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系統識別號 U0007-2701201123472300
論文名稱(中文) 探討門、急診照護人員在H1N1流行期間之焦慮程度、防疫相關措施及其影響因素
論文名稱(英文) A Study of Anxiety Levels, Preventive Strategies Used, and Impact Factors Among Outpatient and Emergency Healthcare Providers During H1N1 Pandemic
校院名稱 臺北醫學大學
系所名稱(中) 護理學研究所
系所名稱(英) Graduate Institute of Nursing
學年度 99
學期 1
出版年 100
研究生(中文) 謝亞芸
研究生(英文) Ya-Yun Hsieh
學號 G455097014
學位類別 碩士
語文別 中文
口試日期 2011-01-05
論文頁數 114頁
口試委員 指導教授-張文英
委員-陳品玲
委員-廖美南
中文關鍵字 H1N1流感  照護人員  急診  門診  焦慮 
英文關鍵字 H1N1  Care providers  Emergency department  Outpatient 
學科別分類
中文摘要 研究所名稱:臺北醫學大學護理學研究所
研究生姓名:謝亞芸
畢業時間:九十九學年度第一學期
指導教授:張文英 臺北醫學大學護理學研究所教授
本研究之目的旨在(一)暸解門、急診照護人員對H1N1之認知程度、自覺H1N1感染管制防護裝備、設備及所採行之防護措施情形及因應H1N1之執業環境感受;(二)暸解門、急診照護人員在H1N1期間之特質與情境焦慮程度;(三)分析門、急診照護人員之基本屬性與特質及情境焦慮之差異性;(四)分析門、急診照護人員的基本屬性、H1N1之認知程度、自覺H1N1感染管制防護裝備、設備及措施情形及對因應H1N1之執業環境感受與特質及情境焦慮之相關性;(五)分析門、急診照護人員的基本屬性、H1N1之認知程度、自覺H1N1感染管制防護裝備、設備及措施情形及對因應H1N1之執業環境感受是否為特質及情境焦慮之重要預測因子。
本研究之設計採橫斷式(corss-sectional)問卷調查法,收集台灣北部醫學中心、區域教學及地區醫院門、急診照護人員之H1N1認知、焦慮程度及影響因素。本研究工具含H1N1認知量表、情境-特質焦慮量表及資料收集表。資料統計方法則包括描述性與推論性統計。
本研究共發出500份問卷,回收487份,有效問卷回收率為97.4%,結果顯示門、急照護人員於H1N1流行期間特質焦慮程度帄均得分為44分,情境焦慮程度帄均得分為46分,且顯示有近八成的門急診照護人員在H1N1期間正處於中、高度焦慮之情境。在門、急診照護人員中,地區醫院(44.80分)的照護人員之特質及情境焦慮高於醫學中心(44.55分)及區域醫院(43.86分),但未達統計上之顯著差異(P>.05)。而年齡及照護年資與特質及情境焦慮程度得分均達統計上之顯著負相關(P<.05),即表示門、急診照護人員年齡及照護年資越高,則其對面臨照護H1N1病人時之焦慮程度尌越低。而在門、急診照護人員自覺H1N1感染管制防護裝備、設備及措施情形及因應H1N1之執業環境感受程度與特質及情境焦慮程度得分亦均達統計上之顯著負相關(P<.05)。另在迴歸模式中,發現影響情境焦慮程度之預測因素為門、急診照護人員之特質焦慮程度及自覺醫院提供後續照護的支持程度,( P<.05),解釋力為38%。本研究結果盼能作為往後醫院在面臨類似新興傳染病時,提升第一線照護人員之自信與能力,並降低其焦慮程度之參考。
英文摘要 Title of Thesis: A Study of Anxiety Levels, Preventive Strategies Used, and Impact Factors Among Outpatient and Emergency Healthcare Providers During H1N1 Pandemic
Institution: Graduate Institute of Nursing, Taipei Medical University
Author:Ya-Yun Hsieh
Thesis directed by: Wen-Yin Chang, Professor
The purposes of this study aimed at (1) understanding the first-line healthcare providers’ knowledge levels about H1N1, the belief in the protection devices, facilities and measures for H1N1 infection control, the perceptions about their working environment during H1N1 pandemic (2) understanding the degrees of state anxiety and trait anxiety of healthcare providers (3) analyzing the differences between the characteristics of healthcare providers and the degrees of state anxiety and trait anxiety (4) analyzing the association between the characteristics of healthcare providers and knowledge levels of H1N1, belief in the protection devices, facilities and measures for H1N1 infection control, perceptions of working environment during H1N1 pandemic, and the state anxiety and trait anxiety (5) determining if the characteristics of healthcare providers, knowledge level of H1N1, belief in the protection devices, facilities and measures for H1N1 infection control, and perceptions of working environment during H1N1 pandemic were important factors for predicting the state anxiety and trait anxiety.
The study was conducted using cross-sectional questionnaire survey to investigate the healthcare providers’ knowledge about H1N1, degrees of anxiety and their affecting factors in the OPDs and EDs of the medical centers, regional teaching hospitals and district hospitals in northern of Taiwan. The instruments used in this study were H1N1 knowledge scale, the State-Trait Anxiety Inventory, and data collection tool. The statistical analysis includes descriptive and inferential statistics.
Of the 500 questionnaires dispatched, 487 questionnaires were returned. The effective response rate was 97.4%. The average degree of trait anxiety was 44 points, whereas the average degree of state anxiety was 46 points for healthcare providers in the OPDs and EDs during H1N1 pandemic. About 80% healthcare providers in the OPDs and EDs were under moderate to high degrees of anxiety status during H1N1 pandemic. The state anxiety scores in district hospitals (44.80 points) were higher than that of in the medical centers (44.55 points) and regional teaching hospitals (43.86 points). However, no statistical significant difference was found (P>0.05). There was a negative correlation between the healthcare providers’ age and the state anxiety and trait anxiety (P<0.05) (i.e. the older the healthcare providers, the lower degree of anxiety while they had to care the infected patients by H1N1 viruses). There was also a negative correlation among the healthcare providers’ belief in the protection devices, facilities and measures for H1N1 infection control, perceptions of working environment during H1N1 pandemic, and the state anxiety and trait anxiety (P<0.05). In the regression model, the degree of healthcare providers’ trait anxiety and hospital subsequent medical support were significant predictors of state anxiety, collectively explaining 38.1% of the total variance (P<0.05). We hope that the study findings can serve as references for future hospitals to raise the first-line healthcare providers’ confidence and ability, to reduce the degree of anxiety when they face similar novel infectious diseases.
論文目次 致 謝......................................................................................................Ⅰ
中文摘要......................................................................................................Ⅱ
英文摘要......................................................................................................IV
目 錄......................................................................................................VI
圖表目次......................................................................................................IX
第一章 緒論
第一節 研究背景與動機......................................................................1
第二節 研究目的..................................................................................4
第三節 操作型定義...............................................................................5
第二章 文獻查證
第一節 新型流行性感冒病毒-H1N1....................................................7
第二節 H1N1的感染管制...................................................................11
第三節 焦慮之相關概念..............................................................15
第四節 影響H1N1期間門急照護人員焦慮程度之相關研究..........18
第五節 研究架構.............................................................................26
第三章 研究方法
第一節 研究假設.................................................................................27
第二節 研究設計.................................................................................28
第三節 研究對象.................................................................................29
第四節 研究工具.................................................................................30
第五節 資料收集流程.........................................................................36
第六節 資料分析.................................................................................39
第七節 倫理考量.................................................................................42
第四章 研究結果 43
第一節 個人基本屬性分佈情形.........................................................44
第二節 門、急診照護人員對H1N1之認知程度................................48
第三節 門、急診照護人員自覺H1N1感染管制防護裝備、設備及措施情形.................................................................................51
第四節 門、急診照護人員因應H1N1之執業環境感受....................55
第五節 門、急診照護人員在H1N1期間之特質與情境焦慮程度…57
第六節 門、急診照護人員基本屬性與特質及情境焦慮之差異性分析.............................................................................................59
第七節 門、急診照護人員的基本屬性、H1N1認知程度、自覺H1N1感染管制防護裝備、設備及措施情形及因應H1N1之執業環境感受程度與特質及情境焦慮之相關性……………….62
第八節 預測影響門、急診照護人員特質及情境焦慮之因素……65
第五章 討論
第一節 門急診照護人員認知程度、自覺防護裝備、設備及措施足夠程度、因應H1N1執業環境感受及焦慮程度分佈情形…68
第二節 各變項與焦慮程度之關係.....................................................72
第三節 門急診照護人員情境焦慮之重要預測變項……………….76
第六章 結論與建議
第一節 結論.........................................................................................78
第二節 應用與建議.............................................................................81
第三節 研究限制.................................................................................83
參考資料
中文部份................................................................................................84
英文部份................................................................................................86
附件
附件一 門急診照護人員對於H1N1認知與焦慮程度之問卷..........91
附件二 醫療機構照護H1N1新型流感病人之感控措施建議..........99
附件三 專家效度評分表...................................................................103
附件四 專家效度名單.......................................................................114
圖表目次
圖一 門、急診照護人員在H1N1期間對H1H1之認知程度、感染管制裝備、設備及措施及因應執業環境感受與焦慮程度之相關性概念架構.....................................................................................................26
圖二 資料收集流程圖.................................................................................38
表一 問卷中各量表信度檢定結果.............................................................35
表二 門急診室照護人員個人基本屬性之描述統計法.............................40
表三 推論性統計.........................................................................................41
表四 門急診照護人員基本資料之分佈.....................................................46
表五 門急診照護人員H1N1認知程度之帄均得分統計..........................49
表六 門急診照護人員H1N1認知程度之答題正確率統計......................50
表七 門急診照護人員自覺H1N1感染管制防護裝備、設備及措施情形.........................................................................................................53
表八 門急診照護人員自覺H1N1感染管制防護裝備足夠、疫苗及措施有效之情形.........................................................................................54
表九 門、急診照護人員對因應H1N1之執業環境感受............................56
表十 門、急診照護人員在H1N1期間之特質與情境焦慮程度分佈情形.........................................................................................................58
表十一 門急診照護人員基本屬性與焦慮程度之差異性分析……….....60
表十二 門急診照護人員基本屬性與焦慮程度高低之差異性分析…….61
表十三 門、急診照護人員的基本屬性、H1N1認知程度、自覺H1N1感染管制防護裝備、設備及措施情形及對因應H1N1之執業環境感受與特質及情境焦慮之相關性分析………………………….63
表十四 門、急診照護人員的基本屬性、H1N1認知程度、自覺H1N1感染管制防護裝備、設備及措施情形及對因應H1N1之執業環境感受與特質及情境焦慮之相關性分析………………………….64
表十五 影響門、急診照護人員特質焦慮程度之逐步迴歸分析結果…...66
表十六 影響門、急診照護人員情境焦慮程度之逐步迴歸分析結果…...67
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