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| 題 名 | 影響護理人員簽署「預立醫療指示」決策的相關因素:創新擴散觀點=Factors Affecting Nurses' Decision-Making to Sign "Advance Directives": From the Perspective of Innovation Diffusionn |
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| 作 者 | 郭彥宏; 張怡萱; 吳佳鉛; 陳綾穗; 陳炳仁; | 書刊名 | 醫務管理期刊 |
| 卷 期 | 25:3 2024.09[民113.09] |
| 頁 次 | 頁207-232 |
| 分類號 | 419.825 |
| 關鍵詞 | 預立醫療指示; 創新擴散觀點; 安寧緩和醫療; 簽署決策; Advance directives; Innovation diffusion theory; Hospice and palliative care; Sign decision; |
| 語 文 | 中文(Chinese) |
| DOI | 10.6174/JHM.202409_25(3).207 |
| 中文摘要 | 目的:以創新擴散觀點探討影響護理人員簽署預立醫療指示決策的相關因素。方法:採橫斷性研究設計,以自編問卷為研究工具,針對南部某醫學中心服務滿三個月以上護理人員共發放310份問卷,回收率為92.90%,有效樣本為288份。結果:護理人員具簽署意圖者達83%,已完成簽署者僅有5.6%。影響護理人員預立醫療指示簽署決策的部分,二元羅吉斯迴歸分析結果顯示以創新擴散的「複雜性」認知(OR = 2.66, 95% C.I.: 1.09~10.05)及「可試驗性」認知(OR = 3.53, 95% C.I.: 1.50~9.23)達統計顯著意義,並且簽署意圖均在兩個因素間存在部分中介效果。結論:創新擴散認知對研究對象簽署意圖與決策具不同的解釋意義,可提供醫療機關規劃教育訓練或安寧教育推廣課程之參考。另外,家人及醫療專業團體是影響簽署的重要對象,可透過其將推廣此概念變成家庭議題。 |
| 英文摘要 | Objectives: The purpose of this research is to explore the relevant factors affecting nurses' decision-making of signing advance directives (ADs) from the perspective of innovation diffusion. Methods: A cross-sectional research design was adopted with nurses for research objects who enrolled more than 3 months from a medical center in southern Taiwan. A convenient sampling was conducted and a total of 310 questionnaires were distributed, with a response rate of 92.90% (288 valid participants). Results: 83% of the nurses revealed intention to sign the ADs; consequently, only 5.6% had completed signing the directives. The binary logistic regression analysis showed that the ADs' perception of diffusion of innovation on "Complexity" (OR = 2.66, 95% C.I.: 1.09 ~10.05) and ADs' perception of diffusion of innovation on "Trialability" (OR = 3.53, 95% C.I.: 1.50~9.23) were statistically significant predictors of ADs signing decisions. Furthermore, the intention to sign was partially mediated by both factors. Conclusions: The perceptions of innovation diffusion show significant explanatory values for the intention and decision to sign an advance directive among the study subjects. Therefore, the results of this study can provide a reference basis for hospitals and relevant government agencies to sign advance directives. In the future, we will make more in-depth explorations on issues related to the promotion of advance directives. |
本系統中英文摘要資訊取自各篇刊載內容。