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研究生:陳瀅淳
研究生(外文):Chen Ying-Chun
論文名稱:臨床護理人員在壓瘡傷口照護的認識、執行及相關因素之探討
論文名稱(外文):Knowledge and Interventional behaviors of Nurses on Pressure Ulcer Care
指導教授:邱艷芬邱艷芬引用關係
指導教授(外文):Chao Yann-Fen
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:2001
畢業學年度:89
語文別:中文
論文頁數:103
中文關鍵詞:壓瘡傷口照護知識行為
外文關鍵詞:pressure ulcer careknowledgebehavior
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本研究目的在探討臨床護理人員在壓瘡傷口照護的認識、執行及相關因素。採描述性研究法,以立意取樣方式,選取中部醫學中心、區域醫院及地區醫院三家之內、外科病房及成人內、外科加護病房N0-N4共248位臨床護理人員,以自擬的結構式「壓瘡傷口照護知識問卷」與「壓瘡傷口照護行為問卷」收集資料。所得資料以t-Test、one way ANOVA、Chi-square及Pearson correlation進行檢定分析。
研究結果發現:在壓瘡傷口照護的認識方面,護理人員的平均得分百分比僅有44.7%,近九成的護理人員在問卷的答對率不到60%。在認識情形的影響因素方面,護理人員年齡大於25歲、大學以上學歷、工作年資5年以上、任職醫學中心或區域醫院及最近一年曾經參加壓瘡傷口照護相關課程者,對壓瘡傷口照護有較好的認識。
在壓瘡傷口照護的執行方面,護理人員經常以優碘消毒無感染跡象的壓瘡傷口,較少以生理食鹽水清潔壓瘡傷口;針對無壞死組織、非感染及少量滲液之第二級壓瘡傷口的敷料使用方面,以將傷口暴露在空氣中、乾紗布覆蓋或噴灑粉狀製劑三種會造成傷口乾燥的方法之平均執行頻率多於使用可以維持傷口濕潤的生理食鹽水紗布濕敷、薄膜或親水性敷料。在執行情形的影響因素方面,護理人員的年齡、工作年資、醫院層級、最近一年是否研讀壓瘡傷口照護相關文獻及設備會對壓瘡傷口照護行為造成顯著的差異。
至於臨床護理人員在壓瘡傷口照護認識與執行情形之相關性方面,護理人員在清潔劑與消毒劑、按摩、氣墊圈及烤燈的知識與使用優碘、按摩、氣墊圈及烤燈的執行頻率呈負相關,其他行為則受包括年齡、工作年資、醫院層級等非認知因素的影響。
本研究結果除了可以提供臨床護理人員對壓瘡傷口照護的瞭解外,還能夠作為護理教師或專家編寫壓瘡傷口照護教材、護理行政者規劃在職教育、病房政策及請領壓瘡傷口照護設備之參考,以期增進壓瘡傷口的照護品質。
The purpose of this study was to investigate the knowledge and interventional behaviors of nurses on pressure ulcer care. This descriptive survey study was carried out in a medical center, a regional hospital and a local hospital in Taichung, Taiwan. A cross-section research design and purposive sampling were adopted. Two hundred and forty eight RNs from medical wards, surgical wards and adult ICUs were enrolled. They filled out a set of questionnaires regarding knowledge and interventional behaviors on pressure ulcer care developed by the researcher. The major stastistical procedures applied in data management were mean, standard deviation, t-test, one way ANOVA, Chi-square and Pearson correlation. The results were as followed:
The mean correct rate of the nurses on knowledge of pressure ulcer care was 44.7%. Topic which nurses had the highest correct ratewas “maintaining wound moisture” (61.1%). Topic which nurses had the lowest correct rate was “the usage of heat light” (17.3%). Higher knowledge scores were in nurses who: (1) were older than 25 years old, (2) had a bachelor or master degree, (3) had work experience more than 5 years in a medical center or regional hospital and attended classes about pressure ulcer care within the previous year.
Nurses usually cleaned non-infective pressure ulcer with povidone-iodine instead of with normal saline(mean performance rate : 75.0% vs. 34.2%). In non-necrotic and non-infective pressure ulcers with small amount exudate, nurses selected to “expose wound to the air”, “apply gauze or powder” more often than to apply “wet dressings”, “film”, or “hydrocolloid dressings”.
The significant factors influencing the nurses’ interventional behaviors of pressure ulcer care were: age, work experience, the level of hospitals, nurses’ private study and materials/equipments available in the unit.
The knowledge score on disinfectants, massage, donut cushions and heat light of the nurses had negative correlations with the performance rate on applying povidone-iodine, massage, donut cushions and heat light usage.
The results of this study suggest that, in order to increase knowledge of pressure ulcer care and interventional behaviors based on this concept, the education level of student nurses and nurses should be enhanced. The information provided by this study can serve as a good reference in planning school and on-job education for student nurses and nurses.
內容目錄
中文摘要…………………………………………………………… i
英文摘要.............................................. iii
內容目錄…………………………………………………………… v
表目錄…………………………………………………………………… viii
第一章 緒論
第一節 研究動機與目的…………………………………………… 1
第二節 研究問題…………………………………………………… 2
第三節 研究範圍…………………………………………………… 2
第四節 研究意義…………………………………………………… 3
第二章 文獻查證與概念架構
第一節 壓瘡傷口照護的變革……………………………………… 4
第二節 臨床護理人員在壓瘡傷口照護的認識情形……………… 10
第三節 臨床護理人員在壓瘡傷口照護認識之影響因素………… 11
第四節 臨床護理人員對壓瘡傷口照護的執行情形……………… 12
第五節 臨床護理人員對壓瘡傷口照護執行之影響因素………… 13
第六節 概念架構…………………………………………………… 15
第七節 名詞定義…………………………………………………… 15
第三章 研究方法
第一節 研究設計…………………………………………………… 17
第二節 研究對象…………………………………………………… 17
第三節 資料收集過程……………………………………………… 17
第四節 研究工具…………………………………………………… 18
第五節 研究工具的信效度控制…………………………………… 19
第六節 資料分析…………………………………………………… 21
第七節 研究對象的權益保護……………………………………… 22
第四章 研究結果
第一節 研究對象的基本資料……………………………………… 23
第二節 臨床護理人員在壓瘡傷口照護的認識情形……………… 24
第三節 臨床護理人員在壓瘡傷口照護認識情形之影響因素…… 26
第四節 臨床護理人員在壓瘡傷口照護的執行情形……………… 31
第五節 臨床護理人員在壓瘡傷口照護執行情形之影響因素…… 33
第六節 臨床護理人員在壓瘡傷口照護的認識與執行之相關性… 41
第五章 討論
第一節 臨床護理人員在壓瘡傷口照護的認識情形……………… 43
第二節 臨床護理人員在壓瘡傷口照護認識情形之影響因素…… 46
第三節 臨床護理人員在壓瘡傷口照護的執行情形……………… 48
第四節 臨床護理人員在壓瘡傷口照護執行情形之影響因素…… 49
第五節 臨床護理人員在壓瘡傷口照護的認識與執行之相關性… 52
第六章 結論與建議
第一節 結論………………………………………………………… 53
第二節 護理之應用………………………………………………… 56
第三節 研究之限制與建議……………………………………… 57
參考文獻
中文部分…………………………………………………………… 59
英文部分…………………………………………………………… 60
表………………………………………………………………………… 65
附錄
附錄一 研究問卷內容專家效度名單……………………………… 96
附錄二 專家內容效度檢定結果…………………………………… 97
附錄三 研究問卷…………………………………………………… 99
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