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系統識別號 U0026-0802201018341300
論文名稱(中文) 台灣精神科護理人員提供戒菸服務自我效能及相關因素之探討
論文名稱(英文) Psychiatric Nurses’ Self-Efficacy on Smoking Cessation Service - An Exploratory Study
校院名稱 成功大學
系所名稱(中) 護理學系碩博士班
系所名稱(英) Department of Nursing
學年度 98
學期 1
出版年 99
研究生(中文) 王愛玲
研究生(英文) Ai-Ling Wang
學號 t2696107
學位類別 碩士
語文別 中文
論文頁數 95頁
口試委員 指導教授-徐畢卿
口試委員-陳柏熹
口試委員-馮瑞鶯
中文關鍵字 精神科護理人員  戒菸  吸菸  戒菸服務  自我效能 
英文關鍵字 Psychiatric nurses  Smoking cessation  Smoking  Smoking cessation service  Self efficacy 
學科別分類
中文摘要 台灣於2007年7月11日公佈菸害防治法修正條文,並於2009年1月11日正式執行。面對已實施菸害防治法,精神科護理人員提供戒菸服務的概況成為極須關注的議題之一。
本研究之研究目的為探討台灣精神科護理人員提供戒菸服務自我效能之概況,並進一步探討人口學變項、對患者吸菸之態度與信念、工作場所吸菸政策實施、戒菸服務實施與提供戒菸服務自我效能的關係及預測因素。為一橫斷式描述相關性研究,採立意取樣,研究對象為台灣中、南部地區18歲以上之精神科護理人員,共193位。以「精神科照護人員戒菸服務問卷」進行調查,共40題。以描述性統計、皮爾森相關、變異數分析及複迴歸進行資料分析。
結果發現1.自評提供戒菸服務自我效能為中等,平均55.57分。2.患者戒菸相關動機越高且護理人員提供戒菸服務所面對的障礙越低,則精神科護理人員提供戒菸服務之自我效能越高。3.護理人員或患者越支持無菸政策、提供及運用各類戒菸服務之頻率越高及工作環境二手菸狀況越少,則提供戒菸服務自我效能越高。4.多元逐步分析顯示,執行戒菸服務障礙、二手菸經驗、自我治療、自評達成患者減菸或戒菸意圖、患者戒菸動機、提供戒菸協助之頻率及與患者討論抽菸問題頻率,為重要的預測因子。
透過本研究的發現,患者戒菸動機、戒菸服務提供頻率、工作環境及自我效能間有不可分割的相互影響,希望可依護理人員所處之不同因素中,依其合適的介入時間進行課程的規劃及在職教育參考,並建議可透過不同並提供相關單位及臨床照護人員提供戒菸服務及相關法規修訂與資源提供之參考。
英文摘要 In Taiwan, THPCA (Tobacco Hazards Prevention Act) was declared on July 11th, 2007, and enforced on January 11th, 2009. The actual situation regarding the smoking cessation services becomes an important issue for psychiatric nurses.
The study explored the condition of psychiatric nurses’ self efficacy in providing smoking cessation services in Taiwan. Further analyses were also performed to explore the relation of their self efficacy in terms of demographic variables, attitudes toward patients smoking, the policy, and the practice of smoking cessation service. The study was designed by a cross-sectional method. Purposive sampling was used to recruit health care providers who take care of psychiatric patients in central and southern Taiwan. A total of 193 participants completed 40 questions in a structured questionnaire. The data was analyzed by the methods of descriptive statistics, Pearson’s correlation, ANOVA and multiple regressions.
The results are as follow: 1. Nurses reported a moderate level of their self efficacy in providing smoking cessation service (M=55.57). 2. If clients obtain a higher motivation in quitting smoking and accept the smoking cessation service, and lower barriers in smoking cessation service offering, the self efficacy of Psychiatric nurses will increase. 3. Nurses with a higher frequency of offering smoking cessation service and agreement with the smoking free policy, and less experience of second hand smoking in workplace would obtain a higher self efficacy. 4. The barrier of smoking cessation offering, the experience of second-hand smok in workplace , whether the providers agree or disagree that smoking can allow the client to self-medicate, the assessment of clients’ motivation for quitting smoking, and the frequency of providing and talking the smoking cessation service with patient were predictive variables of self efficacy. The
The results of this study allowed us to understand the patients’ motivation for quitting smoking, the frequency of smoking cessation service offering, workplace environment and self efficacy which is affecting each other. Additionally, findings from the present study could help us design the tobacco ceasing program and assist in future policy making for mental health care providers in the future.
論文目次 目 錄
摘 要…………………………………………………………………………………Ι
英文摘要………………………………………………………………………………Ⅱ
致 謝……………………………………………………………………………………Ⅳ
第一章 緒論……………………………………………………………………………1
第一節 研究背景與動機………………………………………………………………1
第二節 研究目的………………………………………………………………………4
第二章 文獻查證………………………………………………………………………5
第一節 一般民眾吸菸現況及公共政策………………………………………………5
第二節 精神科護理人員吸菸盛行率及特性…………………………………………7
第三節 精神疾病患者吸菸盛行率及影響……………………………………………9
第四節 吸菸對精神疾病患者之影響………………………………………………11
第五節 自我效能的意涵……………………………………………………………12
第六節 影響精神科護理人員提供戒菸服務自我效能的因素……………………14
(一)人口學變項…………………………………………………………………14
(二)態度、信念與無菸政策的推行……………………………………………15
(三)戒菸服務的實施及資源……………………………………………………17
第三章 研究方法……………………………………………………………………21
第一節 研究架構…………………………………………………………………21
第二節 名詞界定…………………………………………………………………22
第三節 研究設計與研究對象……………………………………………………24
第四節 樣本數估算………………………………………………………………25
第五節 研究工具…………………………………………………………………26
第六節 收案過程…………………………………………………………………30
第七節 研究倫理…………………………………………………………………31
第八節 資料分析方法……………………………………………………………32
第四章 研究結果……………………………………………………………………33
第一節 研究對象…………………………………………………………………33
第二節 精神科護理人員人口學與基本資料與提供戒菸服務自我效能之關係...37
第三節 精神科護理人員對患者吸菸態度及信念與提供戒菸服務自我效能關...39
第四節 工作場所無菸政策實施與提供戒菸服務自我效能之關係………………44
第五節 精神科照護者戒菸服務實務與提供戒菸服務自我效能之關係…………47
第六節 預測精神科護理人員提供戒菸服務自我效能之因素……………………49
第五章 討論…………………………………………………………………………55
第一節 社會人口學特性……………………………………………………………55
第二節 人口學基本資料與提供戒菸服務自我效能之關係………………………58
第三節 精神科護理人員對患者吸菸之態度與提供戒菸服務自我效能之關係…59
第四節 工作場所無菸政策與提出戒菸服務自我效能之關係……………………62
第五節 精神科護理人員戒菸服務實務與提供戒菸服務自我效能之關係………64
第六節 精神科護理人員提供戒菸服務自我效能之預測因子……………………65
第七節 研究結果於護理實務的應用………………………………………………66
第六章 結論、建議與研究限制…………………………………………………70
第一節 結論…………………………………………………………………………70
第二節 建議…………………………………………………………………………71
第三節 研究限制……………………………………………………………………73
參考資料………………………………………………………………………………74
附件
附件一 國立成功大學醫院院附設醫院人體試驗委員會同意臨床試驗證明書....84
附件二 一般受試者同意書...................................................................85
附件三 精神科照護人員戒菸服務問卷....................................................86

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