臺灣博碩士論文加值系統

　　本研究要探討的是末期病人在安寧病房住院期間，身為照顧者的家屬為因應各種疾病末期及住院適應等情況所產生的資訊需求。研究目的如下：（一）了解安寧病房中臨終病人的家屬照顧者評估各項資訊的重要性、滿意度為何；（二）評估家屬照顧者有哪些資訊需求；（三）探討家屬照顧者及病人哪些人口學特質及情境因素與資訊需求內容有關。以便針對其特性提供適切的知識與資訊，以作為改善後續病房服務的參考。
　　本研究以研究者自編問卷進行調查研究，以立意取樣選取南部地區設有安寧病房的三所教學醫院中接受安寧照顧服務達一週之末期病患家屬共92名，問卷由受訪者自填。問卷內容包含六個資訊需求的範疇：照顧工作、與病人疾病相關者、社會福利及其他協助、心理社會層面問題、臨終準備與安寧療護、宗教與靈性的解釋，分別探討目前安寧病房中家屬照顧者對各範疇資訊在重要性及滿意度上的感受程度，以及是否仍有覺得重要但未滿足的資訊需求，並探討各範疇資訊需求與個人相關因素及情境相關因素之間的關係。
　　研究結果發現，家屬照顧者認為最重要的資訊範疇為與疾病相關的資訊，而滿意度最高的是照顧工作相關資訊。而照顧者的資訊需求，即覺得重要但不滿意的資訊，以如何處理心理社會層面的問題為主，尤其有四成以上的照顧者反應出有如何處理病患情緒困擾的資訊需求。
　　影響照顧者資訊需求的個人相關因素以病患的教育水準影響最廣，而年輕的病患，其家屬照顧者在社會福利的資訊需求高，且認為靈性宗教資訊更重要；而家屬照顧者的性別、年齡、教育水準、宗教信仰也對六個資訊範疇的重要性有不同的影響。情境因素方面，接受過的治療類型會影響家屬照顧者評估不同範疇資訊的重要性，另外，醫病溝通時若多由照顧者陳述，則他們在照顧工作及心理社會兩範疇資訊有較多未滿足的部分；照顧者過去的照顧經驗則會使他們評估照顧工作及安寧臨終兩範疇的資訊有更高的重要性。
　　本研究結果可提供安寧療護團隊設計更有效的衛教方案，並提供家屬照顧者在病人住院期間更適切的資訊。

摘要………………………………………………………………………I
誌謝………………………………………………………………………II
目次………………………………………………………………………IV
表次………………………………………………………………………VI
圖次………………………………………………………………………VI
目 次
第一章 導言……………………………………………………………1
　第一節 研究背景……………………………………………………1
　第二節 家屬照顧者的資訊需求……………………………………4
　第三節 研究架構……………………………………………………8
　第四節 研究目的……………………………………………………9
　第五節 名詞釋義…………………………………………………10
第二章 研究方法……………………………………………………11
　第一節 研究對象…………………………………………………11
　第二節 研究工具…………………………………………………12
　第三節 研究步驟…………………………………………………18
　第三節 資料分析方法……………………………………………19
第三章 結果…………………………………………………………21
　第一節 受訪者基本資料分析……………………………………21
　第二節 安寧病房家屬照顧者的資訊需求狀況…………………24
　第三節 影響家屬照顧者資訊需求的相關因素…………………31
　第四節 結論………………………………………………………42
第四章 討論…………………………………………………………44
　第一節 研究對象的基本資料……………………………………45
　第二節 安寧病房中家屬照顧者的資訊需求狀況………………48
　第三節 影響家屬照顧者資訊需求的相關因素…………………51
　第四節 研究限制及未來研究方向的建議………………………54
　第五節 貢獻………………………………………………………55
參考文獻………………………………………………………………57
　中文參考文獻………………………………………………………57
　英文參考文獻………………………………………………………59
　網路參考資料………………………………………………………66
附錄一　訪談初稿……………………………………………………67
附錄二　專家效度名單………………………………………………69
附錄三　專家效度分數與建議………………………………………70
附錄四　正式施測問卷………………………………………………75
表 次
表2-1 訪談家屬照顧者的基本資料…………………………………14
表2-2 原始問卷測得專家效度結果…………………………………16
表2-3 家屬照顧者資訊需求問卷各範疇及總量表之
　　　Cronbach’s α信度係數……………………………………17
表3-1 由家屬照顧者填寫之患者基本特性…………………………22
表3-2 家屬照顧者基本特性之分布…………………………………23
表3-3 家屬照顧者整體資訊需求中各範疇之重要性排序…………25
表3-4 家屬照顧者資訊重要性名列前五名之排序狀況……………25
表3-5 家屬照顧者整體資訊需求中各範疇之滿意度排序…………27
表3-6 家屬照顧者資訊滿意度名列前五名之排序狀況……………27
表3-7 所有受訪者反應出有需求的資訊項目，前20位……………29
表3-8 家屬照顧者反應出各項目資訊需求的強度，前20位………30
表3-9 單因子分析中與資訊重要性相關的因素……………………33
表3-10 單因子分析中與資訊需求強度相關的因素………………35
表3-11 影響家屬照顧者評估資訊重要性的相關因素……………38
表3-12 影響家屬照顧者資訊需求的個人相關因素………………41
圖 次
圖1-1 初診斷癌症病患的資訊需求理論架構………………………6
圖1-2 安寧病房中家屬照顧者的資訊需求理論架構………………8

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