School of Nursing, 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. 2021 Jan 30;18(3):1236. doi: 10.3390/ijerph18031236.
This study aimed to expand on previous research elucidating the effects of dispositional resilience and self-efficacy on practice in advanced care planning (ACP) of terminally ill patients among Taiwanese nurses using path modeling. This cross-sectional study was conducted using cluster sampling. Data were collected using demographics, nurses' knowledge, attitude, and practice of ACP (KAP-ACP) inventory, Dispositional Resilience Scale, and General Self-Efficacy Scale. A total of 266 nurses from a tertiary medical center in northern Taiwan participated in this study in 2019. The results showed that gender and ward were significant K-ACP predictors among nurses. The ACP knowledge, ward, and experience of caring for terminally ill friends or relatives were significant A-ACP predictors, whereas ACP attitudes, dispositional resilience, self-efficacy, ward, and the frequency of caring for terminally ill patients were the key predictors of P-ACP. The path modeling showed that dispositional resilience; self-efficacy; medical, surgical, hematology and oncology wards; previous experience in caring for terminally ill friends or relatives; participating in the do-not-resuscitate signature; and the frequency of caring for terminally ill patients directly influenced ACP practices. We recommend that nurses enhance their dispositional resilience and self-efficacy, which may encourage them to appreciate the value of ACP practice of terminally ill patients and improve the quality of care.
本研究旨在扩展先前的研究，利用路径建模探讨台湾护士的性格韧性和自我效能对终末期患者高级医疗照护计划（ACP）实践的影响。这是一项横断面研究，采用聚类抽样。数据通过人口统计学、护士对 ACP 的知识、态度和实践（KAP-ACP）量表、性格韧性量表和一般自我效能感量表收集。2019 年，台湾北部一家三甲医院的 266 名护士参与了这项研究。结果表明，性别和病房是护士 K-ACP 的显著预测因素。ACP 知识、病房以及照顾临终朋友或亲属的经验是 A-ACP 的显著预测因素，而 ACP 态度、性格韧性、自我效能、病房以及照顾临终患者的频率是 P-ACP 的关键预测因素。路径模型显示，性格韧性、自我效能、内科、外科、血液肿瘤病房、照顾临终朋友或亲属的先前经验、参与不复苏签名以及照顾临终患者的频率直接影响 ACP 实践。我们建议护士增强性格韧性和自我效能，这可能鼓励他们重视终末期患者 ACP 实践，并提高护理质量。
