palliative care ； attitudes of palliative care

期刊名称

新臺北護理期刊

卷期/出版年月

25卷1期（2023 / 03 / 01）

页次

46 - 57

内容语文

繁體中文;英文
中文摘要

背景：近年來政府將安寧緩和療護理念推廣至非癌末期病人照顧，然而大多數非癌末期病人對安寧緩和療護的利用率仍偏低。目的：為瞭解接受長照服務老人之家庭照顧者對安寧緩和療護的知識與態度的現況及其影響因素。方法：本研究採橫斷式調查法，在二家護理之家及一家居家護理所收案，收案條件：（1）被照顧老人年齡≧65歲，入住護理之家或接受居家護理服務時間≧三個月；（2）家庭照顧者年齡≧20歲。結果：共收案家庭照顧者370人，安寧緩和療護知識平均得分25.02（standard deviation，SD=3.71），態度平均得分83.44（SD=11.59）。家庭照顧者為大專／大學（β=2.001,p<.001）、研究所（β=3.004,p<.001）、軍公教（β=1.874,p<.001），則安寧緩和療護知識較好。此外，研究所（β=6.514,p<.05）、軍公教（β=3.882,p<.05）、與被照顧老人討論過安寧緩和療護（β=6.222,p<.05），其安寧緩和療護態度較好。結論：推動社區安寧療護照護網絡，須特別強化教育程度較低及農、工職業之家庭照顧者之安寧緩和知識與態度，讓此類家庭照顧者照顧老人時獲得足夠的支持。
英文摘要

Background: The government has been promoting the concept of palliative care to non-cancerous patients. However, the utilization rate of palliative care is still low. Objectives: The purposes of this study were to understand the current status of knowledge of and attitudes toward palliative care among family caregivers of elders receiving long term care, and to explore its influence factors. Methods: This was a cross-sectional survey study. Participants were recruited from two nursing homes and a homecare center with convenience sampling. Criteria of enrollment included: (1) care recipient who was≧65 years old, use long term care services was at least three months; and (2) family caregiver who was≧20 years old. Results: In total, 370 valid questionnaires were collected. The average score of palliative care knowledge was 25.02 (SD = 3.71). The overall average score of attitude was 83.44 (SD = 11.59). Family caregivers whose education level was college/university (β = 2.001, p < .001) or graduate degree (β = 3.004, p < .001), and whose occupation was soldier, government worker, or teacher (β = 1.874, p < .001) had better knowledge of palliative care. Moreover, graduate degree (β = 6.514, p < .05), soldier, government worker, and teacher (β = 3.882, p < .05) and the elders discussed with palliative care (β = 6.222, p < .05) also had better attitudes toward palliative care. Conclusions: Government policies aim to promote community-based hospice and palliative care network. It is necessary to strengthen the knowledge and attitudes of family caregivers with lower education level and agricultural and industrial occupations. Those family caregivers can obtain sufficient support while caring the elders in institutions or at home.
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. 王淑貞,胡文郁,謝至鎠(2017)。老人安寧緩和療護的需求及處置探討。領導護理，18(2)，3-12。
    連結：
  2. 宋宜盉,鐘淑英,吳宏蘭,劉紋妙(2016)。護理之家護理人員對安寧療護知識與態度的探討。安寧療護雜誌，21(1)，30-45。
    連結：
  3. 陳宜倩,張瑋婷,朱芳瑩,游志興(2018)。影響家庭照顧者預立醫療指示之因素。長期照護雜誌，22(2)，1-16。
    連結：
  4. 陳偉熹,侯弘偉,黃仁慶,陳琮華,林宏昇,尹莘玲(2020)。誰決定善終－《安寧緩和醫療條例》中最近親屬的探討。安寧療護雜誌，25(1)，27-38。
    連結：
  5. 蔡佩渝,賴鈺嘉,許正眉(2007)。影響主要照護家屬讓癌症末期病患接受安寧緩和醫療因素之分析。台灣家庭醫學雜誌，17(2)，85-98。
    連結：
  6. 蕭伃伶,劉芳,戈依莉(2020)。居家安寧療護之性別差異。源遠護理，14(2)，11-17。
    連結：
  7. 全國法規資料庫（2020年12月15日）b‧病人自主權利法‧取自https://law.moj.gov.tw/LawClass/LawAll.aspx?pcode=L0020189
  8. 全國法規資料庫（2020年12月15日）a‧安寧緩和醫療條例‧取自https://law.moj.gov.tw/LawClass/LawAll.aspx?pcode=l0020066
  9. Alam, S.,Hannon, B.,Zimmermann, C.(2020).Palliative care for family caregivers.Journal of Clinical Oncology,38(9),926-936.
  10. 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.
  11. Booth, M.,Nash, S.,Banks, C.,Springett, A.(2014).Three approaches to delivering end-of-life education to care homes in a region of south east England.International Journal of Palliative Nursing,20(1),27-35.
  12. Boyd, C. M.,Xue, Q.L.,Simpson, C. F.,Guralnik, J. M.,Fried, L. P.(2005).Frailty, hospitalization, and progression of disability in a cohort of disabled older women.American Journal of Medicine,118(11),1225-1231.
  13. Cohen, J.(1988).Statistical power analysis for the behavioral sciences.Hillsdale, NJ:Erlbaum Associates, Publishers.
  14. Dzingina, M.D.,Higginson, I. J.(2015).Public Health and Palliative Care in 2015.Clinics in Geriatric Medicine,31,253-263.
  15. Ersek, M.,Carpenter, J. G.(2013).Geriatric palliative care in long-term care settings with a focus on nursing homes.Journal of Palliative Medicine,16(10),1180-1187.
  16. Feng, Z.,Elena Glinskaya, E.,Chen, H.,Gong, S.,Qiu, Y.,Xu, J.(2020).Long-term care system for older adults in China: Policy landscape, challenges, and future prospects.Lancet,396(10259),1362-1372.
  17. Froggatt, K. A.,Moore, D. C.,Block, L.V.,Ling, J.,Payn, S. A.(2020).Palliative Care Implementation in Long-Term Care Facilities: European Association for Palliative Care White Paper.Journal of the American Medical Directors Association,21(8),1051-1057.
  18. Heywood, R.(2015).Revisiting advance decision making under the Mental Capacity Act 2005: A tale of mixed massage.Medical Law Review,23(1),81-102.
  19. Li, Q.,Zheng, N. T.,Temkin-Greener, H.(2013).Quality of end-of-life care of long-term nursing home residents with and without dementia.Journal of the American Geriatrics Society,61(7),1066-1073.
  20. Lund, L.,Ross, L.,Petersen, M.A.,Grønvold, M.(2015).The interaction between informal cancer caregivers and health care professionals: A survey of car- egivers’experiences of problems and unmet needs.Support Care Cancer,23(6),1719-1733.
  21. Martina, D.,Lin, C. P.,Kristanti, M. S.,Bramer, W. M.,Mori, M.,Korfage, I. J.,A Heide, A. V.,Rijt, C.,Rietjens, J.(2021).Advance Care Planning in Asia: A Systematic Narrative Review of Healthcare Professionals’ Knowledge, Attitude, and Experience.Journal of the American Medical Directors Association,22(2),349.e1-349.e28.
  22. Palangkaraya, A.,Yong, J.(2009).Population ageing and its implications on aggregate health care demand: empirical evidence from 22 OECD countries.International Journal of Health Care Finance and Economics,9(4),391-402.
  23. Van der Steen, J. T.,Radbruch, L.,Hertogh, C. M. P. M.,de Boer, M. E.,Hughes, J. C.,Larkin, P.,Volicer, L.(2014).White paper defining optimal palliative care in older people with dementia: A Delphi study and recommendations from the European Association for Palliative Care.Palliative Medicine,28(3),197-209.
  24. Wang, T.,Molassiotis, A.,Chung, B.P.,Zheng, S. L.,Huang, H. Q.,Tan, J. U.(2021).A qualitative exploration of the unmet information needs of Chinese advanced cancer patients and their informal caregivers.BMC Palliative Care,20(83),1-16.
  25. Wilson, O.,Gloria Avalos, G.,Dowling, M.(2016).Knowledge of palliative care and attitudes towards nursing the dying patient.British Journal of Nursing,25(11),600-605.
  26. 內政部戶政司（2021）‧人口統計資料：109年縣市死亡人口按死亡地點（按發生）。https://www.ris.gov.tw/app/portal/346
  27. 內政部統計處（2020年12月15日）‧109年第32週內政統計通報‧取自https://www.moi.gov.tw/News_Content.aspx?n=2905&s=139279
  28. 江貞儀,陳妮婉,黃采薇(2013)。探討護理人員對癌末病人使用安寧療護認知與阻礙因素。澄清醫護管理雜誌，9(3)，15-22。
  29. 余尚儒(2011)。社區長照安寧整合連續性照護─實現「老有所終、末有所安」。台灣老年學論壇，12，1-7。
  30. 周希誠,李選,羅旭宜,周裕銓,張梅芳(2006)。某教學醫院護理人員對安寧緩和療護知識、態度及參與工作恴願之探討。中山醫學雜誌，17(1)，23-32。
  31. 邱啟潤,李逸(2014)。從服務使用者的觀點探討居家護理品質。護理暨健康照護研究，10(3)，229-239。
  32. 徐明儀,江蓮瑩(2014)。無效醫療議題之探討。護理雜誌，61(1)，99-103。
  33. 國家衛生研究院（2019）‧台灣安寧緩和療護政策白皮書‧取自https://lib.nhri.edu.tw/NewWeb/nhri/ebook/39000000464078.pdf
  34. 許煌汶,黃麗霞,林淑芬(2008)。雲林地區護理人員的安寧緩和療護觀點。安寧療護雜誌，13(2)，132-155。
  35. 陳宜貞(2014)。中山大學醫務管理研究所。
  36. 陳願任,林益卿(2015)。台灣DNR制度與預立醫囑。家庭醫學與基層醫療，30(11)，326-330。
  37. 曾怡萍(2011)。臺灣大學護理學研究所。
  38. 黃惠美,郭碧照,胡中傑,謝玉玲,黃曉峰(2005)。台中某社區民眾之安寧緩和療護知識及其影響因素。安寧療護雜誌，10(4)，371-383。
  39. 黃惠暄(2014)。屏東縣，美和科技大學。
  40. 趙可式(2002)。行政院衛生署國民健康局委託研究計畫行政院衛生署國民健康局委託研究計畫,行政院衛生署國民健康局。
  41. 衛生福利部統計處（2020年12月15日）‧106年老人狀況調查‧取自https://dep.mohw.gov.tw/DOS/lp-1767-113.html
  42. 賴莉莉(2015)。南投縣，南開科技大學福祉科技與服務管理所。
  43. 魏美珍(2012)。國立臺北教育大學生命教育研究所。
  44. 羅玉岱(2010)。華人文化對生命末期決策的影響。安寧療護雜誌，15(2)，187-195。
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