臺灣博碩士論文加值系統

本研究主要目的是在探討急診護理人員的自殺行為的態度與護理自殺個案與家屬的困難度及其相關因素。採立意取樣選取南部醫學中心與區域醫院共八所，以其急診室女性臨床護理人員為研究對象，有效樣本共194名，以不記名自填結構式問卷收集資料，所得資料以描述性與推論性統計進行分析。
結果發現：（1）依同意程度（1-4分）平均得分來看，急診護理
人員對自殺行為的態度為2.4分，偏負向態度人次百分比最多的三項分別是「重覆自殺個案應自費就醫以避免浪費社會醫療資源」、「自殺是自私行為」以及「自殺並非不得已，不值得同情」。（2）模擬案例中護理自殺個案與家屬之困難度標準化得分在50.9-54.4分，屬中等範圍困難度；其護理困難程度（1-4分）＞3分之偏高困難的護理措施為：引導個案說出感受、探討與處理其自殺原因以及評估與處置家屬照護問題。（3）急診護理年資久與定期參加宗教活動之急診護理人員對自殺行為的態度顯著較正向。（4）急診護理人員對自殺行為的態度、年齡、護理工作年資及急診護理年資與護理割腕自殺案例的困難度呈現負相關；另接受過護理自殺個案之訓練者在護理割腕自殺案例的困難度顯著低於沒有參加過訓練者。（5）造成急診室自殺個案與家屬之護理困難主要原因為個案不合作與護理時間人力的不足。
本研究結果可作為急診護理人員臨床實務與相關在職教育安排之參考，以增進其對自殺行為之正向態度及提昇急診室自殺個案與家屬之照護品質。

Abstract
The aim of this study was to explore the attitudes and difficulties in nursing
interventions toward suicidal behavior of nurses working in the emergency department（ED） . Cross-sectional and retrospective method was applied and 194 ED nurses from three medical centers and five district hospitals in southern Taiwan were recruited with the convenience sampling method. Participants were asked to respond to a valid and reliable questionnaire requiring the attitudes and difficulties in nursing interventions to suicidal behavior. Descriptive and inferential statistics were applied to analyze the data.
The results were as follows（1）The mean score of ED nurses’ attitudes toward suicidal behavior on 4 points scale was 2.4, and the leading three of negative attitudes as proportion were “ Patients with a history of repeated suicidal attempts should pay the medical fee by themselves ,because they wasted the social medical resources.” ,
“Suicide is a selfish behavior” and “Suicide is aimed behavior, not worthy to sympathize.”（2）The standardized score of the difficulties to care suicidal patients and their families was at the medium level（50.9-54.4）. The most difficult nursing interventions were “To encourage expression of feeling ”,“To assess and resolve the factor which evoke a patient to suicide”,” To assess and resolve the family’s problem in caring the patient”（3）The ED nurses who participated religious activity regularly, had more emergency nursing experience, had more positive attitudes toward suicidal patients.（4）The ED nurses who were elder, had more positive attitudes toward suicidal behavior, more general and emergency nursing experience, received training program about the care of patients with suicidal behavior, had lower difficulty to nurse the patient who made an attempt on her self’s life by cutting wrist.（5）Patient’s incorporative attitude, inadequate time and staffing were the major factors to induce the difficulty of nursing the patient with suicidal behavior.
The results of this study could be used for reference in providing the training
program for ED nurses to improve positive attitudes and reduce difficulties in nursing
interventions toward patients with suicidal behavior, thereby raising the level of
emergency nursing quality in the care of suicidal patients and their families.

第壹章 緒論
第一節 研究背景及重要性
第貳章 文獻查證
第一節 自殺問題之現況
第二節 急診護理人員在自殺防治的角色功能
第三節 醫護人員對自殺行為的態度及其影響因素
第四節 自殺個案的護理處置
第五節 急診室自殺個案之護理困難及其影響因素
第參章 研究架構與研究假設
第一節 研究架構
第二節 研究假設
第三節 名詞界定
第肆章 研究方法
第一節 研究對象
第二節 研究工具
第三節 研究工具之信度與效度檢測
第四節 研究步驟
第五節 資料分析
第伍章 研究結果
第一節 研究對象之基本屬性分布
第二節 急診護理人員對自殺行為的態度
第三節 急診室自殺個案與家屬之護理困難度
第四節 急診護理人員對自殺個案與家屬護理困難之主要原因
第五節 急診護理人員基本屬性與其對自殺行為的態度之關係
第六節 急診護理人員基本屬性與護理自殺個案及家屬困難度之關
係
第七節 急診護理人員對自殺行為的態度與護理自殺個案及家屬
的困難度之關係
第八節 急診護理人員對自殺個案及家屬護理困難度之預測因素
第陸章 討論
第一節 急診護理人員對自殺行為的態度
第二節 急診護理人員對自殺行為的態度之影響因素
第三節 急診室自殺個案與家屬之護理困難度
第四節 急診護理人員護理自殺個案與家屬的困難度之影響因素
第柒章 結論與建議
第一節 結論
第二節 研究限制
第三節 建議
參考文獻
附錄一：研究工具
附錄二：專家內容效度名單
附錄三：研究對象權益說明書

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