基于态度结构一致性的临终关怀教育对护士和护生临终关怀态度的影响

摘要

目的 探讨根据态度结构一致性特点实施临终关怀学校教育和继续教育的效果.方法 以汉化的照护临终患者态度量表(Frommelt Attitude Toward Care of the Dying Scale,FATCOD),并将其分为情感与认知2个分表;分别对肿瘤科护理人员及护理专业学生各50名进行问卷调查;分析影响学生和护士临终关怀态度的主要因素,并根据结果实施教育干预.结果 (1)教育前护生临终关怀态度总分、均分优于护理人员(P<0.05);(2)护理人员态度总分与认知成分得分密切正相关(r=0.978,P<0.01),与情感密切负相关(r=-0.935,P<0.01),认知与情感成分得分呈密切负相关(r=-0.841,P<0.01),临终关怀态度主要基于认知;护生态度总分与情感及认知均正相关(r=0.943、0.418,P<0.05);情感与认知相关性无统计学意义(r=0.091,P>0.05),其态度形成主要基于情感;(3)教育干预后护生与护士临终关怀态度积极性显著提高,差异均有统计学意义(P<0.05).结论 认知、情感、经验三轨并进的教育方法有利于护生积极临终关怀态度的形成;通过增加态度协调成分、减弱不协调成分、增强信念等途径,可提高护理人员临终关怀态度的积极性.%Objective To explore the effect of hospice care education and continuing education based on the consistency of attitude structure. Methods Two sub-scales developed from the Chinese version of Frommelt Attitude Toward Care of the Dying Scale (FATCOD) were used to investigate 50 oncology nurses and 50 nursing students. Factors influencing nurses ' and nursing students' attitude toward care of dying patients were analyzed then corresponding intervention was implemented. Results Before the intervention, the total score and mean score of hospice care of nursing students were higher than those of nurses ( P<0.05). In nurses, the total score of attitude was closely positively correlated with the score of cognitive components ( r=0.978, P<0.01) but negatively with the score of emotion (r=-0.935, P<0.01);there was a significantly negative correlation between cognition and emotion components (r=-0.841, P<0.01) and nurse' attitude toward care of the dying was mainly based on their cognition. In nursing students, there was positive correlation between the total score of attitude and emotion component ( r=0.943, 0.418, P<0.05) and no significant correlation between emotion and cognition was found; (r=0.091, P>0.05); nursing students' attitude toward hospice care was mainly based on their emotion. After the intervention, nursing students' and nurses' attitude was significantly improved and the difference was statistically significant(P<0.05). Conclusion The education based on cognition, emotion and experience will benefit the formation of positive attitude toward hospice care. Coordination components and conviction are conducive to enhancing nursing staff 's attitude toward hospice care.