臺灣博碩士論文加值系統

靜脈導管是現代醫療不可或缺的用品之一，臨床上可依病患的病情選擇合適的導管置放，靜脈導管適合給予藥物、輸液、輸血及腸道外高營養液體的給予，尤其在化學治療上，靜脈導管占有舉足輕重的地位。周邊置入中心靜脈導管(Peripherally Inserted Central Venous Catheter；簡稱 PICC)是一個放置程序簡單、安全，不需進入開刀房，置入後位置正確即可使用之導管。本研究目的為探討護理人員對於周邊置入中心靜脈導管照護的知識、自我效能及其相關因素。研究方法採橫斷式相關性研究設計，以中部某醫學中心直接參與癌症照護之護理人員為收案對象，採立意取樣共155位樣本完成有效問卷；研究工具採自擬問卷，包括周邊置入中心靜脈導管照顧知識量表周邊置入中心靜脈導管照顧自我效能量表。資料分析方法含：百分比、平均值、標準差、t檢定、單因子變異數分析、Pearson’s 積差相關分析等。
研究結果發現：（一）研究樣本對於導管照護的知識平均答對率58.4%；（二）研究樣本對於導管照護的自我效能平均分數為2.4分（SD = 0.6）；（三）研究樣本的基本屬性中接受PICC導管相關訓練（p <0.05）、照顧過裝置PICC導管之癌症病人（p <0.05）與導管照護知識有相關，並達統計上之差異；（四）研究樣本的基本屬性中工作科別（p <0.05）與導管照護之自我效能有相關，並達到統計上之差異；（五）研究樣本的照護知識與自我效能呈正相關（r = .242, p < 0.05）。
基於本研究結果，在臨床護理工作者應接受在職教育，並由受過完整訓練之護理人員輔助床邊教育，提供導管照護的知識以及提高護理人員的自我效能，以期周邊置入中心靜脈導管的照護品質更趨完善。

The intra-venous catheters is one of the modern indispensable device of medical treatment. The suitable device to put to have clinically in accordance with the patient''s condition. The intra-venous catheters is suitable for offering the medicine , infusion , blood transfusion and intestinal high liquid offering of nutrition , especially in chemotherapy. Peripherally inserted central venous catheters (PICCs) not only offer a safer, simpler and less expensive way to achieve central venous access for cancer patients but also have the correct insertion site of venous catheter to use.
The research purpose is to understand nursing staff’s knowledge, self-efficacy and relevant factors for the peripherally inserted central catheter care in medical center. The study design is a cross-sectional correlation survey on 155 nurses, who provided direct nursing care for cancer patients, of a medical center by sampling was conducted. The instrument are Nurse Staffs’ knowledge in Peripherally Inserted Central venous catheter scale, and Nurse’s self- efficiency in Peripherally Inserted Central venous catheter scale. The analytical method of the materials includes : Percentage , assay by average , standard deviation , t -test, one-way ANOVA , Pearson'' s correlation were applied.
The result of study is found: (1) 58.4% nurses of answering questions rate PICC of knowledge ; (2)The nurse’s Self- efficiency average is 2.4 points of (SD =0.6); (3) Accept the relevant training of PICC device in basic attribute to study sample (p <0.05), caring for PICC device cancer patient (p <0.05) , Nurse’s knowledge for PICC were significantly positive correlated with each other; (4) The self- efficiency for PICC which the station department (p <0.05 ) were significantly positive correlated with each other; ; (5) The Study finding after knowledge and self- efficiency and presenting positive correlation (r = . 242, p < 0.05) .
Because of result of study this, in clinical to attend to worker should accept the clinical education , and educate by training completely in beside education , the knowledge of PICC and self- efficiency of PICC will improving by the nursing staff . With careful management of PICCs will make the administration of chemotherapy not only more reliable but also more comfortable for cancer patients during the process of chemotherapy.

中文摘要 I
ABSTRACT III
第一章 緒論 1
第一節 研究動機與重要性 1
第二節 研究目的 3
第三節 研究問題與研究假設 4
第四節 操作性定義 5
第二章 文獻查證 6
第一節 周邊置入中心靜脈導管歷史背景 6
第二節 周邊置入中心靜脈導管的介紹 7
第三節 周邊置入中心靜脈導管的合併症 11
第四節 周邊置入中心靜脈導管的護理 15
第五節 護理人員對於周邊置入中心靜脈導管認知之現況 19
第六節 護理人員之自我效能 22
第三章 研究方法 25
第一節 研究架構 25
第二節 研究設計 26
第三節 研究場所及對象 27
第四節 研究工具源起與信效度測試 28
第五節 研究倫理考量 36
第六節 研究步驟 37
第七節 資料處理與分析 39
第四章 研究結果 41
第五章 討論 55
第一節 樣本特性 55
第二節 研究樣本對於周邊置入中心靜脈導管照護知識與自我效能相關性 57
第三節 研究樣本的知識程度與基本屬性之相關性 58
第四節 研究樣本之自我效能與基本屬性之相關性 59
第六章 結論與建議 60
第一節 研究結論 60
第二節 應用與建議 62
第三節 研究限制 64
第七章 參考資料 65

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