住院患者家屬對病人自主權利法認知、態度及預立醫療決定行為意向之相關研究

Abstract

本研究目的是在探討住院患者家屬對「病人自主權利法」的認知、態度和預立醫療決定行為意向及其相關因素探討，採橫斷式相關性研究，並以自擬結構式問卷作為調查工具。自2019年3月至2019年10月進行調查，於台北某國立醫學中心內外科病房及加護病房之住院患者家屬為訪問對象，共發出100份問卷，而有效樣本為80份，約80%回收率。 研究結果發現:1.本研究之住院患者家屬對「病人自主權利法」的認知得分不低，對於法案的法律相關條文較不清楚，較了解的部分為法案的理念與定義，在性別、婚姻狀態與生活品質達到統計上顯著。2.對於「病人自主權利法」的態度趨於正向，僅性別達到統計上顯著。3.面對疾病末期時，選擇醫療方式的考量因素，個人方面：以治療後能不能恢復清醒和行動是否依舊自主，家庭方面：治療後會不會造成經濟負擔為主要考量。4.面臨疾病末期時，當自己最親近的人和自己處於相同病況情境時，面對親近的人所採取或支持的醫療選擇，趨於積極想延長其生命長度。5.對病人自主權利法持正向態度、好的生活品質是預立醫療決定行為意向的預測因子。 結論：多數人對於「病人自主權利法」的內容有基本的認識，卻不清楚這法案的真正涵義。透過政府機關的宣導、醫療院所及第一線的醫療工作人員也是好的推廣者，才能達到這法案立法的立意目的。

The purpose of this study was to investigate the knowledge, attitude toward Patient Autonomy Act and behavioral intention toward Advance Directive among the inpatients’ family. It was conducted using a cross-sectional research method and the instrument was a self-designed structured questionnaire. From March 2019 to October 2019, inpatients’ family was recruited from a norther academic medical center. The study distributed 100 questionnaires and 80 questionnaires were returned with 80% of returning rate. The results revealed 1. The knowledge score of inpatients’ family toward Patient Autonomy Act was not low. The relevant provisions of the act of the article were not clear, and the more understood part was the concept and definition of the article. The study was statistically significant in terms of gender, marital status and quality of life. 2. The attitude of inpatients’ family toward Patient Autonomy Act tend to be positive, and the only gender was statistically significant. 3. In the terminal condition, the top three issues: whether clear consciousness could be regained, whether mobility could be recovered, and if the resulting condition after treatment caused a heavy financial burden. 4. When the inpatients’ family and the person closest to them were in the same terminal condition, they wanted to lengthen the closest one’s life expectancy. 5. The predictors of the behavioral intention toward Advance Directive included positive attitude and good quality of life The results of the study were that most people had a basic understanding of the content of the Patient Autonomy Act, but they were not knowing the true meaning of the article. In order to achieve the legislative purposes, it could be through the advocacy of government agencies, medical institutions, and medical staff.