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  • 學位論文

加護病房護理人員批判性思考能力與關懷照護行為之研究

The Critical Thinking Abilities and Caring Behaviors on Intensive Care Unit Nurses

指導教授 : 黃惠滿

摘要


背景:加護病房護理人員在病人病情嚴重時,運用批判性思考在有限時間內找出病人問題,偏重於生理問題的處理,卻易忽略病人的需求及對病人的關懷,批判性思考能力與關懷照護行為是加護病房護理人員應具備的照護能力,因此探討加護病房護理人員批判性思考能力、關懷照護行為及其影響因素有其必要性。 目的:探討加護病房護理人員的批判性思考能力、關懷照護行為及其關係。 方法:採橫斷式相關性研究,以方便取樣選取醫學中心、區域醫院和地區醫院三家醫院352位加護病房護理人員,以「批判性思考能力量表」、「關懷照護行為量表」和「加護病房護理人員基本特質問卷」三份問卷收集資料。 結果︰(1)加護病房護理人員呈現中等程度的批判性思考能力和關懷照護行為。(2)批判性思考能力受臨床層級影響;其次量表中的解釋能力受到職稱影響,推論能力則受加護病房工作總年資影響。(3)整體關懷照護行為總表受年齡、婚姻、臨床層級、臨床工作總年資與ICU總年資影響。(4)批判性思考能力和關懷照護行為間無相關性。 結論/實務應用:在臨床實務,加護病房護理人員可藉參與臨床案例討論會,共同討論以及經驗分享,加強其批判性思考的能力;再者舉辦以病人為中心的跨團隊會議,以了解病人多層面的照護需求,協助護理人員能表現出以病人為中心的關懷照護行為。在護理教育,建議學校教師運用問題導向學習法的教學策略,讓護生從臨床實務的情境中學習,培養與病人相關資訊歸納技巧和問題解決技能,提升護生批判性思考和問題解決的能力;再者,可運用案例分享、角色扮演和團體討論於課室教學,讓護生學習關懷病人的具體行為,以期日後在護理工作中能適時展現關懷照護行為。

並列摘要


Background: Intensive care unit (ICU) nurses will use their critical thinking ability to find out the major issues of seriously ill patients, all done in a limited time. However, the severe illness and time limitations may make nurses emphasize the physical problems and ignore the patient’s other needs and the nurse’s caring behavior. Therefore, both critical thinking ability and caring behavior should be basic abilities for ICU nurses. For this reason, it is necessary to study the critical thinking ability and caring behavior and their related factors for intensive care unit nurses. Purpose: This study investigated the correlation between critical thinking ability and caring behavior of nurses in intensive care units (ICUs). Methods: A cross-sectional correlational research design and convenience sampling were adopted to collect data from 352 nurses working in ICUs at three hospitals (i.e., a medical center, a regional hospital, and a district hospital) in Southern Taiwan. The research tools were structured questionnaires combining “Critical Thinking Ability Scale”, “Caring Behavior Scale” , and “Demographic Data of Nurses”. Results: The results show that: (1) the nurses possessed an average level of critical thinking ability and caring behavior.(2) the nurses’ critical thinking ability was influenced by their clinical ladder ; “interpretation ability” was influenced by their position title, and “inference ability” was influenced by their seniority in an ICU.(3) the nurses’ caring behavior was influenced by their marital status, age, clinical ladder, seniority working in a hospital, and seniority working in an ICU.(4) there was no correlation between the nurses’ critical thinking ability and caring behavior. Conclusions/Implications for Practice: For clinical practice, ICU nurses can improve their critical thinking ability by attending clinical case discussion meetings. During those meetings, nurses can share their experience and discuss their case in group discussions and it will help to enhance their critical thinking ability. In order to present caring behavior with patient-center attitudes, nurses can arrange cross-disciplinary teamwork meetings to understand the patients’ multi-level care and needs. In nursing education, nursing teachers can use problem-based learning teaching tactic to let nursing students learn from clinical practice. This can cultivate the patient-related information induction skill, problem-solved skills, and improve nursing student critical thinking as well as problem-solved ability. Case study, cosplay and group discussion can be used to make nursing students learn the specific behavior of caring patients and they can show appropriate caring behavior in their future nursing careers.

參考文獻


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