| Summary: | 碩士 === 弘光科技大學 === 護理研究所 === 102 === Abstract
About sixty percent of Taiwan’s cancer patients have yet to use hospice care services. This implies the promotion of hospice care in terminal cancer patients still faces many obstacles. As close caregivers healthcare staff play an important role in spreading these ideas. This study aims to understand the obstacles faced by healthcare staff in the use of hospice care by terminal cancer patients, specifically awareness and barrier factors, and the relationship between awareness and barriers. Methodology: Cross-sectional analysis of healthcare staff in a Central Taiwan regional teaching hospital. Randomized stratified sampling yielded 277 subjects (62 physicians, 215 nursing staff) who were given a structured questionnaire using a hospice care awareness scale, a hospice care barrier factor scale, and basic data. Response rate was 100%. The statistical package SPSS 18.0 for Windows was used to analyze data for correlation and testing the research hypothesis.
Results found (1) healthcare staff’s awareness score was above moderate level(M=109.36±14.65 ). Staff with religious faith had higher score than those without (t=-2.049, p<.05). Staff with relatives or friends who were terminal patients (t=-1.975, p<.05), who self-assessed as having “an understanding of hospice and palliative care” (t=-2.923, p<.05), or had a DNR advanced directive (t=-2.685, p<.05) demonstrated greater awareness than those without. (2) Healthcare staff with above-moderate obstructive factor scores(M=115.35±19.35 ). had “experienced critical illness” (t=-2.010, p<.05), “taken courses related to hospice care” (t=-2.651, p<.01), “studied life-and-death issues in class” (t=-3.174, p<.01), or self-assessed as having “an understanding of hospice/palliative care” (t=-2.725, p<.05), had higher barrier scores. (3) Positive correlation (r=.653, p<.001) was found between hospice care awareness score and barrier score. (4) No difference was found between physician and nursing scores on hospice care awareness or barrier factors. (5) Physicians with DNR directives had higher awareness scores than nurses with similar directives (t=2.221, p<.05). In conclusion our research shows that the greater the awareness of hospice care among healthcare staff, the greater the understanding of barrier factors in clinical practice. Our results provide healthcare staff a reference in the promotion of hospice care, specifically the remediation of incorrect awareness and alleviation of barrier factors, in order to facilitate the goal of a Good Death for the patient and family, and provide better hospice care.
Keywords: healthcare staff, hospice care, awareness, barrier
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