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題名:探討加護護理人員照護「不予心肺甦醒術」病人之態度及倫理困境
書刊名:榮總護理
作者:莊紫雲楊易宏熊道芬謝佑珊
作者(外文):Chuang, Tzu-yunYang, Yi-hungHsiung, Tao-fenHsieh, Yeu-shan
出版日期:2011
卷期:28:4
頁次:頁378-386
主題關鍵詞:加護護理人員不予心肺甦醒術倫理困境Intensive care nursing staffDo no resuscitationEthical dilemma
原始連結:連回原系統網址new window
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  • 共同引用共同引用:44
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本研究之目的係探討各科加護護理人員照顧DNR病人之態度與其倫理困境之相關因素。採橫斷式描述性設計,以立意取樣方式,選取對象為北部某醫學中心加護中心護理人員,以結構式問卷量表調查385位加護單位護理人員,平均年齡為33.81歲。平均臨床年資為129.52個月,級階以N2最多有250人(64.9%)。結果顯示:加護病房科別屬性及護理人員年資會影響其對DNR與對照顧DNR病人之態度;級階越低及年齡越輕者在對DNR之態度方面反而越好;年齡越輕者其痛苦程度與發生倫理困境的頻率越高。本研究可用來瞭解並確立加護護理人員之基本資料屬性,其對DNR的態度、照顧DNR病人的態度與倫理困境的分佈、相關性及差異性,期能藉由建立標準化之照護指引,提供加護單位護理人員在面對DNR病人時能提升臨床照護DNR病人之品質。
Making a decision of "do no resuscitation" (DNR) is an ethical dilemma commonly encountered in everyday nursing care practices. However, this issue has never been fully explored in an intensive care setting. Therefore, we conducted this cross-sectional descriptive study with an aim to identify the attitude of intensive care nursing staff in making DNR decision, caring for patients with DNR and associated factors. The study population was selected from a single medical center in northern Taiwan via purposeful sampling and questionnaires consisting of general background survey, scale on taking patient with DNR and ethical dilemma delivered to each study object. The study enrolled 385 nursing staffs with an average age of 33.81 years. The average clinical practice period was 159.52 months and most of them were clinically rank as N2 (64.9%). The results showed that the difference in attitude on DNR and taking patients with DNR were associated with clinical field and different clinical practice periods. Participants with a younger age and a lower clinical rank had better attitude toward issues associated with DNR. Frequency in encountering ethical dilemma and suffering from the issuance of DNR increased in younger age group. Results of this study help us to understand the general attitude on DNR, the care of DNR patients among intensive care nursing staff and factors associated with the issue. We wish that the result could be applied in the establishing of standardized practice guideline which would promote the quality of care for DNR patients in the future.
期刊論文
1.詹美珠、李淑秋、胡瑞桃(20050800)。加護病房護理人員對DNR態度及其照顧病患相關因素探討。安寧療護,10(3),272-285。new window  延伸查詢new window
2.汪素敏、顧乃平(20000700)。照顧瀕死病人的倫理考量。國防醫學,31(1),72-79。  延伸查詢new window
3.胡文郁、邱泰源、呂碧鴻、陳慶餘、謝長堯、陳月枝(20010300)。醫護人員對「安寧緩和醫療條例」之教育需求。醫學教育,5(1),21-32。new window  延伸查詢new window
4.陳敏鋑、姜安波(19960800)。不予施行心肺復甦術醫囑的相關倫理議題。安寧療護,1,33-39。new window  延伸查詢new window
5.蔡翊新、林亞陵、黃勝堅(20070800)。重症病患之生命末期照護。安寧療護,12(3),312-320。new window  延伸查詢new window
6.Edmond, L.(2008)。Nurses more confident in their ability to initiate DNR discussions than physicians。Pulmonary Reviews,13(7),17-18。  new window
7.Corley, M. C.(1995)。Moral distress of critical care nurses。American Journal of Critical Care,4(4),280-285。  new window
8.Jezewski, M. A.、Finnell, D. S.(1998)。The meaning of DNR ststus: Oncology nurses' experiences with patients and families。Cancer Nursing,21(3),212-221。  new window
9.Jocelyne, T. P.、Jesen, L. A.、Hodgins, M.(2000)。Critical care nurses' perceptions of DNR status。Journal of Nursing Scholarship,32(3),259-265。  new window
10.Lund, M.(1990)。Conflicts in ethics: Is DNR right choice?。Geriatric Nursing,11(6),291-292。  new window
11.Murphy, P.、Price, D.(2007)。How to avoid DNR miscommunications。Nursing Management,38(3),17-20。  new window
12.Rushton, C. H.(1992)。Care-giver suffering in critical care nursing。Heart & Lung,21(3),303-306。  new window
13.Sherman, D. A.、Branum, K.(1995)。Critical care nurses' perceptions of appropriate care of the patient with orders not to resuscitate。HEART LUNG,24(4),321-329。  new window
14.Zoch, T. W.、Desbiens, N. A.、DeStefano, F.、Stueland, D. T.、Layde, P. M.(2000)。Short- and long-term survival after cardiopulmonary resuscitation。Archives of Internal Medicine,160,1969-1973。  new window
15.林小玲、蔡欣玲(19981200)。探討加護護理人員其倫理困境與相關因素。榮總護理,15(4),363-374。new window  延伸查詢new window
16.謝紅桂、顏妙芬(20010600)。不予心肺復甦之探討。護理雜誌,48(3),75-78。new window  延伸查詢new window
學位論文
1.黃錦鳳(2007)。加護病房重症病人簽署不予急救同意書對醫療處置之影響(碩士論文)。臺北醫學大學,台北市。  延伸查詢new window
 
 
 
 
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