李秋香Lee, Chiu-Hsiang劉靜宜LIU, CHING-YICHING-YILIU護理學系碩士班2026-10-282029-02-0120242024-01-17https://handle.ncl.edu.tw/11296/anybaphttps://scholars.csmu.edu.tw/handle/123456789/34755研究目的：失禁性皮膚炎(Incontinence-associated dermatitis , IAD)在住院患者中普遍存在，尤其是加護病房，可能導致疼痛、感染風險增加，護理師需要擁有足夠的認知來保護患者的皮膚完整性，識別高風險患者及正確分類失禁性皮膚炎，並給予預防和治療策略，而護理師對實證實踐的態度也會顯著影響IAD的預防和治療，因此本研究目的在了解重症護理師對失禁性皮膚炎照護的認知及態度之現況、不同背景變項在認知與態度之差異情形，進而探討重症護理師在失禁性皮膚炎照護的認知及態度之關係。研究方法：本研究採描述性橫斷式研究法，以中部某醫學中心之成人加護病房共171位重症護理師為研究對象，以自擬的結構式「失禁性皮膚炎照護認知問卷」與「失禁性皮膚炎照護態度問卷」收集資料，於民國 112年5月1日至5月30日期間先進行問卷的專家內容效度檢定及題目內容的修改，於民國112年6月01日至6月10日於呼吸照護中心發放30份進行問卷的預試，於民國112年 6月15日至 6月 30日進入正式施測階段。其中「失禁性皮膚炎照護認知」分為「失禁性皮膚炎傷口之判斷」及「失禁性皮膚炎照護之知識」兩部分，「失禁性皮膚炎照護態度問卷」分為「關於失禁性皮膚炎對病患影響的看法」及「關於照護失禁性皮膚炎的態度」兩部份。所得資料以 SPSS/Window22 套裝軟體進行描述性及推論性統計分析。 研究結果：本研究共收案171位，男性16名、女性155名，平均年齡為31.64±7.58歲，約94%的參與者擁有學士及以上學歷，30.4%的參與者臨床經驗<5年，最常見的工作單位是內科加護病房(39.7%)、外科加護病房(39.7%)，在失禁性皮膚炎照護認知平均得分為27.55±2.23 (總分35分)，整體答對率為78.8%，其中「失禁性皮膚炎傷口之判斷」層面整體答對率僅為 59%，其次為失禁性皮膚炎的預防知識層面，答對率為75.5%。失禁性皮膚炎的照護態度平均得分為65.99±5.62(總分84分)。護理師基本屬性中護理職級及照護失禁性皮膚炎知識主要來自於學校會影響失禁性皮膚炎照護的認知，而護理師基本屬性對失禁性皮膚炎的照護態度則未達顯著性差異。重症護理師在失禁性皮膚炎照護之認知與態度雖呈現正的弱相關，但進一步進行廣義線性模型分析發現結果仍有顯著差異。結論與建議：重症護理師對失禁性皮膚炎照護的認知愈好，愈有正向的照護失禁性皮膚炎的態度，但護理師在失禁性皮膚炎傷口之判斷及預防層面知識較不足，建議可介入多元化的教育訓練，透過在職教育、研習會或納入易於取得的現代媒體技術、線上應用程式，加強護理師在失禁性皮膚炎照護內容的正確認知，提高護理照護品質。Objective：Incontinence-associated dermatitis (IAD) is prevalent among hospitalized patients, particularly in intensive care units, and may lead to increased pain and infection risk. Nurses require sufficient awareness to protect skin integrity, identify high-risk patients, accurately classify IAD, and implement preventive and treatment strategies. Nurses' attitudes toward evidence-based practice significantly impact IAD prevention and treatment. Therefore, this study aims to understand the current status of intensive care nurses' knowledge and attitudes towards IAD care, examine differences in knowledge and attitudes based on various background variables, and explore the relationship between intensive care nurses' knowledge and attitudes towards IAD care.Method：This descriptive cross-sectional study involved 171 intensive care nurses from an adult intensive care unit at a medical center in central Taiwan. Data were collected using self-designed structured questionnaires on "IAD Care Knowledge" and "IAD Care Attitudes." Expert content validity testing and questionnaire pre-testing were conducted between May 1st and May 30th, 2023. The formal survey was administered from June 15th to June 30th, 2023. The "IAD Care Knowledge" questionnaire included sections on "Assessment of IAD Wound" and "Knowledge of IAD Care," while the "IAD Care Attitudes" questionnaire comprised sections on "Perceptions of the Impact of IAD on Patients" and "Attitudes towards IAD Care." Data were analyzed using descriptive and inferential statistics with SPSS/Window22 software.Results：A total of 171 participants (16 males, 155 females) with an average age of 31.64±7.58 years were included. Approximately 94% of participants had a bachelor's degree or higher education. The most common work units were medical intensive care units (39.7%) and surgical intensive care units (39.7%). The mean score for IAD care cognition was 27.55±2.23 out of 35, with an overall correct rate of 78.8%. The proper rate for the "Assessment of IAD Wound" section was only 59%. The average score for IAD care attitudes was 65.99±5.62 out of 84. Nursing rank, and knowledge of IAD care primarily obtained from schools influenced nurses' cognition of IAD care, while nurses' basic attributes did not significantly affect attitudes toward IAD care. Although a weak positive correlation existed between intensive care nurses' knowledge and attitudes towards IAD care, further generalized linear model analysis revealed significant differences.Conclusion and Recommendations： Intensive care nurses with better cognition of IAD care demonstrate more positive attitudes toward caring for IAD. However, nurses' knowledge regarding IAD wound assessment and prevention needs to be improved. Diversified educational interventions are recommended, including in-service education, workshops, or integration of easily accessible modern media technology and online applications, to enhance nurses' accurate understanding of IAD care and improve nursing care quality.重症護理人員失禁性皮膚炎認知態度Intensive Care Unit Nursesincontinence-associated dermatitiscognitionattitudethesis