| 摘要: | 本研究目的旨在探討公共衛生護士之遺傳學知識、態度與執行遺傳護理服務之相關性，以中部五縣市公共衛生護士為研究對象，採橫斷式調查研究法，以自擬結構式問卷為研究工具，運用郵寄問卷方式進行資料收集，共計回收有效問卷563份，回收率93.36﹪。茲將重要結果歸納如下：
一、研究對象的遺傳學知識普遍偏低，各分項中以「產前遺傳診斷」、「細胞生理學」的平均得分最高，「家庭史與遺傳機率」的平均得分最低。與遺傳學知識得分相關的因素為：教育程度、年齡、畢業年數、公衛年資、接受遺傳學課程與訓練。
二、研究對象的遺傳學態度相當正向，各分項中以「遺傳資訊自主權」、「對公衛業務影響」、「對遺傳教育之看法」態度最為正向，「心理衝擊」得分最低。與遺傳學態度得分相關的因素為：臨床年資、獲得遺傳學知識的管道、遺傳護理服務之執行頻率。
三、公共衛生護士之遺傳護理服務執行頻率偏低，每年平均僅1-3次，三成的研究對象表示從未提供過相關護理服務，其中以「處理家庭相關決策」、「解釋遺傳疾病治療方式」、「討論遺傳疾病的風險」未執行比率最高，83﹪的研究對象認為自己的遺傳學知識不足，面對後基因體時代的來臨，宜加強有關多因子疾病、遺傳機率之計算以及倫理法律社會的衝擊與因應。
四、遺傳學知識、遺傳學態度及遺傳護理服務執行頻率成正相關趨勢。
根據研究結果，本研究建議：
一、在護理養成教育及在職教育中，應增加「遺傳護理教育」之課程，並重新設計課程內容，以提昇公共衛生護士執行遺傳護理活動之知識與技能。
二、加強與遺傳專業機構聯繫管道，舉辦個案研討會，讓公衛護士熟悉遺傳諮詢及服務流程，獲得所需資訊。
三、推動遺傳專科護理認證工作，以確保遺傳服務的資格與品質。
The purpose of this study was to determine the association factors of knowledge, attitude, and practice of genetic nursing among public health nurses in the post-genomic era. A cross-sectional study design was conducted via self-structured questionnaire collected by mail. Five hundred and sixty-three questionnaires were returned (93.36%). Significant results were as followed:
1.Genetic knowledge was low among study samples. The average score of genetic knowledge regarding “prenatal diagnosis”, ”cell biology” were among the highest, those regarding ”family history and probability” were among the lowest. Special feature of the demographic characteristics of public health nurses, such as: highest level of education, age, year of graduation from nursing school, number of years in public health nursing, completion of education and training in genetic all were associated with genetic knowledge.
2.Genetic attitude was positive. The average score of genetic attitude regarding “genetic information autonomy” “effect upon public health service”, “genetic education” was among the highest, and it means the most positive attitude. Those regarding “ psychological impact” were among the lowest. The factors associated with genetic attitude were: number of years in clinic nursing, the sources of information about genetic knowledge, frequency of genetic nursing service.
3.The frequency of genetic nursing service was only 1-3 per year among study samples. Thirty percent of the study subjects never offered genetic nursing services. Decision-making process, explanation of the treatment choices of genetic disorder, discussion of genetic risk was at the lowest rank of the frequency. 83% respondents perceived themselves as lack of knowledgeable in genetics. In the post-genomic era, knowledge about multiple-factor disease, risk of genetic disorder and impact on ethic, legal, social is necessary.
4.There were positive relationship among genetic knowledge, attitude, and frequency of genetic nursing service.
According to the results of this study, I propose the followings:
1.”Genetic nursing education” courses should be part of curriculum for professional education and continuing education programs.
2.In order to get more information about genetic counseling and service skill, it is necessary to create the source to communicate with professional genetic institute or hold more genetic conferences.
3.Certification and credentialing for nurses who specialize in genetics could help nursing professional to sure the service quality and integrated into genetics community in health care. |
