Lien Ru-Yu, Lu Shu-Fen, Wang Yuan, Chin Shu-I, Shiung Tao-Fen
MSN, RN, Assistant Head Nurse, Department of Nursing, Taipei Veterans General Hospital, Taiwan, ROC.
MSN, RN, Head Nurse, Department of Nursing, Taipei Veterans General Hospital, Taiwan, ROC.
Hu Li Za Zhi. 2020 Oct;67(5):33-43. doi: 10.6224/JN.202010_67(5).06.
Critical care nurses must often care for patients who are dying and their families. Thus, understanding the self-efficacy and life attitudes of nursing staff in the ICU in response to death is important to the development and provision of relevant education and training.
This study was designed to explore the self-efficacy of ICU nurses in response to death and related predictive factors.
This was a cross-sectional research study. The subjects were 216 nurses in the adult ICU of a medical center in northern Taiwan. The research tools used included the death coping self-efficacy scale and the life attitude scale. Data were analyzed using Pearson's correlation, t-test, one-way ANOVA, and multiple regression.
The results showed: 1. In terms of death coping self-efficacy, the mean score was 112.0 ± 14.3, with the highest scoring subscale, hospice care, earning a mean score of 51.1 ± 6.3. In terms of life attitude, the mean score was 128.9 ± 13.8, with the highest scoring subscale, life autonomy, earning a mean score of 24.0 ± 3.2. 2. Nurses with experiences of withdrawal of life support had better coping efficacy (t = 1.94, p = .05) and those with a graduate degree or above earned a better average life attitude score than those educated to the university / junior college level. 3. Age and ICU seniority were found to correlate positively with grief-related coping skills (r = .241- .315), with the life-attitude subscales of aspiring, life-autonomy, love, and caring showing positive correlations with death coping self-efficacy (r = .138- .482). 4. The predictors found in this study for death coping self-efficacy were age, aspiring, life-autonomy, love, and caring, with a total explained variance of 30.1% (F = 12.78, p < .001).
The results of this study indicate that education level and having hospice care experience are both significant predictors of life attitude in ICU nurses, which is a factor that is known to affect self-efficacy in response to death. Life attitude and hospice care training programs for ICU nurses should be promoted to foster positive life attitudes and thereby enhance self-efficacy in response to death to improve the quality of intensive clinical care.
重症护理护士常常需要照顾濒死患者及其家属。因此,了解重症监护病房(ICU)护理人员面对死亡时的自我效能感和生活态度,对于开展和提供相关教育与培训十分重要。
本研究旨在探讨ICU护士面对死亡时的自我效能感及相关预测因素。
这是一项横断面研究。研究对象为台湾北部某医疗中心成人ICU的216名护士。所使用的研究工具包括死亡应对自我效能量表和生活态度量表。数据采用Pearson相关性分析、t检验、单因素方差分析和多元回归进行分析。
结果显示:1. 在死亡应对自我效能方面,平均分为112.0±14.3,得分最高的子量表为临终关怀,平均分为51.1±6.3。在生活态度方面,平均分为128.9±13.8,得分最高的子量表为生活自主性,平均分为24.0±3.2。2. 有生命支持撤除经历的护士应对效能更好(t = 1.94,p = 0.05),研究生及以上学历的护士平均生活态度得分高于本科/大专学历的护士。3. 年龄和ICU工作年限与悲伤相关应对技能呈正相关(r = 0.241 - 0.315),有抱负、生活自主性、爱和关怀等生活态度子量表与死亡应对自我效能呈正相关(r = 0.138 - 0.482)。4. 本研究中发现的死亡应对自我效能的预测因素为年龄、有抱负、生活自主性、爱和关怀,总解释方差为30.1%(F = 12.78,p < 0.001)。
本研究结果表明,教育水平和有临终关怀经验都是ICU护士生活态度的重要预测因素,而生活态度是已知影响面对死亡时自我效能感的一个因素。应推广针对ICU护士的生活态度和临终关怀培训项目,以培养积极的生活态度,从而提高面对死亡时的自我效能感,改善重症临床护理质量。