第五章 討論
第二節 限制及建議
二、研究工具
因臺灣目前無適切之問卷可適用此類型研究，故本研究採自擬問卷方式進行，
結合健康信念模式與護理人員實際施行早產兒常見處置之種類及頻率深入調查，
因為國內第一份此領域之問卷，進行研究分析及討論後，在使用量表時還需再精 煉，以下列出對於未來相關研究使用本問卷之建議：
（一) 在調節因素人口學變項、單位特性以及個人信念自覺行動利益、自覺行動 障礙題項方面，與研究結果較無顯著相關，建議在題項的論敘方式豐富性可再增 加；
（二） 在問卷設計方面，本研究預設收集多面向之資料，故題數眾多、概念重複、
表格複雜，建議在未來研究可依照本問卷之雛形，使用因素分析等方式使題項更 為精簡；
（三） 疼痛控制之現況問卷部份，本問卷以五成為有效施行，由研究結果可知，
護理人員在執行疼痛控制方面皆可達五成以上，因疼痛控制措施為重要議題，建 議未來在介入頻率劃分上可採取更加嚴格的標準如七成至八成。
（四）因本問卷設計為護理人員自填式，受限於收案時間及人力，無法經由研究 者實際觀察及記錄，未來研究若能克服此項限制，結果將更加客觀公允。
雖本問卷經實際施測後有上述之限制及改善空間，但經兒科相關領域之專家 進行審定，其 CVI 值可達 0.99 - 1.00，表示具有相當可信度，後繼相關健康信念 模式領域或早產兒疼痛控制現況研究可以此問卷為藍本，發展為更適切使用之工 具。
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11296/ndltd/56262338414065209612
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衛生福利部（2017）．衛生福利部醫院評鑑優等以上、醫院評鑑合格之醫學中心 或區域醫院、 醫院評鑑及教學醫院評鑑合格之全民健康保險特約醫院名單．
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90%88%E6%A0%BC%E4%B9%8B%E9%86%AB%E5%AD%B8%E4%B8%A D%E5%BF%83%E6%88%96%E5%8D%80%E5%9F%9F%E9%86%AB%E9%
99%A2%E3%80%81%E9%86%AB%E9%99%A2%E8%A9%95%E9%91%91%
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%B0%91%E5%81%A5%E4%BF%9D%E9%86%AB%E9%99%A2%E5%90%8 D%E5%96%AE--1060327.pdf
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親愛的護理人員您好：
感謝您在百忙之中撥冗填寫此份問卷。雖然於早產兒疼痛控制領域已有相關研究及照護指引可輔助施行，但臺 灣現階段針對執行現況之研究有限，故本問卷期望探討此一議題，以健康信念模式為架構，深入瞭解早產兒疼痛控 制照護情形，並分析其相關影響因子。
您所填寫的各項資料僅供本研究使用，不會對外公開，請安心依照實際情形作答，感謝您的配合。敬祝 一切順利
國立臺灣大學護理研究所碩士班 指導教授 楊曉玲 博士 研究生 黃湘鈞 敬上 連絡電話：0937-455386 Email: rm6y7sm3@hotmail.com
中華民國 105 年 11 月
附錄
附錄一 新生兒病房護理人員施行早產兒疼痛控制措施之現況問卷
第一部份：護理人員個人基本資料及單位特性
答題說明：請您依照您的實際情形選取適合的答案，並在□內打勾。
個人基本資料
1. 性別： □男 □女 2. 年紀 _______歲
3. 目前最高教育程度
□護校 □專科 □大學（含二技） □碩士 □博士 4. 目前的職位為
□護理長 □副護理長 □正職護理師（N_______）
□契約、約聘護理師（N_______） □其他_______________________
5. 從事護理工作的年資共 ________年 6. 任職於新生兒病房年資共 ________年
單位特性
7. 我目前病房為
□新生兒加護病房 (ICU) □新生兒中重度病房
□混和式病房（加護病房及中重度病房未分割） □其他____
8. 我目前病房床位數為 ________床 9. 我目前病房護理師人數為 _______人 10. 我目前病房的照護人力比為
□ 1：2-3 人 □ 1：4-6 人 □ 1：7 或以上 □其他____
102
第二部份：疼痛控制健康信念量表
一、 自覺感受性 答題說明：圈選您認為早產兒在進行下列治療處置時未接受疼痛控制，會產生的疼痛強度分數（0 分為完全不痛，
10 分為無法忍受的疼痛）。
檢察與治療項目 此處置會導致早產兒的疼痛強度
1. 抽痰 完全不痛 0 1 2 3 4 5 6 7 8 9 10 無法忍受的疼痛 2. 放置口胃管／鼻胃管／鼻腸管 完全不痛 0 1 2 3 4 5 6 7 8 9 10 無法忍受的疼痛 3. 正壓呼吸器鼻導管使用
(nasal prong CPAP)
完全不痛 0 1 2 3 4 5 6 7 8 9 10 無法忍受的疼痛
4. 移除膠帶/移除生理監視器貼片 完全不痛 0 1 2 3 4 5 6 7 8 9 10 無法忍受的疼痛 5. 採集足跟血 完全不痛 0 1 2 3 4 5 6 7 8 9 10 無法忍受的疼痛 6. 接受周邊動脈／靜脈注射 完全不痛 0 1 2 3 4 5 6 7 8 9 10 無法忍受的疼痛 7. 接受肌肉／皮下注射 完全不痛 0 1 2 3 4 5 6 7 8 9 10 無法忍受的疼痛 8. 放置周邊置入中心靜脈導管 (PICC/PCVL) 完全不痛 0 1 2 3 4 5 6 7 8 9 10 無法忍受的疼痛 9. 氣管內管插管 完全不痛 0 1 2 3 4 5 6 7 8 9 10 無法忍受的疼痛 10. 放置導尿管 完全不痛 0 1 2 3 4 5 6 7 8 9 10 無法忍受的疼痛 11. 放置胸腔引流管 完全不痛 0 1 2 3 4 5 6 7 8 9 10 無法忍受的疼痛 12. 移除胸腔引流管 完全不痛 0 1 2 3 4 5 6 7 8 9 10 無法忍受的疼痛 13. 腰椎穿刺 完全不痛 0 1 2 3 4 5 6 7 8 9 10 無法忍受的疼痛 14. 眼底鏡檢查 完全不痛 0 1 2 3 4 5 6 7 8 9 10 無法忍受的疼痛 15. 接受外科手術及術後一天 完全不痛 0 1 2 3 4 5 6 7 8 9 10 無法忍受的疼痛
二、 自覺嚴重性：
104
檢查與治療項目 您認為該處置對早產兒的影響程度 5. 採集足跟血 □不確定
□無影響
□產生短期影響（如疼痛期間短暫生命徵象及情緒變化，待疼痛感停止後影響可停止）
□產生短期影響（如疼痛期間短暫生命徵象及情緒變化，待疼痛感停止後影響可停止）