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研究生:蔡麗雅
研究生(外文):Li-Ya Tsai
論文名稱:泌尿科護理人員提供病患性衛教面臨的問題及需要的協助
論文名稱(外文):Problems and needs experienced by urology nurses on teaching sexual health to patients
指導教授:黃秀梨黃秀梨引用關係
指導教授(外文):Shiow-Li Hwang
學位類別:碩士
校院名稱:國立臺灣大學
系所名稱:護理學研究所
學門:醫藥衛生學門
學類:護理學類
論文種類:學術論文
論文出版年:1999
畢業學年度:87
語文別:中文
中文關鍵詞:泌尿科護理人員性衛教面臨的問題需要的協助
外文關鍵詞:urology nursessexual health teachingproblemsneeds
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護理人員在病患的健康照護角色中,強調整體性護理的重要性,也承諾性健康照護是護理的一環,國內外文獻指出護理人員提供病患的性健康照護不足夠,品質有待提升,因而確認干擾或阻礙護理人員提供性健康照護過程的因素益顯重要。國內外相關文獻的探討著重護理人員的性知識、性態度與護理行為間關係的探討,對於泌尿科也尚無文獻報告。本研究因此探討泌尿科護理人員提供病患性衛教面臨問題的發生頻率、困擾程度與需要協助的程度,以提供本土初探性資料作為護理專業發展性健康照護與教育課程安排之參考。
研究採敘述性橫斷式研究調查法,以立意取樣的方式選取北部準醫學或醫學中心工作屆滿三個月的泌尿科女性護理人員共90名,使用結構性問卷『泌尿護理人員提供病患性衛教面臨的問題及需要的協助』進行資料收集,以SPSS for Windows 進行資料處理與統計分析。
研究結果指出大多數護理人員是因病患提出性問題時才與之討論,主動評估病患的性衛教需要而給予性衛教者僅佔少數﹐護理人員提供病患的性衛教仍待加強。因素分析結果歸類出護理人員提供病患性衛教時,面臨來自於病患的反應、環境互動與護理人員準備度等三方面的問題,其中環境互動層面的問題是泌尿科護理人員提供病患性衛教中最常面臨、最為困擾,且最需要協助的部份。護理人員提供病患性衛教面臨問題發生頻率較高的前三項依序為(1)性衛教成效不易追蹤或評值,(2)未建立信任關係通常無法有深入的討論,以及(3)病患不敢吐露他對性方面的疑問;困擾程度較高的前三項問題依次為(1)性衛教成效的評值或追蹤不易,(2)沒有足夠或適當的性衛教資料、教材,以及(3)缺乏安靜、隱私的環境;需要協助的程度較高的前三項問題依次為(1)沒有足夠或適當的性衛教資料、教材,(2)性的衛教層面太廣且複雜,自己不易獨立完成,以及(3)性衛教成效不易評值或追蹤。
逐步複迴歸分析結果發現,護理人員提供病患性衛教面臨問題發生頻率的重要預測變項為『提供性衛教的準備度』、『護理工作總年資』與『提供性衛教積極程度』,可解釋迴歸模式21%變異量;護理人員提供病患性衛教面臨問題困擾程度的重要預測變項為『提供性衛教準備度』﹐可解釋迴歸模式6%變異量;護理人員提供病患性衛教面臨問題需要協助程度重要預測變項為『提供性衛教的準備度』以及『護理工作總年資』﹐可解釋迴歸模式11%變異量。
本研究結果提供泌尿科護理人員於病患性衛教護理情境面臨的問題與需要協助的情形,並作為護理教育及臨床在職教育課程安排之參考,對提升性衛教護理品質有很大的助益。
英文摘要(Abstract)
Human sexuality is an integral part of health care, nurses consider it as a part of their role as a nurse and integrate sexual health care into the holistic care. Previous research has shown that patients'' sexual health care is frequently neglected of nursing practices. It revels that to investigate the barriers and interference nursing process of patients sexual health care is very important. In past years, either overseas studies or civil studies had focused on nurses'' knowledge of and attitudes towards sexuality and the relationship of these with nursing practice, and never about the urology. This study investigated the problems and needs experienced by urology nurses on delivery sexual health teaching of patients care and related factors, and it could be a basic data and information by further improvement of clinical nursing practice or educational programs, then promote the quality of patients sexual health care.
This study used a cross-section survey method and purposive sampling. A total of 90 urology nurses who worked at a medical center hospital in north Taiwan and had been employed for more then three months were selected. Date was collected by a list of 26 items based on former research, in order to explore the problems and needs experienced by urology nurses'' on delivery sexual health teaching of patients care, which were self-administered by subjects. Date was processed by SPSS for Windows software.
This study reveals the major of urology nurses provided sexual health teaching when patients asked sexual problems. Factor analyses resulted in a 3-factor structure with the problems connotation that experienced by urology nurses on delivery sexual health teaching of patients care, which included three factors were related to patients'' reaction, related to relationship and environment, relation to nurses'' provision. The relationship and environment were the major frequent, disturbance, and needs problems experienced by urology nurses on sexual health teaching. The highest frequently problem was "It is difficult to evaluated or follow up sexual health teaching", the 2nd frequently problem was "Neither the trust relationship between nurses and patients, nor furthermore dissuasion", the 3rd frequently problem was "Patients were hesitated to express their sexual problems";The highest disturbance problem was "It is difficult to evaluated or follow up sexual health teaching", the 2nd disturbance problem was " there was insufficient information for sexual teaching" ,and the 3rd disturbance problem was " lack of quite and privacy site for addressed sexual issues with patients;The highest need of assist to deal with the problem was " there was insufficient information for sexual teaching", the 2nd need of assist to deal with the problem was "Urology nurses perceived that the most sexual problems were too complex to be within the realm of nursing practice", and the 3rd problem need of assist to deal with the problem was "" It is difficult to evaluated or follow up sexual health teaching".
Stepwise multiple regression analyses demonstrated the provision of providing sexual teaching, years of nursing services, and the positive degree of providing, were significant variables related to the frequency of the problems experienced by urology nurses on delivery sexual health teaching of patients care, accounting for 21% of the variance. The provisions of providing sexual teach, was significant variable related to the disturbance degree of experienced by urology nurses on delivery sexual health teaching of patients care, accounting for 6% of the variance. The provision of providing sexual teaching and years of nursing service were related to the needs of assist to deal with problems of experienced by urology nurses on delivery sexual health teaching of patients care, accounting for 11% of the variance.
The result of this study may provide an information for understanding the problems and needs as urology nurses on delivery sexual health teaching of patients care. It is a good prior reference for nursing curriculum or continuous education programs, by further making modification to raise the quality of sexual health care for patients.
Key word:urology nurses, sexual health teaching , problems and
needs
目錄
頁次
致 謝--------------------------------------------------- Ⅰ
論文摘要---------------------------------------------------
英文摘要---------------------------------------------------
內容目錄---------------------------------------------------Ⅲ
圖表目錄--------------------------------------------------- Ⅳ
第一章 緒論1
第一節 研究動機及目的------------------------------ 2
第二節 研究問題與研究假設----------------------- 4
第三節 名詞界定---------------------------------------- 5
第二章 文獻查證
第一節 人類性學與發展史--------------------------6
第二節 性健康照護的護理發展------------------- 7
第三節 護理人員在病患性健康照護的專業角色 8
第四節 護理人員題翁病患的性健康照護行為與影響因素------11
第五節 護理人員提供性健康照護面臨的問題----------------13
第六節 護理人員提供性健康照護的需求--------------------15
第三章 研究方法
第一節 研究設計----------------------------------------18
第二節 研究對象與場所----------------------------------19
第三節 研究工具----------------------------------------19
第四節 研究工具的信效度檢定---------------------------- 21
第五節 資料收集過程------------------------------------23
第六節 資料處理與統計分析------------------------------24
第七節 倫理考量----------------------------------------25
第四章 研究結果
第一節 護理人員背景資料分佈情形------------------------30
第二節 護理人員提供病患性衛教面臨的問題與問題發生的頻率40
第三節 護理人員提供病患性衛教面臨問題的困擾程度--------42
第四節 護理人員提供病患性衛教需要協助的程度------------44
第五節 護理人員提供病患性衛教面臨問題的發生頻率、困擾程
度與需要協助的程度之影響因素--------------------52
第五章 討論
第一節 護理人員提供病患性衛教的處理方式----------------61
第二節 護理人員提供病患性衛教面臨的問題與需要的協助----64
第三節 護理人員提供病患性衛教面臨問題的發生頻率、困擾程
度與需要協助的程度與相關影響因素----------------71
第六章 結論與建議
第一節 結論--------------------------------------------75
第二節 護理上的應用------------------------------------77
第三節 研究限制與建議----------------------------------78
參考資料
中文部份------------------------------------------------80
英文部份------------------------------------------------82
附錄
附錄一 問卷內容效度專家名單----------------------------87
附錄二 致護理人員之書面說明及同意書--------------------88
附錄三 研究問卷----------------------------------------89
圖表目錄
頁次
圖3-1 研究的概念架構--------------------------------------18
表3-1 護理人員提供病患性衛教面臨問題的發生頻率量表之因素分
析結果----------------------------------------------26
表3-2 護理人員提供病患性衛教面臨問題的困擾程度量表之因素分
析結果----------------------------------------------27
表3-3 護理人員提供病患性衛教面臨問題需要協助的程度量表之因
素分析結果------------------------------------------28
表3-4 研究工具之內在一致性信度與穩定信度------------------29
表4-1-1 護理人員基本屬性分佈--------------------------------34
表4-1-2 護理人員曾經界受過的性學教育課程--------------------35
表4-1-3 不同醫院等級護理人員的基本屬性之差異分析------------36
表4-1-4 護理人員對提供性衛教的觀點--------------------------37
表4-1-5 病患詢問以及護理人員提供的性衛教內容----------------37
表4-1-6 護理人員提供性衛教的執行方式------------------------38
表4-2-1 護理人員提供病患性衛教面臨的問題--------------------46
表4-2-2 護理人員提供病患性衛教面臨問題的人次排行榜----------47
表4-2-3 護理人員提供病患性衛教面臨問題的發生頻率、困擾程度與
需要協助的程度各方面之得分--------------------------46
表4-2-4護理人員提供性衛教面臨問題的發生頻率之得分及排行榜--48表4-3-1 護理人員提供性衛教面臨問題的困擾程度之得分及排行榜--49表4-4-1護理人員提供性衛教面臨問題需要協助的程度之得分及排行
榜--------------------------------------------------48
表4-5-1 護理人員基本屬性、對性衛教觀點與提供性衛教準備度之相
關的影響--------------------------------------------56
表4-5-2 護理人員教育、宗教及提供性衛教準備度與問題的發生頻率
、困擾程度、需要的協助間之差異性分析----------------57
表4-5-3 護理人員基本屬性、對性衛教觀點及性衛教準備度與問題的
發生頻率、困擾程度、需要的協助間之相關性-------------58
表4-5-4 護理人員提供病患性衛教面臨問題發生頻率的逐步迴歸分析59
表4-5-5 護理人員提供病患性衛教面臨問題困擾程度之逐步回歸分析59
表4-5-5 護理人員提供病患性衛教面臨問題需要協助的程度之逐步回
歸分析-----------------------------------------------59
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