醫務社工人員在預立醫療照護諮商認知、執行態度及勝任程度之研究
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Date
2023
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Abstract
背景與目的：
全臺現有5萬餘人參與預立醫療照護諮商(以下稱ACP)，其研究層面多以醫護為主，尚無醫務社工人員之量性論文。本研究旨在探討醫務社工人員在ACP認知、執行態度與勝任程度之差異與相關性，以供醫務社工同行與政策參酌。
研究方法：
以統計軟體SPSS，從描述統計、Pearson積差相關、t檢定、卡方分析與單因子變異數、迴歸進行分析。
研究結果：
一、ACP認知：立法目的正確率高，顯示醫務社工人員已將人權視為優先準則，惟啟動程序仍有進步空間。整體而言ACP認知與勝任程度有顯著差異。
二、ACP態度：近一成受訪者對死亡態度接受度較薄弱，總言之ACP執行態度與勝任程度為顯著正相關。
三、ACP程度：近六成受訪者擔憂協助多元群體參與ACP。
四、人口變項與ACP認知、執行態度與勝任程度之相關差異程度：以「服務單位」、「完成ACP訓練」、「教育程度」及「有陪伴經驗」有顯著差異。
結論：
醫務社工人員於ACP認知較高，執行態度與勝任程度呈正相關。另人口變項以「完成ACP訓練」、「教育程度」、「有陪伴經驗」與勝任程度有差異。未來ACP之精進策略：增進醫務社工人員參與生命識能訓練、儲備對多元化群體參與ACP能力、提升AD啟動之社工任務。希冀健保給付包含ACP，不僅支持專業人員願投入該領域，也益於民眾參與預立醫療決定及減少社會成本支出。
Background and purpose:There are currently more than 50,000 people in Taiwan participating in advance medical care planning (hereinafter referred to as ACP), and its research level is mostly medical care, and there are no quantitative papers on medical social workers. This study research on the differences and correlations among the medical social workers' knowledge, implementation attitudes and competences of advance care planning, so as to provide reference for medical social workers and policies. Method: Statistical software SPSS was used to analyze from descriptive statistics, Pearson product difference correlation, t test, chi-square analysis, single factor variance and regression. Result: 1. ACP knowledge: the accuracy of the legislative purpose is high, which shows that medical social workers have regarded human rights as a priority criterion, but there is still room for improvement in the initiation process. Overall, there are significant differences in ACP cognition and competence.2. ACP implementation attitudes: Nearly 10% of the interviewees have relatively weak acceptance of death attitude. In general, ACP implementation attitude is significantly positively correlated with the degree of competence.3. ACP competences: Nearly 60% of the respondents are worried about assisting diverse groups to participate in ACP.4. The degree of correlation between demographic variables and ACP knowledge, implementation attitudes and competences: there are significant differences in"service unit", "completion of ACP training", "education level" and "accompanying experience". Conclusion: Medical social workers have a high awareness of ACP, and their execution attitude is positively correlated with their competence. In addition, there are differences in demographic variables such as "completion of ACP training", "education level", "accompanying experience" and competence level. Strategies for improving ACP in the future: Enhancing the participation of medical social workersin life awareness training, reserving the ability to participate in ACP for diverse groups, and improving the social work tasks of AD activation. It is hoped that the National Health Insurance payment will include ACP, which will not only support professionals willing, but also benefit the public to participate in Advance decision and reduce social costs.
Background and purpose:There are currently more than 50,000 people in Taiwan participating in advance medical care planning (hereinafter referred to as ACP), and its research level is mostly medical care, and there are no quantitative papers on medical social workers. This study research on the differences and correlations among the medical social workers' knowledge, implementation attitudes and competences of advance care planning, so as to provide reference for medical social workers and policies. Method: Statistical software SPSS was used to analyze from descriptive statistics, Pearson product difference correlation, t test, chi-square analysis, single factor variance and regression. Result: 1. ACP knowledge: the accuracy of the legislative purpose is high, which shows that medical social workers have regarded human rights as a priority criterion, but there is still room for improvement in the initiation process. Overall, there are significant differences in ACP cognition and competence.2. ACP implementation attitudes: Nearly 10% of the interviewees have relatively weak acceptance of death attitude. In general, ACP implementation attitude is significantly positively correlated with the degree of competence.3. ACP competences: Nearly 60% of the respondents are worried about assisting diverse groups to participate in ACP.4. The degree of correlation between demographic variables and ACP knowledge, implementation attitudes and competences: there are significant differences in"service unit", "completion of ACP training", "education level" and "accompanying experience". Conclusion: Medical social workers have a high awareness of ACP, and their execution attitude is positively correlated with their competence. In addition, there are differences in demographic variables such as "completion of ACP training", "education level", "accompanying experience" and competence level. Strategies for improving ACP in the future: Enhancing the participation of medical social workersin life awareness training, reserving the ability to participate in ACP for diverse groups, and improving the social work tasks of AD activation. It is hoped that the National Health Insurance payment will include ACP, which will not only support professionals willing, but also benefit the public to participate in Advance decision and reduce social costs.
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Keywords
醫務社會工作, 預立醫療照護諮商, 執行態度, 勝任程度, medical social work, Advance care planning, implementation attitudes, competences