- 學位論文
新進職業衛生護理師工作核心能力勝任程度及相關因子之現況分析
An investigation on core competencies and related factors in novice occupational health nurses
摘要
研究背景與目的：《勞工健康保護規則》於2011年修法，明定職業衛生護理師應完成從事勞工健康服務護理人員訓練課程後方能從業，但許多初踏入職護領域的新進人員反映完成訓練課程後仍自覺能力不足、無法獨立作業，而職護的能力與勞工的健康與安全息息相關，故本研究旨在調查新進職護自覺工作核心能力表現之現況，並分析不同能力養成背景與事業單位特性對新進職護工作核心能力表現之相關性。預期藉由研究結果，彙整出提升新進職護工作能力之相關訓練與課程建議。 研究方法：以「職業衛生護理師從事勞工健康服務現況調查」之結構性問卷作為研究工具，問卷內容包含：個人及事業單位基本資料、職業衛生相關課程經驗、自覺工作核心能力程度四大部分。使用(1)滾雪球取樣發放網路問卷至職護社群交流群組；(2)分層抽樣法，以登記僱有或特約職護之事業單位名冊作為抽樣母群體，依地區、事業單位規模及產業類別之比例進行分層，使用郵寄方式發放問卷。收案條件為執業中、完成並通過勞工健康服務訓練課程、從事職護工作年資兩年以內之職護。問卷回收後以SPSS 25.0統計軟體進行分析，討論個人與事業單位資料變項、職業衛生相關課程經驗、自覺工作核心能力程度之現況，再以卡方檢定分析影響新進職護工作核心能力之相關變項。 研究結果：共回收240份有效問卷（有效回收率：48.1%）。參與研究之新進職護平均年齡為36.32歲（標準差7.26）；平均職護工作年資1.31年（標準差0.62）。能力養成背景：(1)護理教育程度及最高教育程度（含非護理）皆以大學學歷佔多數，分別為60.8%與67.9%；(2)養成教育課程經驗，以沒有修過相關課程的人居多。事業單位特性：(1)聘僱方式以公司專任較多（n=128, 53.3%）；(2)公司專任職護的行業別以製造業與服務業群為大宗（n=98, 76.6%）。然而，不同能力養成背景及事業單位特性的新進職護皆普遍認為「預算編列與稽核」、「研究能力」、「政策與法規制定之遊說與參與」以及「跨文化照護能力」無法勝任，但僅研究能力與教育程度及部分養成教育課程具有顯著相關性。 結論與建議：我國新進職護的工作核心能力應被有效提升，其能力養成之方式應須重新審視，建議參考研究結果修正現有的訓練課程，並將職護教育納入正式護理養成教育中，例如設立相關學程或學位，將課程普及化，增添課程多樣性。俾使護理人員在初踏入職護領域時，即具備一定之能力與知識背景，進入工作後也得以持續銜接進修與提升能力，勞工的健康與安全也能得到更佳的保障。
並列摘要
Background and Purpose: The amended “Regulations of the Labor Health Protection” in 2011 stipulated that occupational health nurses (OHN) must complete training courses before gaining employment. Even after completing the training courses, many novice OHNs still consider they are not proficient and cannot work independently. Moreover, the ability of OHNs is closely related and important to the health and safety of workers. Therefore, the study aims to investigate the current situation of novice OHNs’ work core competencies and to analyze the impact of different ability development backgrounds and enterprise characteristics on their work core competencies. Training and course suggestions should be identified based on the research findings in order to improve the core competencies of novice OHNs. Methods: The research tool is the structure questionnaire for the survey on the status of occupational health nurses within labor health services. Among the contents of the questionnaire were: information about individuals and workplaces, experience with occupational health-related courses, and core competencies at work. Use (1) snowball sampling to distribute online questionnaires to OHNs' communication software; (2) stratified sampling to send paper questionnaires by post, based on the proportion of enterprises' industry categories, unit size, and the geographical locations that provide registered or contracted OHNs. OHNs who are currently practicing, have finished and passed the labor health service training courses, and have worked in labor health care for fewer than two years are eligible to apply. The data factors of individuals and enterprises, experience with occupational health related-courses, and the present status of core competencies at work were analyzed using SPSS 25.0 statistical software, and the chi-square test was performed to evaluate the important variables affecting the results. Results: A total of 240 questionnaires were eligible for final analysis (effective response rate: 48.1%). The mean age of novice OHNs was 36.32 years (SD 7.26), and the labor health care experience was averaged at 1.31 years (SD 0.62). Background in ability development: (1) Bachelor degrees dominated the nursing education level and the highest education level (including non-nursing), with 60.8% and 67.9% respectively; (2) The majority of novice OHNs have not taken relevant courses.Characteristics of enterprises: (1) Full-time employment accounted for the majority of novice OHNs (n=128, 53.3 %); (2) Manufacturing and service industries accounted for the majority of full-time OHNs (n=98, 76.6 %). However, participants with different ability development backgrounds and enterprise characteristics generally considered that "budgeting and auditing", "research ability", "policy/regulation-making and participation", and "cross-cultural care ability" were not competent. However, only research ability was found to be significantly associated to educational attainment and specific formative education courses. Conclusion and Recommendation: The core competencies of novice OHNs in our country should be effectively strengthened, and the method of growing their abilities should be re-examined. It is recommended to revise the existing training courses based on the research findings, and that occupational health nursing education should be integrated into formal nursing education, such as by establishing appropriate programs or degrees to popularize and diversify the curriculum. This allows OHNs to enter the field of labor health service with specific skills and knowledge, and to continue to learn and enhance their talents after they start working. Workers' health and safety can also be better safeguarded.
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