Department of Nursing, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan, Republic of China.
Department of Nursing, Chang Gung University of Science and Technology, Tao-Yuan, Taiwan, Republic of China.
BMC Palliat Care. 2019 Nov 11;18(1):99. doi: 10.1186/s12904-019-0483-9.
Despite the documented and well known patient benefits of ACP, the completion of ACP, only a minority of patients, during the advanced or EOL stage of their illnesses, receive such care. The misconceptions about ACP for healthcare providers, such as nurses, might become potential barriers to the effective implication of ACP. Also, from the transcultural perspective, it is evident essential to explore Taiwanese nurses' attitudes, knowledge, and actions of ACP. The purposes of this study were to explore the implication of ACP or hospice care for nurses caring for non-cancer chronic illness patients at a regional teaching hospital in Taiwan; and, to identify predictors of those nurses' knowledge, attitudes, and actions toward ACP.
This cross-sectional study with a purposive sample of 218 nurses was conducted at a teaching hospital in southern Taiwan. Structured questionnaires were employed and data were analyzed with descriptive statistics, t-test, one-way ANOVAs, Pearson's correlation and multiple regressions.
16.1% of Taiwanese physicians actively initiated ACP issues or conversations with patients or their family members. Nurses' attitudes toward ACP were fairly positive but their knowledge about ACP was insufficient and actions of ACP were not positively executed. The predictors of ACP-Knowledge (ACP-K) included position title, education hours and lacking of educational training. The predictors of ACP-Attitude (ACP-A) included ACP-K and "fear of patient or family member not accepting", whereas ACP-A, position title, "patients do not feel necessary" and "not sure physician's concern" were the predictors of ACP-Act.
Continuous education and training for nurses regarding ACP needs to be improved by taking those predictors found in this current study into account, and more studies on the nurse's role in ACP also should be further examined.
KAFGH 106-012. Date of registration 1 May 2017.
尽管有文件记录和众所周知的患者从ACP 中受益，但只有少数患者在疾病的晚期或生命末期接受这种护理。医疗保健提供者（如护士）对 ACP 的误解可能成为有效实施 ACP 的潜在障碍。此外，从跨文化的角度来看，探索台湾护士对 ACP 的态度、知识和行为是至关重要的。本研究的目的是探讨在台湾一家地区教学医院照顾非癌症慢性病患者的护士实施 ACP 或临终关怀的情况；并确定影响护士对 ACP 的知识、态度和行为的预测因素。
本研究采用横断面研究，对台湾南部一家教学医院的 218 名护士进行了有针对性的抽样。采用结构问卷进行调查，采用描述性统计、t 检验、单因素方差分析、皮尔逊相关和多元回归进行数据分析。
16.1%的台湾医生主动与患者或其家属讨论 ACP 问题或谈话。护士对 ACP 的态度相当积极，但对 ACP 的知识不足，对 ACP 的行动也没有积极执行。ACP 知识（ACP-K）的预测因素包括职位头衔、教育时间和缺乏教育培训。ACP 态度（ACP-A）的预测因素包括 ACP-K 和“害怕患者或家属不接受”，而 ACP-A、职位头衔、“患者觉得没有必要”和“不确定医生的关心”是 ACP-A 行动的预测因素。
需要根据本研究发现的预测因素，对护士进行持续的 ACP 教育和培训，并进一步研究护士在 ACP 中的角色。
KAFGH 106-012。注册日期 2017 年 5 月 1 日。
