護理人員理想角色與實際角色知覺差距及其在自我反思上之應用

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Title:	護理人員理想角色與實際角色知覺差距及其在自我反思上之應用 Nurse's Role Perception Discrepancy and Its' Implication on Self-Reflection
Authors:	陳淑月;曾雅玲;林綽娟;黃士鈞
Contributors:	中國醫藥大學護理學系
Keywords:	好的護理;護理人員;理想角色;實際角色;知覺差距;自我反思;actual role perception;discrepancy of role perception;ideal role perception;nurse;self-reflection
Date:	2010-07
Issue Date:	2010-09-02 18:49:05 (UTC+8)
Abstract:	護理照護品質是護理專業的責任。病人是脆弱的(vulnerable)，是求助的角色，病人和家屬是不懂護理專業的，相關研究若只著重病人和家屬的滿意度、觀點或意見，是不夠的。護理人員是提供護理照護的主體，具有一定水準的專業實力，應該善用其自我調整(self-regulation)之功能，確保時時提供病人適切的護理照護。護理人員需要在認知層次上有所體認，才有可能帶動行為的改變，進而有一定程度適當的情意表現。這是一個「自我反思」的歷程，「反思」二字帶有些許嚴肅，如何用比較活潑有趣的方式落實之，乃本研究小組所關注之重點。因此，如何在護理人員的認知上強化其自我覺識，從而透過反思，然後調整護理照護行為，實值得研究。本研究之目的： (1)研發製作「好的護理」卡片；(2)建構「好的護理」卡用在護理人員「自我反思」之模式；(3)探討「好的護理」卡用於護理人員「自我反思」模式之優劣，及其提升自我反思的成效。本研究計畫第一年採用文獻探討法、Q 研究法、訪談法。先查閱相關文獻確認出合適的「好的護理」項目，製作成卡片，再用Q 研究法找出理想角色與實際角色知覺的落差，同時以訪談法了解落差的原因。以立意取樣法選擇研究對象，擬收案60 位年資介於2-15 年一般病房護理人員。以Q 相關和Q 因素分析法分析量性資料，以內容分析法分析訪談逐字稿。同時，檢視「好的護理」卡的適用性，加以改良成為第二年建構「好的護理」卡用在護理人員「自我反思」之模式的媒材。第二年擬採焦點團體訪談進行試驗(或介入)和資料收集，6-10 位受試者一組，每位成員一付「好的護理」卡片，由主持人帶領卡片分類和優先順序排列(card sorting and prioritizing)，並以訪談法引導成員間分享「好的護理」能做到的項目、不能輕鬆做到的項目及其原因、想改善的項目及改善的方法。過程中，除錄音寫成逐字稿，也記錄成員的非語言行為，以利分析。自我反思的成效擬採自我反思洞察(SRIS)量表測量介入前後的差異。以內容分析法分析訪談逐字稿，以相依樣本t 檢定法分析自我反思洞察前後測之差異。取樣方式擬採立意取樣法或理論取樣法，擬收案60 位。 Quality of nursing care is nurses’responsibility. Patients are vulnerable and come to seek help. They and their family are lay people of nursing care. Nurses are the people who provide nursing care and supposedly clinically competent, and should assure good nursing consistently through self-regulation. It is possible to better perform in nursing care by self-awareness, i.e., self-reflection. How to make the process of self-reflection interesting and funny is our concerns. It warrants research to develop a tool or a model to strengthen nurses’self-awareness, and then self-reflection. The aim of the study is (1) to develop a set of good nursing card, (2) to construct a model to guide nurses to self-reflect through playing the good nursing card, and (3) to explore the strength and drawback of the model and evaluate its impact on self-reflection. In the first year we try to use literature review, Q-methodology, and interview to identify the items of good nursing, and then each item will be printed on a card. The Q-methodology will be employed to explore the role discrepancy of ideal and actual role perception of the participants. The reasons for the role discrepancy will be collected using interview. The interview data will be transcribed verbatim, and analyzed using content analysis. Q-correlation and Q-factor analysis will be used to analyze quantitative data. A purposive sampling will be used to recruit 60 general nurses who are of 2-15 working experiences. Then the cards will be examined against their applicability and reprinted to be the tool for the intervention of the study next year. The second year a focus group method will be applied to do the intervention and to collect data by the assistance of interview guide. In each group 6-10 nurses, having a set of card in hand, will be guided to sort and prioritize the card. Simultaneously, the members share the items which have been done well, the items which could not be performed without efforts, and why, and then the items they want to do better in the future. The interview will be videotaped and transcribed verbatim, and the nonverbal message will also be recorded to assist the data analysis. The self-reflection and insight scale (SRIS) will be used as an outcome measure. The difference of the pre-test and post-test will be examined using dependent t-test. Content analysis will be used to analyze the qualitative data. 60 nurses will be recruited via a purposive sampling or a theoretical sampling.
Appears in Collections:	[護理學系暨碩士班] 研究計畫

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