Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei City 11490, Taiwan.
Department of Nursing, Tri-Service General Hospital, Taipei City 11490, Taiwan.
Int J Environ Res Public Health. 2020 Aug 31;17(17):6350. doi: 10.3390/ijerph17176350.
This study aimed to elucidate the predictors and the effects of path modeling on the knowledge, attitude, and practice toward do-not-resuscitate (DNR) among the Taiwanese nursing staff. This study was a cross-sectional, descriptive design using stratified cluster sampling. We collected data on demographics, knowledge, attitude, and practice as measured by the DNR inventory (KAP-DNR), Mindful Attention Awareness Scale, General Self-Efficacy Scale, and Dispositional Resilience Scale. Participants were 194 nursing staff from a medical center in northern Taiwan in 2019. The results showed that participation in DNR signature and education related to palliative care were significant positive predictors of knowledge toward DNR. The DNR predictors toward attitude included DNR knowledge, mindfulness, self-efficacy, dispositional resilience, and religious belief of nurses. Generally, the critical predictors of DNR practice were DNR attitude, dispositional resilience, and male nurses. In path modeling, we identified that self-efficacy, dispositional resilience, master's degree, and religious belief directly influenced practice constituting DNR. Based on the findings of this study, we propose that nurses should improve their self-efficacy and dispositional resilience through training programs. Encouraging staff to undertake further education and have religious beliefs can enhance the practice of DNR and provide better end-of-life care.
本研究旨在阐明台湾护理人员对不施行心肺复苏术（DNR）的知识、态度和实践的预测因素和路径建模的影响。本研究采用了横断面描述性设计，使用分层聚类抽样。我们收集了人口统计学、知识、态度和实践方面的数据，使用 DNR 清单（KAP-DNR）、正念注意意识量表、一般自我效能感量表和性格韧性量表进行测量。参与者是 2019 年来自台湾北部一家医学中心的 194 名护理人员。结果表明，参与 DNR 签名和与姑息治疗相关的教育是 DNR 知识的显著正向预测因素。DNR 态度的预测因素包括 DNR 知识、正念、自我效能、性格韧性和护士的宗教信仰。一般来说，DNR 实践的关键预测因素是 DNR 态度、性格韧性和男性护士。在路径建模中，我们确定自我效能、性格韧性、硕士学位和宗教信仰直接影响构成 DNR 的实践。基于本研究的结果，我们建议护士通过培训计划提高自我效能和性格韧性。鼓励员工接受进一步的教育和拥有宗教信仰可以增强 DNR 的实践，并提供更好的临终关怀。
