台湾地区护理人员对缓和医疗谘商服务的知识、态度和实践之路径模式：一项横断性研究。
Path modeling of knowledge, attitude and practice toward palliative care consultation service among Taiwanese nursing staff: a cross-sectional study.
机构信息
School of Nursing, National Defense Medical Center, No.161, Sec. 6, Minquan E. Rd., Neihu Dist., Taipei City, 114, Taiwan.
Department of Nursing, Tri-Service General Hospital, Taipei City, Taiwan.
出版信息
BMC Palliat Care. 2017 Aug 17;16(1):42. doi: 10.1186/s12904-017-0228-6.
BACKGROUND
The Taiwanese government has promoted palliative care consultation services (PCCS) to support terminally ill patients in acute ward settings to receive palliative care since 2005. Such an intervention can enhance the quality of life and dignity of terminally ill patients. However, research focusing on the relationship between the knowledge, attitude and practice of a PCCS using path modelling in nursing staff is limited. Therefore, the aim of this study was to elucidate the effect of path modeling on the knowledge, attitude and practice toward PCCS in Taiwanese nursing staff.
METHODS
This was a cross-sectional, descriptive study design using convenience sampling. Data collected included demographics, knowledge, attitude and practice as measured by the PCCS inventory (KAP-PCCSI). Two hundred and eighty-four nursing staff from a medical center in northern Taiwan participated in the study in 2013. We performed descriptive statistics, regression analysis, and path modeling using SPSS 19.0 and set p < 0.05 as the statistical significance threshold.
RESULTS
The results showed that the identical factor significantly associated with knowledge, attitude, and practice toward PCCS among nurses was the frequency of contact with PCCS. In addition, higher level of knowledge toward PCCS was associated with working in haematology and oncology wards, and participation in education related to palliative care. A more positive attitude toward PCCS was associated with working in a haematology and oncology ward, and experience of friends or relatives dying. Higher level of practice toward PCCS was associated with nurses who participated in education related to palliative care. In the path modeling, we found that holders of a master's degree indirectly positive affected practice toward PCCS. Possession of a bachelor degree or above, being single, working within a haematology and oncology ward, and frequency of contact with PCCS positively affected practice toward PCCS.
CONCLUSIONS
Based on this study, it is proposed that consultation with PCCS has a positive impact on the care of terminally ill patients. Encouragement of staff to undertake further education can improve the practice of ward staff providing palliative care.
背景
自 2005 年以来，台湾政府一直在推广缓和医疗咨询服务（PCCS），以支持急性病房环境中的终末期患者接受缓和医疗。这种干预可以提高终末期患者的生活质量和尊严。然而，关于使用路径建模研究护理人员对 PCCS 的知识、态度和实践之间关系的研究有限。因此，本研究旨在阐明路径建模对台湾护理人员对 PCCS 的知识、态度和实践的影响。
方法
这是一项使用便利抽样的横断面描述性研究设计。数据收集包括人口统计学信息、知识、态度和实践，使用缓和医疗咨询服务调查问卷（KAP-PCCSI）进行测量。2013 年，我们从台湾北部的一家医疗中心招募了 284 名护理人员参与研究。我们使用 SPSS 19.0 进行描述性统计、回归分析和路径建模，并将 p < 0.05 作为统计学显著性阈值。
结果
结果表明，护士对 PCCS 的知识、态度和实践具有相同影响的因素是与 PCCS 接触的频率。此外，对 PCCS 的知识水平较高与在血液学和肿瘤科工作以及参与与缓和医疗相关的教育有关。对 PCCS 的态度越积极与在血液学和肿瘤科工作以及朋友或亲戚去世的经历有关。对 PCCS 的实践水平较高与参与与缓和医疗相关的教育的护士有关。在路径建模中，我们发现，硕士学位持有者间接对 PCCS 的实践产生积极影响。拥有学士学位或以上学历、单身、在血液学和肿瘤科工作以及与 PCCS 的接触频率较高与 PCCS 的实践呈正相关。
结论
基于本研究，建议缓和医疗咨询服务对终末期患者的护理有积极影响。鼓励员工接受进一步教育可以提高病房工作人员提供缓和医疗的实践水平。
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