探討民眾簽署「預立醫療決定書」之意願及相關因素

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Title:	探討民眾簽署「預立醫療決定書」之意願及相關因素 Explore factors of residents' intentions to sign the Advance Decision. 背景：隨著病人自主意識的抬頭，國際社會將醫療選擇權納入人權範圍之一，「預立醫療決定」也日益受到矚目。臺灣也在2019年開始實施「病人自主權利法」，內容就包含簽署「預立醫療決定書」，讓年滿20歲以上之完全行為能力人，在意識清楚的時候，為自己生命做最後的安排。因此，本研究使用計畫行為理論並加入認知變項，探討民眾簽署「預立醫療決定書」的意願及相關影響因素。方法：研究方式採問卷調查法，以年滿20歲以上之完全行為能力人作為研究對象，委託市調公司進行線上問卷蒐集後，有效樣本數為215份。問卷參考計畫行為理論的態度、主觀規範與知覺行為控制為主要變項，並加入認知變項來探討「預立醫療決定書」的簽署意願。問卷信度介於0.7~0.9之間，效度則經過專家檢測。問卷結果分析使用SPSS統計軟體進行，分別利用獨立t檢定、單因子變異數分析、皮爾森相關係數分析及迴歸分析等統計方法。結果：研究結果顯示，在人口學變項中性別、子女數、職業和自覺健康狀況對認知、態度、主觀規範、知覺行為控制和簽署行為意圖研究變項皆沒有顯著性的差異，而在認知方面有顯著差異的分別是教育程度和月收入，在態度方面有顯著差異的分別是有宗教信仰和月收入，在主觀規範有顯著差異的分別是婚姻狀況和宗教信仰，在知覺行為控制有顯著差異的分別是婚姻狀況和宗教信仰，在簽署行為意圖有顯著差異的分別是年齡、婚姻狀況和宗教信仰。認知、態度、主觀規範、知覺行為控制與簽署行為意圖呈顯著正相關；主觀規範會顯著正向影響簽署「預立醫療決定書」之行為意圖，迴歸模型解釋力達37%。結論與建議：結果顯示目前民眾對「病人自主權利法」、「安寧緩和醫療條例」和「預立醫療決定書」均不熟悉，因此建議政府可以著手培育「預立醫療決定書」或「病人自主權利法」的種子講師，以及在教育課綱內增添相關內容，透過講師深入各地方進行宣導並增添海報，可以加強民眾對這方面的相關知識。 Background: With the rise of patient self-consciousness, the international community has included the right of medical choice into the scope of human rights, and the ";Advance Decision";has attracted increasing attention. ";Patient Right to Autonomy Act";including to sign the ";Advance Decision";has implemented in Taiwan since 2019. Persons with fully capability over the age of 20 can make their arrangements for final lives when they are conscious. The purpose of this study is to use the theory of planned behavior theory and add cognitive variables to explore the behavioral intention of the residents to sign the ";Advance Decision";and related influencing factors.Method: This study adopted a cross-sectional questionnaire survey. People with full capacity over 20 years old were the research objectives. Appointing a market survey company to collect online questionnaire data, a total of valid samples is 215. Variables like attitude, subjective norms, and perceived behavior control, and behavioral intention of the planned behavior theory were used as main variables, and adds a cognitive variable to explore the intentions to sign ";Advance Decision";. Reliabilities of the questionnaire were between 0.7 and 0.9, and the expert validity was tested. Data was analyzed by using the statistical software. Statistical methods such as independent t-test, one-way ANOVA , Pearson correlation coefficient and the regression analysis were used in this study. Results: Results show cognition, attitude, subjective norms, perceived behavior control, and behavior intention of signing ";Advance Decision";have no significant differences in the demographic variables of gender, number of children, education level, and perceived health status. There are significant differences of cognition in education level and monthly income. There are significant differences of attitudes in religious beliefs and monthly income. There are significant differences of subjective norms and perceived behaviors control in marital status and religious beliefs. The intention of signing ";Advance Decision";are different in age, marital status, and religious beliefs. Cognition, attitude, subjective norms, perceptual behavior control and s behavior intentions of signing ";Advance Decision";are significantly positive correlated. Subjective norms is the only significantly and positively affect the behavior intentions of signing the ";Advance Decision";, and the regression model has an explanatory power of 37%.Conclusions and recommendations: Results of this study indicate that the residents are not familiar with the ";Patient Right to Autonomy Act";, the ";Hospice Palliative Care Act";and the ";Advance Decision";. Therefore, we recommended that the government should cultivate seed lecturers for the ";Advance Decision";or ";Patients Right to Autonomy Act";, and add relevant contents to the educational curriculum. The lecturers can go out in public and make posters to strengthen the relevant knowledge of the public residences.
Authors:	賴怡君
Contributors:	醫務管理系林為森
Keywords:	計畫行為理論預立醫療決定書病人自主權利法認知 The planned behavior theory Advance decisions Patient right to autonomy Act Cognition
Date:	2020
Issue Date:	2022-10-21 10:35:23 (UTC+8)
Relation:	學年度：108， 104頁
Appears in Collections:	[Dept. of Hospital and Health (including master's program)] Dissertations and Theses

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