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研究生:邵文娟
研究生(外文):shao wên chüan
論文名稱:中部地區公共衛生護士強制精神病患送醫意願之相關因素研究
論文名稱(外文):Factors Related to the Willingness of Public Health Nurses to Send Psychiatric Patient for Coerced Treatment in Central Taiwan
指導教授:劉俊昌劉俊昌引用關係
指導教授(外文):liu chüan ch''ang
學位類別:碩士
校院名稱:亞洲大學
系所名稱:長期照護研究所
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:2007
畢業學年度:95
語文別:中文
論文頁數:110
中文關鍵詞:公共衛生護士精神病患強制送醫
外文關鍵詞:public health nursepsychiatric patientscoerced treatment
相關次數:
  • 被引用被引用:1
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  • 下載下載:0
  • 收藏至我的研究室書目清單書目收藏:9
近年來,國內屢見強制精神病患送醫過程中發生意外事件。現今社區精神病患的照護体系及法規,仍有缺乏完善之處,值得探討。研究目的在瞭解公共衛生護士強制精神病患送醫之意願相關因素。本研究採橫斷性調查法,問卷內容包括人口學、專業經驗、資源、困難及執行意願等變項。困難及意願題目採四點量表計分。研究對象為中部地區彰化縣、南投縣、台中縣、台中市、雲林縣等衛生所之公衛護士。調查期間自95 年8 月至9 月止,共發出641 份,回收有效問卷為635 份(98%)。以SPSS/PC12.0 套裝軟體進行分析。
結果發現,有91.8%護士表示與危險精神病患接觸有困難,70.8%擔心被告強制送醫之合法性。經分析發現,執行經驗、上級單位支持度以及感受到執行的困難度等三者為與執行意願最密切的主要因素。近二年曾處置過強制送醫者,意願較低;感受到衛生局主辦人員
支持度高者,其意願高;感到強制送醫困難度愈高者,其意願愈低。加強公共衛生護士接觸危險精神病患之專業能力,衛生局主管業務人員主動支持,以及整合強制送醫之流程,將可提高公衛護士執行意願。
Objective:Some adverse events happened during the coerced treatment
process of psychiatric patients Taiwan in recent years. It is worthwhile to find out the shortcomings of the present caring system and regulations of the mental health community in Taiwan. This study aims to explore the influence factors to the willingness of Taiwan public health nurses to send psychiatric patients coerced treatment.
Method:The study is a cross-sectional survey, and a self-administered
questionnaire which was developed for this study. The questions consist of variables such as demography, professional experiences, resources, execution difficulties, and execution willingness. Among the questions, the ones concerning difficulties and willingness were all evaluated using a four-point scale. Data on all public health nurses working in middle Taiwan including these five areas: Changhua County, Nantou County, Taichung County, Taichung City, and Yunlin County. The questionnaire was collected from August to September 2006. 635 nurses (98%) out of 641 anonymous ones responded to the questionnaire. Data was analyzed by descriptive method and logistic regression (SPSS/PC120 bundled software).
Results:Study results indicated that 91.8% claimed they had difficulties contacting the patients, and 70.8% worried about the legitimacy of coerced treatment process. Additional analysis showed three major factors affecting nurses’ willingness of carrying out coercive treatment process: execution experiences, the level of support from superintendents, and the degree of difficulties confronted during the procedure. Those who ever dealt with coerced treatment patients in the last two years were less willing; those who had higher support from the officers of local health bureau were more willing; those who experienced higher degree of difficulties at the process were again less willing. Conclusions : The study suggests strengthening professional ability training programs for the public health nurses to deal with dangerous psychiatric patients. The local bureau in charge should actively finds out the obstacles that executors are facing, and also positively support and integrate the coerced treatment procedure.
目錄
第一章緒論-1
第一節研究緣起-l
第二節研究重要性-3
第三節研究目的- 5
第四節名詞界定-5
第二章文獻探討-7
第一節國內外精神醫療資源及強制送醫發展-7
第二節公共衛生護士強制送醫意願之相關因素-16
第三節公共衛生護士強制送醫之困難-24
第三章研究方法- 27
第一節研究設計及工具-27
第二節研究對象-34
第三節資料分析-34
第四章研究結果-36
第一節公共衛生護士之人口學及特性之分佈-36
第二節公共衛生護士強制送醫意願及困難之分佈-40
第三節公共衛生護士強制送醫意願之相關因素結果-48
第五章討論-54
第一節公共衛生護士人口學、資源與強制送醫意願之分析-54
第二節縣市別公共衛生護士強制送醫困難與意願之分析-56
第三節公共衛生護士強制送醫意願及相關因素之分析二-57
第四節公共衛生護士強制送醫的困難分析-60
第六章結論與建議-64
第一節結論-64
第二節建議-64
第三節對未來研究者之建議-66
第四節研究限制-67
參考文獻-68
附錄-76
附錄一精神衛生法修正草案說明(立法院一讀通過)-76
附錄二凱旋醫院提供高雄市處置流程- 81
附錄三彰化縣社區精神病.忽照護各單位權責分工表- 82
附錄四社區精神病.忽或疑似精神病.忽緊急送醫作業流程圖二- 85
附錄五表2 一3 我國與加拿大卑詩省之精神衛生法的比較註解二-86
附錄六衛生著公共衛生護士精神病.忽照護分級照護表-88
附錄七研究問卷-90
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