| 研究生: |
戴志楠 Tai, Chin-Nan |
|---|---|
| 論文名稱: |
加護病房護理人員執行遺體護理之現況探討 Exploring the Current Status of the Post-mortem Care by Nursing Professionals in an Intensive Care Unit |
| 指導教授: |
顏妙芬
Yen, Miao-Fen |
| 學位類別: |
碩士 Master |
| 系所名稱: |
醫學院 - 護理學系 Department of Nursing |
| 論文出版年: | 2017 |
| 畢業學年度: | 105 |
| 語文別: | 中文 |
| 論文頁數: | 80 |
| 中文關鍵詞: | 加護病房護理人員 、遺體護理 、哀傷撫慰 |
| 外文關鍵詞: | critical care nurses, post-mortem care, bereavement care |
| 相關次數: | 點閱:83 下載:12 |
| 分享至: |
| 查詢本校圖書館目錄 查詢臺灣博碩士論文知識加值系統 勘誤回報 |
加護病房護理人員有很高的比例需面對病人的死亡,好的遺體護理有助於家屬經歷急性哀傷期。過去遺體護理相關研究很少,本研究目的為探討加護病房護理人員遺體護理的執行程度與勝任程度、對遺體護理的想法與感受、及過程中面臨的困難與阻礙。採橫斷式調查,自擬結構式問卷為工具,以南台灣某醫學中心加護病房護理人員為對象,共收案259位,回收率92.1%。使用SPSS 進行描述性統計、單因子變異數分析、T檢定及相關性分析,以了解人口學資料、過去遺體護理相關教育訓練及個人遺體護理經歷,在遺體護理執行程度及勝任程度上的差異,最後分析執行程度與勝任程度間的關係。
結果顯示加護病房護理人員執行遺體護理多著重於身體清潔,家屬急性哀傷撫慰較困難勝任。人口學屬性包括年齡、性別、宗教、最高教育程度、護理層級、護理工作總年資、加護病房工作年資、目前工作單位及過去是否有安寧相關經驗等變項於執行及勝任程度上無顯著差異。新生兒及兒科加護單位於執行程度顯著較內外科加護單位得分高(p =.003)。三年內曾接受過遺體護理相關訓練者(p =.023)及經歷過至親好友死亡的經驗者(p =.002)於執行程度皆比沒有經驗者得分高。此外,執行遺體護理的感受有:「感傷不捨放手祝福」、「善盡職責維護尊嚴」、「如做善事有意義感」、「映照自我反思生命」等。執行遺體護理之困難與阻礙為:「行政流程壓縮時間」、「缺乏標竿學習的典範」、「遺族哀傷追蹤為醫療照護缺口」。本研究突顯遺體護理教育需學理及實作並重之重要性,可做為遺體護理作業標準訂定、以及未來護理教育及在職訓練之參考,提升護理人員遺體護理及哀傷撫慰能力。
Critical care nurses have a high proportion facing death. Appropriate post-mortem care helps families experience acute grief. However, There are few previous studies on post-mortem care. The purpose of this study was to investigate how critical care nurses carry out post-mortem care in terms of nurses’ thoughts and feelings, as well as the difficulties and obstacles they face when doing so. The research was conducted as a cross-sectional study. The data were collected by self-designed structured questionnaire to explore the current status of the post-mortem care in ICU. The results showed that ICU nurses felt competent to do body care, but it is weakness on bereavement care.
一、中文文獻
王愛玲 (2010)•台灣精神科護理人員提供戒菸服務自我效能及相關因素之探討•未發表的碩士論文•台南:國立成功大學醫學院護理學研究所。
行政院衛生福利部(2013)•中華民國102年健康促進統計年報,2015年11月5日取自http://www.hpa.gov.tw/BHPNet/Portal/file/FormCenterFile/201502021139544762/stat_yearbook_102.pdf
行政院衛生福利部(2012)•醫療法•總統華總一義字第 10100274311號。
余玉眉、蔣欣欣、陳月枝、蘇燦煮、劉玉秀(2009)•質性研究資料的量化及詮釋—從研究例證探討臨床護理研究方法與認識學•護理研究,7(3),276-288。
林承霈(2014)•護理人員面對生命末期癌症病人照顧之態度與行為•未發表的碩士論文•台南:國立成功大學醫學院護理學研究所。
邱皓政 (2010)•量化研究與統計分析-SPSS(PASW)資料分析範例解析•台北:五南。
邱慧洳、李雅玲、鄭夙芬(2011)•人體試驗之倫理與法律•護理雜誌,58(5),89-94。
張芬芬(2010)•質性資料分析的五步驟:在抽象階梯上爬升•初等教育學刊,35,87-120。
曾美珠、李燕蕙(2006)•非安寧病房護理人員面對遺體護理之心理歷程探討•中華心理衛生學刊,19(4),395-415。
楊婉萍、賴維淑、趙可式 (2008)•協助一位末期病人面對整體苦難之全人照護經驗•護理雜誌,55(6),101-106。
趙可式(2007)•醫師與生死(61-86頁)•臺北:寶瓶文化事業。
趙可式(2009)•台灣安寧療護的發展與前瞻•護理雜誌,56(1),5-10。
趙可式(2014)•照護基本功:趙可式教授實作教學•台北市:華杏。
趙可式(2015)•安寧療護是普世價值且為護理的本質•護理雜誌,62(2),5-12。
賴維淑、楊婉萍、趙可式(2008)•安寧療護的教育-護生、一般護理人員及專科護理師•護理雜誌,56(1),11-16。
李英芬(2013)•第四篇 臨終照護 第二十二章 瀕死期病人的照顧•蔡麗雲、賴允亮、顧乃平(主編)•安寧緩和護理學(第四版)(22-4-22-22頁)•臺中市:華格那企業。
鍾月枝、鄭高珍(2010)•加護病房中長期醫療資源使用和死亡率分析,醫務管理期刊,11(1),33-44。
謝俊民 (2010)•加護病房護理人員人格特質、情緒智力、工作特性、情緒勞務與工作倦怠關係之研究•未發表的碩士論文•台南:國立成功大學管理學院管理學研究所。
羅惠敏、高碧月、蔡玉純、吳霞玲、徐南麗(2015)•遺體護理教學光碟對護理人員認知成效探討•健康與建築雜誌,2(1),46-54。
二、英文文獻
Beattie, S. (2006). Hands on help post mortem care. RN, 69(10), 24ac2-24ac4.
Celik, S., Ugras, G. A., Durdu, S., Kubas, M., & Aksoy, G. (2008). Critical Care nurses’ knowledge about the care of deceased adult patients in an intensive care unit. Australian journal of advanced nursing, 26(1), 53-58.
Curtis, J. R., & Patrick, D. L. (2001). How to discuss death and dying in the ICU. Managing Death in the ICU. New-York: Oxford University Press, 85-102.
Daaleman, T. P. (2012). A health services framework of spiritual care. Journal of Nursing Management, 20, 1021–1028.
Emanuel, L. L. & Librach, S. L. (2011). Palliative Care Core Skills and Clinical Competencies. (2 end.). p 337-340.
Espinosa, L., Young, A., Symes, L., Haile, B., & Walsb, T. (2010). ICU Nurses’ Experiences in providing terminal care. Critical Care Nursing Quarterly, 33(3), 273-281.
Faber-Langendoen, K., & Lanken, P. N. (2000). Dying patients in the intensive care unit: forgoing treatment, maintaining care. Annals of Internal Medicine, 133(11), 886-893.
Forsberg, A., Floden, A., Lennerling, A., Karlsson, V., Nilsson, M., & Fridh, I. (2014). The core of after death care in relation to organ donation-A grounded theory study. Intensive and Critical Care Nursing, 30, 275-282.
Fridh, I., Forsberg, A., & Bergbom, I. (2007). End-of-life care in intensive care units: family routines and environmental factors. Scandinavian Journal of Caring Sciences, 21(1), 25-31.
Gillon, R. (1994). Medical ethics: four principles plus attention to scope. British Medical Journal, 309(6948), 184-188.
Hadders, H. (2007). Dealing with the dead patient at the intensive care unit. Mortality, 12(3), 207-222.
Jevon, P. (2010). Care of the dying and deceased patient: A practical guide for nurses. Oxford, UK: Willey-Blackwell. Doi: 10.1002/9781444315271.
Kingdon, C., Givens, J. L., O’Donnell, E., & Turner, M. (2015). Seeing and Holding Baby: Systematic Review of Clinical Management and Parental Outcomes After Stillbirth. Birth, 42(3), 206-218.
Kwan, C. W. M. (2002). Families’ experiences of the last office of deceased family members in the hospice setting. International Journal of Palliative Nursing, 8(6), 266-275.
Marthaler, M. T. (2005). End of life care practical tips. Dimension Critical Care Nursing, 24(5), 215-218.
Martin, S. & Bristowe, K. (2015). Last offices: nurses’ experiences of the process and their views about involving significant others. International Journal of Palliative Nursing, 21(4), 173-178.
McCallum, A. & McConigley, R. (2013). Nurses' perceptions of caring for dying patients in an open critical care unit: A descriptive exploratory study. International journal of Palliative Nursing, 19(1), 25-30.
Miller, P. A., Forbes, S., & Boyle, D. K. (2001). End-of-life care in the intensive care unit: a challenge for nurses. American Journal of Critical Care, 10(4), 230–237.
National Consensus Project for Quality Palliative Care. (2013). Clinical practice guidelines for quality palliative care (3rd ed.). Retrieved from http://www.nationalconsensusproject.org/Guidelines_Download2.aspx
Olausson, J. & Ferrell, B., R. (2013). Care of the body after death: Nurses’ perspective of the meaning of post death patient care. Clinical journal of oncology nursing, 17(6), 647-651.
Pattison, N. (2008). Care of patients who have died. Nursing Standard, 22(28), 42-48.
Quested, B. & Rudge, T. (2003). Nursing care of dead bodies: a discursive analysis of last offics. Journal of Advanced Nursing, 41(6), 553-560.
Ranse, K., Yates, P., & Coyer, F. (2010). End of life care in the intensive care setting: A descriptive exploratory qualitative study of nurses’ beliefs and practices. Australian Critical Care, 25, 4-12.
Shinjo, T., Morita, T., Miyashita, M., Sato, K., Tsuneto, S., & Shima, Y. (2010). Care for the bodies of deceased cancer inpatients in Japanese palliative care units. Journal of palliative medicine, 13(1), 27-31.
Tod, A. M., Allmark, P., & Alison, A. (2009). A practical guide to attaining research ethics approval in the UK. Nursing standard, 23(25), 35-41.
Waltz, C., Strickland, O., & Lenz, E. (2010). Measurement in Nursing and Health Research ( 4th ed.). New York, NY: Springer Publishing Company .
Valiee, S., Negarandeh, R., & Nayeri, N. D. (2012). Exploration of Iranian intensive care nurse's experience of end of life care. Nursing in Critical Care, 17(6), 309-315.
Yu, H. U. & Chan, S. (2012). Nurses’ response to death and dying in an intensive care unit a qualitative study. Clinical Nursing, 19, 1167-1169.