護生實習表現及其它因素對精神科護理工作印象是否提升之影響

The Impacts of Clinical Performance and Related Factors on Psychiatric Nursing Attitudes’ Changes among Nursing Students

白純宜(Pai Chun Yi)

指導教授 ： 廖宏恩

亞洲大學/健康學院/長期照護研究所在職專班/碩士(2010年)

摘要

背景與目的：以往一般護理人員或畢業護生未來在職涯選擇上，多不願意將精神科列入首選；然而，在護理養成教育中，實習訓練為護生最實際接觸精神科護理的時機，因此，實習訓練各階段過程，可能影響護生對精神科護理工作印象，本研究係探討實習過程前後，護生對於精神科護理工作印象之改變狀況，及分析實習表現及其它相關因素對護生精神科護理工作印象是否提升之影響，並初探未來護生選擇精神科作為職涯的意向。
方法：本研究屬縱貫式前後觀察比較方式（One group pretest posttest design），採普查方式蒐集，在2009年09月至2010年01月期間，以台灣中部某精神專科療養院實習一個月之五專及四技護理科（系）護生為研究對象（n＝170），填寫兩類自擬式問卷，分別各由實習護生及其實習指導教師分別填答護生實習表現。統計軟體以SPSS12.0進行描述性分析與推論性分析。
結果：大多數護生不確定將精神科護理工作，作為職涯首選，但倘若未來有機會進入該科別服務，多傾向會願意接受而不排斥，甚至投入此專科後，傾向不會再找尋選擇其他科別領域的護理工作。
護生（n＝170）經實習後，對精神科護理工作印象有提升者佔65.9%；而未提升者佔34.1%。實習前後印象改變程度，平均分數由54.35分提升為56.66分（p= 0.000），統計上呈現顯著。
透過二元邏輯斯迴歸分析，結果顯示護生精神科護理工作印象提升與護生愈內控人格特質、及實習前學業成績排名屬中等（成績全班排名為31%~70%）的護生皆呈正相關；護生工作印象提升與實習訓練介紹期表現自我評量結果較落後者呈現負相關。
結論：經四週精神科實習後，有65.9%護生對精神科護理工作印象有提升。再者，當護生具較內控的人格特質、實習前學業成績排名中等、在實習的介紹期裏，自我認定未達實習目標者，對精神科護理工作印象提升的機會愈大。期本研究結果可作為日後精神科臨床指導教師幫助護生提升精神科護理工作印象之教學參考，進而增加護生未來選擇投入精神科護理職涯的意願。

關鍵字

工作印象 ； 精神科護理 ； 臨床實習表現 ； 招募與甄選 ； 職涯

並列摘要

Background and Purpose: Nursing school graduates seldom chose psychiatric department as their beginning career. Clinical internship trainings are the most vivid life experience for nursing students during their school education. Therefore, the process of clinical internship program might play some role to influence psychiatric nursing attitudes. In this study, we investigated the impacts of cllinical performance and related factors on psychiatric nursing attitudes’ changes in a nursing student internship program. In addition, we design several questions to explore nursing students’ preferences for their future nursing careers.
Method: This study adopted a prospective one group pretest posttest design to collect data of 170 eligible nursing students with one-month clinical internship from September 2009 to January 2010.at a large-size psychiatry hospital in the middle of Taiwan area. The instruments are self-administered questionnaires for nusing students to fill in their perceived performances at each end of four training stages, and a before-after questionnaire to fill in their psychiatric nursing attitudes. Meanwile, the clinical instructors were also asked to fill in a questionnaire regarding the performance of their nursing students at ach end of four training stages. We employed SPSS (version 12.0) as our software to have statistical inferences.

Result: Most nursing students were still not sure whether psychiatric department were their favoriate at the staring careers. However, they inclined to take the job if there were a nursing position open in the psychiatric department. Furthermore, most respondents tended not to change their careers if they got involved in psychiatric nursing.
After the implementation of the clinical internship program, there were 65% of 170 nursing students having positive changes toward psychiatric nursing attitudes. The average attitude score of total nursing students increased significantly from 54.35 to 56.66 (p=0.000).
Binomial Logistic regression analysis showed the improvement of psychiatric nursing attitude was positively correlated with personality with internal locus of control and students’ past academic performance ranking between 31% and 70%, compared to those ranking after 70%; On the other hand, the improvement of psychiatric nursing attitude was negatively correlated with students’ performance at the second stage of the internship program.
Conclusion: There are 65% of 170 nursing students having positive changes toward psychiatric nursing attitudes right after four weeks of psychiatric internship. The nursing student tends to positive changes of attitudes toward the psychiatric department if she possesses a internal locus of control personality, past academic performance ranking between
31% and 70%, or perceives a unsatisfied performance at the secomd stage of the internship program. Hopefully, the results of this study can servce as a reference for improving the psychiatric nursing attitude for stakeholders, as well as for enhancing the willingness of nuring manpower toward the psychiatric department.

並列關鍵字

Attitudes ； Psychiatric Nursing ； Clinical Practice ； Internship Performance ； Recruitment and Selection ； Career

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