護理人員照護呼吸器依賴患者之學習經驗
| 論文名稱(中/英文) | 研究生 | 指導教授 |
| 護理人員照護呼吸器依賴患者之學習經驗 The Learning Experience of Nursing Staff on the Care of Ventilator-Dependent Patients |
朱依敏 | 許麗齡博士 |
| [ 摘要 ] | ||
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醫學科技的進步,使得病人的存活率上升,而導致呼吸器依賴患者逐年增加,此時期的疾病通常已治療至慢性不可逆狀態,但使用呼吸器而兼具重症特性,重點應轉移至患者的生活品質及家屬的身、心及經濟負荷;若為護理人員擔任此項照護之責,想了解他們照護患者之實際情形,及如何使家屬之身、心、靈盡量安適。 本研究旨在探討護理人員照護呼吸器依賴患者之學習經驗,目的在了解護理人員在照護的過程之收穫、困難、感受與成長;期待藉由本研究結果以作為提昇護理人員之照護品質並提供相關建議。本研究為質性研究設計,以半結構式訪談指引為研究工具,透過與十位護理人員的深度訪談和參與式觀察進行資料收集,並以內容分析法做資料分析,歸納出四個主題,得知護理人員照護呼吸器依賴患者之學習經驗為:(一)呼吸照護病房護理人員之角色學習、(二)呼吸照護病房護理人員之照護行為、(三)呼吸照護病房護理人員之工作調適、及(四)呼吸照護病房護理人員之專業展現。護理人員經由照護之歷程,獲得學習經驗的結論為護理新芽的茁壯、臨床實務的實踐、護理人員壓力困境的突破、以工作為導向到以人為中心之專業展現,最後終將蛻變成一位具「呼吸照護」專業能力的護理師。 根據研究結果,建議臨床指導老師能了解及融入新世代,多鼓勵,少責罵,並依其專業性設計學習計畫;建議學校實習課程或臨床選習能增設「呼吸照護病房」;另外,醫院能成立支持團體或臨床心理輔導員以達到相互支持與關懷;最後,制定交班作業規範和統一護理措施流程,應可降低工作壓力,並有助於職場之留任。 |
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| [ Abstract ] | ||
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Recent advances in medical science have led to longer life expectancies for many patients. This, in turn has increased the number of ventilator-dependent patients at a steady rate in previous years who are characterized by having a wide range of comorbidities. This study looks at the quality of life of these patients as well as the physical, mental and economic stresses placed on family members. It reflects on the practical experience of respiratory care nurses to find out ways of better catering to the physical and mental needs of these family members. This study investigates the learning experiences of respiratory care nurses on ventilator-dependent patients in a chronic respiratory care ward. Its purpose is to find out the difficulties, evolution of successful techniques as well as emotional and overall rewards gained from their care-giving journey. I hope to use the results of this studyas a basis for improving the quality of care of our nursing staff and provide them with relevant suggestions. I enrolled ten nursing staff and used qualitative research for my study, adopting semi-structured interview guidelines as research tools with in-depth interviews and close observation. After collecting data and using content analysis method for analysis, this study yielded four points. They are (1) new staff should learn about the role played by respiratory care nurses; (2) master the kind of care given to respiratory care patients; (3) learn ways a nurse should adjust to this environment; (4) show their professionalism as respiratory care nurses. Through the process of care-giving, the nurse gain new knowledge, be pioneers in this new field, putting their training into practice and helping others coup with work-related stress. Instead of pointing their focus on jobs done, they can direct their energy to person oriented care, and finally become a respiratory care nurse with professional competence. The result of this study recommends that trainers should try to integrate themselves with the new generation; giving more encouragements and reprimanding less. The learning plans should be designed in relation to this chronic stable environment. Nursing internship should incorporate "respiratory care ward" in their courses. Besides this, hospitals can set up support groups or clinical counselors to provide mutual support and care. Lastly, having a SOAP flow chart for shift changes is a way be minimize work related stress and encourage nurses to stay on the job. |
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