| 摘要: | 背景與動機：由於政府積極推動醫療服務國際化，醫護人員外語溝通能力正受重視。英語溝通壓力及缺乏動機可使護理人員提供英語醫療服務意願低落，加上語言溝通障礙，將可能產生病人安全及醫療品質潛在威脅。有鑒於目前於此意願之研究闕如，本研究旨在探討門診護理人員提供英語醫療服務意願及相關因素。
目的：瞭解門診護理人員提供英語醫療服務的意願，並探討影響其提供英語醫療服務意願之相關因素。
方法：以全國參與醫療服務國際化旗艦計畫32家醫療院所門診護理人員為研究對象，使用通過信度、效度檢驗(Cronbach’s α=0.821、CVI=0.85)之自編結構式問卷，共取得19家醫療院所(問卷回收所佔醫院比率為59.38%)之390份有效問卷。主要統計方法為探索性因素分析(EFA)及複迴歸。
結果：門診護理人員提供英語醫療服務意願平均值為3.25。EFA共萃取五成份：動機、政策認知、壓力感受、品質認知及主觀規範。雙變項暨多變項分析顯示相關因素為動機、政策認知、教育程度、自覺英文能力、是否曾參加英語能力檢定、是否曾接受過額外英語教育、壓力感受(皆p<0.01)，以及是否透過家教方式接受額外英語教育(p<0.05)。複迴歸分析發現顯著相關因素為動機、壓力感受、自覺英文能力及曾遊(留)學時間(皆p<0.05)。
結論：動機為一重要因素。相關單位宜激勵國際化旗艦計畫門診護理人員提供英語醫療服務之內外在動機，加上實施考量門診護理人員個人特性之系統性教育訓練課程，可作為輔助推動醫療服務國際化政策之有效支援配套措施。
Background: The foreign language competence among medical staff is receiving more attention due to the "Plan of International Medical Services" the government has been promoting. The pressure of English communication and lack of motivation as well as language barrier will reduce the willingness to offer medical services by English among medical staff, which may be a potential threat to patient safety and quality of care. In view of a dearth of research in the related topics, this study sought to investigate the willingness of outpatient department (OPD) nurses toward offering English medical services and associated factors.
Methods: The studied population is the OPD nurses of all the 32 medical institutions participating in the "Plan of International Medical Services". The self-administered structured questionnaire was used to collect 390 valid samples from 19 medical institutions (response rate: 59.38%). The validity and reliability of the questionnaire reached acceptable levels (CVI=0.85; Cronbach’s α=0.82). Major statistical methods include exploratory factor analysis (EFA) and multiple regression.
Results: The mean of the willingness of OPD nurses toward offering English medical services was 3.25. Of all the questionnaire items, the five components extracted by EFA were “motivation”, “policy cognition”, “perceived stress”, “quality cognition”, and “subjective norm”. Bivariate analysis showed that the associated factors were motivation, policy cognition, education, perceived English proficiency, English competence, extra English education, perceived stress (all p<0.01), and additional English education by tutor (p<0.05). Multiple regression results showed that motivation, perceived stress, English competence, and duration of study abroad were the factors significantly associated with the willingness (all p<0.05).
Conclusions: Motivation is the critical factor. The authorities should utilize the internal and external motives of the OPD nurses in effectively uplifting the provision of English medical services. Furthermore, the systematic training courses customized to the characteristics of the nurses might be one of the supportive supplementary measures in endeavoring to accomplish the "International Medical Services Policy". |
