照顧服務員對護理之家住民餵食行為之現況及相關因素探究

Abstract

護理之家失能住民為營養不良高風險族群，機構雖有營養師進行營養評估並擬訂個別飲食計畫，但失能者需透過照顧服務員的餵食協助方可獲得營養，本研究目的在探討影響照顧服務員對護理之家住民餵食行為之相關因素。研究對象為新竹縣、市立案之護理之家照顧服務員，採用橫斷式調查法，研究工具為自編結構式問卷，包括餵食認知量表、餵食態度量表、餵食自我效能量表、餵食行為量表。2022年10至11月期間共回收215份問卷，以描述性統計、單因子變異數分析、皮爾遜積差相關、多元回歸分析等統計方法進行分析。研究結果發現： 一、照服員年齡以40-60歲居多，工作年資呈兩極化分布，16.3%具技術士證，61.9%照服員每班有大於5位住民需餵食協助，66.5%照服員每餐總餵食時間在30分鐘以下。 二、照服員餵食認知答對率58.6%，年資長、教育程度高、本國籍、具照服員技術士證、接受過餵食在職教育者、任職於100床以上機構之照服員餵食認知較佳。餵食態度得分3.76分，中立偏正向，具照服員技術士證、接受過餵食在職教育者餵食態度較佳。自我效能平均得分4.27分，年齡21-40歲、外國籍的照服員自我效能較佳。餵食行為平均得分4.54分，任職機構床數100-199床、外國籍者有較好餵食行為。 三、餵食認知與餵食態度呈正相關（p＜0.01），餵食態度、餵食自我效能與餵食行為呈正相關（p＜0.01）。 四、以研究對象的人口背景及教育訓練、勞動條件、餵食認知、餵食態度、餵食自我效能來預測研究對象餵食之行為，可解釋總變異量的25.2％。餵食自我效能（p＜0.001）是預測研究對象餵食行為最主要的變項。 本研究結果供長照機構擬定教育訓練與人力安排參考，建議可進一步探討護理之家照服員餵食相關因素與餵食行為，確保餵食工作執行正確性，以提升護理之家照顧品質。Disabled residents are a group at high risk of malnutrition in nursing home. The feeding dependence residents need feeding assistance from nursing attendants to obtain nutrients. The purpose of this research is to investigate nursing attendants feeding behavior and relevant factors in nursing homes.The subject is nursing attendants in nursing homes registered in Hsinchu County and Hsinchu City. A cross-sectional survey was conducted using a self-administered structured questionnaire including feeding cognition scale, feeding attitude scale, feeding self-efficacy scale, feeding behavior scale. 215 questionnaires were collected from October to November 2022, and statistical methods such as descriptive statistics, one-way analysis of variance, Pearson's performance correlation, and multiple regression analysis were used for analysis.The results of the study showed that： 1. The majority of attendants are 40 to 60 years old, with a polarized distribution of years of experience; 16.3% attendants had a technical license; 61.9% of attendants had more than five residents on each shift who needed feeding assistance; 66.5% of attendants had a total feeding time of less than 30 minutes per meal. 2. The average awareness rate of feeding cognition onlywas 58.6%.Attendant with long years of experience, high education level, local nationality, technician certificate, in-service education on feeding, and those working in nursing home with more than 100 beds had better feeding cognition. The IV average score of feeding attitude was 3.76, neutral to positive. Those who with a technical license and had received in-service education on feeding had better feeding attitude. The average score of self-efficacy was 4.27, with those aged 21-40 and foreign nationals have better self-efficacy. The mean score of feeding behavior was 4.54, and those who worked in nursing home with 100- 199 beds and foreign nationals had better feeding behavior.3.There is a positive correlation between feeding cognition and feeding attitude (p< 0.01). Feeding attitude, feeding self-efficacy, and feeding behavior are positively correlated (p < 0.01). 4. The prediction of "feeding behavior" by demographic background and education training, labor conditions, feeding cognition, feeding attitude, and feeding self-efficacy could explain 25.2% of the total variance. "Feeding self-efficacy" were most important variables in predicting the feeding behavior of the study participants（p < 0.01）. The results of this study can be used as a reference for long-term care institutions to develop educational training and manpower arrangements. It is suggested that feeding-related factors and feeding behaviors of attendant in nursing homes can be further explored to ensure the correctness of feeding performance and improve the quality of care in nursing homes.