醫療照護人員對撤除生命末期病人維生醫療之意向及相關因素之探討

The Study of the Intention and Related Factors Toward Withdrawal of Life Sustaining Treatment in Health Care Providers

10.6530/YYN.202203_16(1).0008

張佳雯(Chia-Wen Chang)；黃采薇(Tsai-Wei Huang)

計畫行為理論 ； 醫療照護人員 ； 生命末期 ； 撤除維生醫療 ； Theory of planned behavior ； health care provider ； end of life ； withdrawal of life sustaining treatment

源遠護理

16卷1期（2022 / 03 / 01）

55 - 64

繁體中文

本研究利用行為計畫理論為架構，探討醫療照護人員的態度、主觀規範、知覺行為控制對撤除生命末期病人維生醫療之意向及影響因素。為橫斷式研究設計，以方便取樣方式，選取北部一家區域教學醫院進行研究，使用自擬結構式問卷進行資料收集，問卷內容包括態度8題、主觀規範7題、知覺行為控制10題及行為意向2題等四部份。研究結果顯示：醫療照護人員對於撤除生命末期病人維生醫療的行為意向與態度、主觀規範、知覺行為控制皆達顯著相關。利用邏輯式迴歸，找出影響行為意向的重要因素，而在控制干擾變項後，僅「態度」對行為意向之影響達統計上顯著水準（OR = 1.12, p = 0.02），對於醫療照護人員在撤除維生醫療行為意向影響最大。建議未來可經由安寧相關教育訓練，照顧末期病人經驗提升醫療人員對撤除維生醫療的態度。臨床上及早與家屬進行溝通，提供家屬正確資訊，將能夠共同討論做出最符合病人利益及需求之決策。

This study used a theory of planned behavior as a framework to explore the effect of health care providers' attitudes, subjective norms and perceived behavioral control on their intention to withdraw life-sustaining treatment of end-of-life patients. This research is a cross-sectional research design. Convenience sampling was performed at a regional teaching hospital in northern Taiwan. A self-devised structured questionnaire on attitudes (8 items), subjective norms (7 items), perceived behavioral control (10 items), and behavioral intention (2 items) was used to collect data. The results are shown as follows: Health care providers had a significant correlation with the behavioral intentions and attitudes, subjective norms, and perceived behavioral control for the withdrawal of life sustaining treatment. Logistic regression analysis was conducted to determine crucial factors affecting behavioral intention. After intervening variables were under control, statistical significance was observed only in the effect of attitudes on behavioral intention (OR = 1.12, p = .02), implying that attitudes had the greatest influence on health care providers' behavioral intention to withdraw life-sustaining treatment. It is recommended that the future education and training on palliative care emphasizes on the attitude of health care providers towards withdrawing life sustaining treatment. Early communication with the patient's family members and provide them with correct information. Discuss and make decisions mutually to best meet patient's interests and needs.

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