「離島及偏遠地區」護理工作模式之現況評估及未來進階護理工作模式之建構計畫

中國醫藥大學機構典藏 China Medical University Repository, Taiwan > 健康照護學院 > 護理學系暨碩士班 > 研究計畫 > Item 310903500/25401

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题名:	「離島及偏遠地區」護理工作模式之現況評估及未來進階護理工作模式之建構計畫 The Assessment and Development of Advanced Nursing Practice Model in Rural and Remote Area
作者:	林綽娟;馬金足;李采娟;黃玉珠;許智皓
贡献者:	中國醫藥大學護理學系
关键词:	公共衛生護理;進階制度;護理工作模式;偏遠地區
日期:	2008-02
上传时间:	2010-08-31 19:54:46 (UTC+8)
摘要:	本研究目的係包括1.收集並整理我國偏遠地區的衛生政策資料。2.收集美國、英國、日本等三國偏遠地區護理執業模式資料。3.分析離島偏遠居民的健康需求及所需的健康服務項目的現況。4.了解護理人員業務執行內容及探討未來偏遠地區護理人員的職掌與所具備的能力。研究方法包括1.以文獻查證收集資料包括：我國離島偏遠地區衛生政策、居民的健康狀況，以及美國、英國及日本的離島偏遠地區護理工作模式及護理人員進階制度。2.以焦點團體訪談探討偏遠地區衛生所護理人員所須提供的護理服務項目、衛生所護理人員的工作職掌及所需具備的能力。焦點團體的研究對象係包括信義鄉、烏來鄉、七美鄉等三衛生所護理人員與社區領袖及護理長、衛生行政主管等八場次共66位。3.以問卷調查探討偏遠地區衛生所護理人員工作內容與工時情形。問卷經信效度檢定。研究對象是84個衛生所，共發出約643份，回收率68.42%。量表的內容包括基本資料、業務執行頻率及緊急救護執行表現。其效度執行專家效度問卷依此修正，信度以內在一致性測量為.90與.94。研究結果顯示：(1)偏遠地區公共衛生護理人員在業務項目與工時與平地衛生所護理人員比較均較多，在緊急醫療救護方面，亦有相似結果。(2)三個國家（英美日）均於2006年左右在公共衛生護理專業上有新的政策，以重新調整公共衛生護理人員的角色、職稱、職掌、訓練要求等。三個國家均提出進階護理人員執行較專精的公共衛生護理人員業務。 (3)在公共衛生護理人員養成計畫方面，未來應可適時增加名額，尤其是台灣本島以培訓在地人服務在地人，以提升偏遠地區公衛護理人員的留任。 (4)本研究提出偏遠地區衛生所的護理工作模式及培訓課程草案。 The purpose of this study was 1) to collect the health policies of rural area in Taiwan, 2) to collect nursing models of public health practice in rural area in US, UK, and Japan. 3) to analyze health needs, demands, and types of health resources in rural area, 4) to explore services provided by public health nurses and their function and role in rural area. Three methods to collect data: 1) Appling literature review health policies and health status in Taiwan rural area, and compare to nursing models and nurse ladder system in three countries. 2) Using focus groups to get nurses, nursing administrators, and community leaders to get information about items of nursing services, job description and competency. The 66 participants were invited from community leaders and public heath nurses in Shin-I County, Wu-Lai County, and Chi-Mai County. Additionally, head nurses in rural area and health administrators. 3) Adopting surveys to get data of nursing items and time consuming. The questionnaire includes three parts: demographics, nursing items and time consuming. The questionnaire has been examined by content validity and Cronbach’s alpha. The questionnaire was modified by experts’ comments and Cronbach’s alpha was .90 & .94. The 643 questionnaires were given to PHN in 84 health stations, return rate was 68.42%. The results showed as follow: 1)It showed that nursing items and its time consuming in rural area were more than sub-rural area. In emergency care, there were showed a similar result. 2)Three countries (US, UK, and Japan) proposed their public health nursing (PHN) policies around 2006 about PHNs’ competency and their job title and job description. Their also proposed the need of advanced practice nurses (clinical nurse specialist) in specific area of PHN. 3)The need of training program for PHNs(who live in the area) in the rural area from the government to decrease turnover rate and increased PHNs’ job description. 4)A nursing model in health stations in rural area and training program was proposed in the study.
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