| 摘要: | 目標：台灣人口結構趨向高齡及少子化，陪同病患住院的外籍看護日益增多，本研究目的在探討醫院住院病患聘雇之外籍看護的照護能力及相關影響因素。方法：採橫斷式調查研究，以自擬結構性問卷為研究工具，並經信效度的處理後，由訪員親訪進行資料的收集，問卷內容包含：外籍看護基本資料、對外籍看護在病患照護知識能力的評量、護理人員對外籍看護照護技術能力的評量三部分。自100年12月1日至101年2月29日止，針對中部某醫學中心內外科病房之外籍看護進行收案。結果:取得有效問卷201份，拒訪率10.67%，研究結果發現：外籍看護在緊急及意外事件處理、感染控制等項目的知識得分顯著較低；在導尿管護理項目的技術得分亦顯著低於其他構面。在變異數分析及複迴歸分析的結果顯示:國籍為越南籍、來台全部時間、來台後的看護工作經驗、來台後照顧此病人的時間等愈長、自覺中文溝通能力愈佳、病患入院前的照顧地點為養護機構，皆會顯著正向影響外籍看護的整體照護能力，而知識得分愈高者，其技術得分亦愈高。結論：外籍看護照護能力的養成在於來台後工作經驗的累積，而在養護機構中可能因有醫護人員可供指導及監督，故有較佳的技術能力。建議醫療機構應加強外籍看護在緊急意外事件處理及感染控制的指導及諮詢，並制定多國語言照護指引手冊；政府機構則應建立外籍看護來台後的知識技能檢定制度，加強中文訓練及延長工作年限，將其納入長期照護管理系統，並要求其持續接受在職教育，以確保病患的照護品質。
GOALS: Since in Taiwan population aging and the fertility rate is getting lower, the number of foreign caregivers needed by inpatients is increasing. The purpose of the research is to study caring competence of foreign caregivers and the correlated factors.
METHODS: A cross-sectional survey was used. A self-developed, structured-oriented, and validated questionnaire consists of 3 parts was designed, including basic personal data of foreign caregivers, evaluation on the caring competence of knowledge, and evaluation on caring competence of skills rated by licensed nurses. Face-to-face interviews were conducted with foreign caregivers in Internal and Surgical wards at a medical center in central Taiwan, during a period of Dec. 1st, 2011 and Feb. 29th, 2012.
RESULTS: A total of 201 valid questionnaires were collected; 10.67% was rejected. According to the survey, foreign caregivers have significantly lower ratings in the fields of emergency and incident management, and infection control. The technique of foley caring also shows a lower rating than that in other fields. The Variance and Multiple Regression Analysis indicates that Vietnamese nationality, length of time staying in Taiwan, work experiences of caring patients in Taiwan, length of time of caring a given patient in Taiwan, speaking ability of Chinese language, and working experience in Nursing Home before the patient is transferred to hospital have significantly and positively impacts on caring skills of foreign caregivers. Moreover, the rating of caring knowledge closely parallels that of caring skill.
CONCLUSION: Foreign caregivers acquire their abilities in caring gradually by accumulating their work experiences in Taiwan. Foreign caregivers with better skills may be due to the guidance and supervision of supervisors provided in Nursing Home. The results of the study suggest that medical institutions should strengthen the supervision and consultation of foreign caregivers in emergency and incident management, and infection control, as well as develop a multilingual instructional manual for caring. To assure care quality, the government authority should establish a testing system of caring knowledge and skills to foreign caregivers, provide service of Chinese language education, extend their working time limitation, include foreign caregivers under normal long-term care supervision system, and require them to receive continuing education. |
