照顧愛滋病患護理人員工作壓力與因應行為之初探

The Initial Study of Working Pressure and Adaptive Behavior of Nurses in Caring AIDS Patient

顧淑芳(Shu-Fang Ku) ； 蔣欣欣(Hsien-Hsien Chiang) ； 劉盈君(Ying-Chun Liu) ； 楊美紅(Meei-Horng Yang)

《中華職業醫學雜誌》 9卷1期 (2002/01) Pp. 11-20

摘要

愛滋病的快速流行已經造成社會的注意及健康照顧者的挑戰，而護理人員是人數最多且直接參與照顧病患的健康照顧者。為瞭解照顧愛滋病患護理人員所面對的壓力與因應行為取向，於1999年12月至2000年3月，在台北某醫學中心邀請照顧愛滋病患的護理同仁參與支持性團體。由兩位具有精神科護理專業背景的護理教師擔任團體領導者、協同領導者。每次團體的進行之前先舉行病人團體，然後才是護理人員團體。將團體過程紀錄，經由與專家討論方式進行分析、命名及歸類。結果發現護理人員面對照顧愛滋病患的工作壓力包括：個人的心理壓力－怕被感染、對疾病的不瞭解、病患的基本需要照顧多、面對病患自殺產生無力感、溝通上擔心病患被傷害；社會的烙記－擔心家人不能給予支持、鄰人或其他社交朋友異樣的眼光；道德的衝擊－對同性戀的偏見；專業的責任－制服下的壓力與責任。經由團體過程，護理人員在瞭解及覺醒工作的壓力之後，離職意願顯著下降，並能尋求適當的資源，作有效的調適，有助於提昇因應行為與個人成長，進而提高工作的專業能力與病患的照顧品質。

關鍵字

愛滋病 ； 護理人員 ； 支持性團體 ； 工作壓力 ； 因應行為

並列摘要

The rapid spread of AIDS has caused great concerns in the society and become one of the challenges that care providers encounter nowadays. Among them, nurses are not only the ones who directly take care of AIDS patients, but also outnumber any other care providers. Therefore, from December 1999 to March 2000, a medical center in Taipei invited the nurses in charge of the care of AIDS patients to participate in supportive groups, aiming to understand the pressures they underwent and the adaptive behaviors they tend to. During the process, two nursing teachers with professional background of psychiatric-mental health nursing acted as the group leaders and the coordinating leaders respectively. The nurse supportive group took place every time after AIDS inpatient therapeutic group. We documented the process of the supportive groups and discussed with experts, trying to analyze, categorize and term the pressures that the nurses underwent while providing care to AIDS patients. Study result showed that the pressures included: personal pressure--being afraid of being infected, not having enough understanding about the disease, patients’ lack of the ability to take care of themselves, helplessness upon facing patients’ committing suicide, worrying that patients might be hurt during their communications; social stigma-worrying that families were not supportive, the unusual attitude from neighbors or social cooperators; moral conflictprejudice toward homosexuality; professional responsibility- the pressure and responsibility of wearing nurses’ uniform etc. With the help of the supportive groups, nurses are able to have further understandings about their pressures and thus to search for proper supporting resources. After the process of group, they can effectively accommodate themselves to their jobs and reduce the will to quit, which is helpful for them to take adaptive behaviors and to promote the ability with their jobs. In return, both the nurses’ professional capability and the quality of care they provide will be improved.

並列關鍵字

AIDS ； Nurse ； Supportive Group ； Working Pressure ； Adaptive Behavior