| 摘要: | 許多研究調查中發現，即使具備愛滋病相關知識的醫療人員，也會出現對愛滋病病人的偏見態度與醫療歧視，且照護愛滋病的意願相較於一般疾病也顯著不足。國內研究曾探討影響傳染科病房與非傳染科病房護理人員對愛滋病相關之知識、態度與相關行為，經歷時代變遷已逾二十年，在近年來歷經法令政策制定，社會變遷與推行愛滋病除標籤化，迄今尚未藉由理論架構來完整進一步探討現況，並審視與比較影響護理人員照護愛滋病意願之相關因素與¬二十年前之差異性，故本研究在理性行為理論（Theory of reasoned action）架構下建構自擬式問卷，藉以探討護理人員愛滋病知識、行為態度、主觀規範對照護愛滋病行為意圖之影響。
本研究為以自擬式之結構式問卷蒐集資料的橫斷式調查，共計調查115位北區某醫學中心內科系病房護理人員。取得收案醫院人體試驗委員會核准認可後，進行蒐集資料，採推論性與描述性統計分析進行探討護理人員照護愛滋病的知識、行為態度、主觀規範程度與愛滋病行為意圖之相關性。研究結果包括：本研究對象多為20~24歲女性非感染科護理人員，教育程度大學佔最多(N=82,71.3％）、多數未參加過相關職前訓練佔52.2％（60人）。而護理人員愛滋病知識程度平均得分為14.46±2.09
分（滿分為23分），其中愛滋病傳染途徑相關知識得分較高、愛滋病法令相關知識得分最低；護理人員個人屬性與照護愛滋病行為意圖之相關性中，發現護理人員的病房別，其行為意圖程度皆達到統計上之顯著意義(p=0.01)，其中非感染科病房護理人員行為意圖分數又高於非感染科；在愛滋病知識、行為態度、主觀規範與行為意圖的相關性中，愛滋病知識與行為意圖之間未達到統計上顯著相關；行為態度部分結果顯示行為意圖不論與行為信念、結果評估及行為態度總分都達到顯著性正相關（r=0.33, p <0.01; r=0.25, p <0.01; r=0.33, p <0.01），表示護理人員對愛滋病照護行為信念、結果評估及行為態度越正向，其照護行為意圖越高；主觀規範與行為意圖之間的相關性分析則發現遵從動機 (p<0.01)與主觀規範總分(p<0.01)呈顯著性正相關，表示護理人員對愛滋病照護遵從動機越強與主觀規範越正向，其照護行為意圖越高。
本研究結果顯示透過理性行為理論架構，可得知研究對象的個人屬性、行為態度、主觀規範與行為意圖之相關性，建議未來研究擴及各單位的全面性調查，以瞭解不同科別單位護理人員愛滋病知識、行為態度及行為意圖之差異性，並針對個別性特點提供相關介入措施，並持續縱貫性追蹤護理人員愛滋病知識、行為態度與意圖間的變化。臨床面，醫療機構可多舉辦照護經驗分享團體與工作坊，提供照顧愛滋病的角色模範，此外，透過家庭、學校與社會教育適時導入改善方針，減少護理人員照護壓力與挫折，並能從照護過程中增強自我價值，達到提升愛滋病行為意圖之成效。
Although health care staffs are equipped with knowledge for AIDS treatment, prejudiceattitudes and discrimination toward AIDS patients have been found in various studies. Moreover, their willingness to take care of AIDS patients were much less than caring for patients with other diseases.Taiwanese study had explored and compared factors that influenced nurses’ knowledge, attitudes, and behaviors between infectious and non-infectious wards in past two decades.Recently, societal change with the reduction of stigma of AIDS patients along with the progress of policy and regulations. However, no theoretical framework has been taken into the account of comprehensively explore the status and compare factors that influence nurses’ willingness to take care of AIDS patient. Moreover, the differences of nurses’ willingness and relevant factors between nowadays and two decades ago were not investigated. Therefore, this study aims to explore nurses’ knowledge, behavioral attitudes, and subjective toward AIDS patients with self-developed questionnaire on the theoretical basis of reasoned action theory.This cross-sectional study investigated 115 medical wards nurses of a medical center with self-develop structured questionnaire. After obtaining the approval from the institutionalreview board of the hospital, data collection was carried out. Descriptive and inferential statistics were used for analyzing the relationships among nurses’ knowledge, behavioral attitudes, subjective norms, and behavioral intention toward AIDS patient.
The majority of study participants were 20 to 24 years old non-infectious wards nurses with bachelor degree(N=82,71.3％)and had never received orientation training(N=60, 52.2％).The average score of nurses’ knowledge of AIDS was 14.46±2.09（total score =23）.Nurses had greater knowledge score on the infection route of AIDS and lower score on AIDS regulations.
Demographics of nursing unit has significant effect on their behavioral intention on caring for AIDS patients(p=0.01). Nurses of non-infectious units had greater behavioral intention scores than infectious units.Among the correlations ofknowledge toward AIDS, behavioral attitude, subjective norm, and behavioral intention, no significant correlation was found between knowledge toward AIDS and behavioral intention. In the realm of behavioral attitude, significant correlations were found among behavioral belief, outcome assessment, and behavioral attitude. This indicated that nurses who has greater behavioral belief providing care for AIDS patients, outcome assessment, and more positive behavioral attitude, they will have higher behavioral intention toward providing care for AIDS patients 0.33 (p<0.01),0.25(p<0.01),0.33(p<0.01).Significant correlation between subjective norms score(p<0.01) and behavioral intentions of comply with motivation(p<0.01) were found.
Study results suggested that relevant interventions and longitudinal follow up can be carried out for observing the change of the relationships among nurses’ knowledge, behavioral attitudes, and behavioral intentions toward AIDS patients. Additionally, improvement strategies to reduce the stress and frustrationthrough family, school, and social education should be considered. This will increase the value and self- image of nurses from providing care for AIDS patients that can enhance their behavioral intention. |
