精神科護理人員自我效能與自覺職業危害之研究

The Relationship of Self-efficacy and Perceived Occupational Hazards of Psychiatric Nurses

張雅芬(Ya-Fen Chang)

指導教授 ： 李選

中山醫學大學/醫學院/醫學研究所/碩士(2005年)

https://doi.org/10.6834/CSMU.2005.00093

摘要

本研究目的在探討精神科護理人員照護自我效能與自覺職業危害之現況、與人口學變項、照護自我效能及自覺職業危害之相關性，本研究採用相關性研究法。採立意取樣，於民國九十四年四月至五月，使用護理人員照護層自我效能量表、自覺職業危害量表為研究工具，針對中區南區兩所署立精神科專科醫院急性病房護理人員進行問卷調查，獲有效問卷145份。資料以描述性統計、t檢定、單因子變異數分析及 Pearson correlation 等統計方法進行分析。
結果發現：1.精神科護理人員對自我照護能力有八成信心其實際能力表現方面也有七成以上之把握，顯示對自我專業能力持肯定的態度。2.年齡、工作年資、婚姻與照護預期自我效能及實際表現均呈正相關。3.精神科護理人員對自覺職業危害之程度以「生物、化學、物理危害」因素認知最高，平均3.87分。4.工作年資與自覺職業危害呈負相關，職稱在自覺職業危害認知層面之「心理社會危害」因素有差異。5.近一年樣本經歷危害事件種類以遭受暴力攻擊為主。在因應各項危害事件之處置以「尋求同事協助」為主。6.再次經歷各項危害事件中，以再經歷「處理病患逃跑造成人員損傷（包括病患生命危急、醫療糾紛）」者之壓力指數居冠(7.46分)。7.護理人員發生生物傷害以失眠居多(37.8%)、人因工程傷害以肌肉骨骼酸痛(59.3%)居多、心理社會傷害以焦慮(48.3%)居多。
根據以上結果，年齡與工作年資是影響照護自我效能及自覺職業危害的重要因素，精神科護理人員之照護自我效能需加強「非常規性」之照護能力，而自覺職業危害程度與實際發生危害事件仍以暴力攻擊為主，可作為護理實務、教學、研究及未來制定改善精神科護理職場政策之參考依據。

關鍵字

精神科護理人員 ； 照護自我效能 ； 自覺職業危害

並列摘要

This study was to explore the nurses’ self-efficacy of patient care and their perceptional occupational hazards in psychiatric hospitals. The relationship among the above two variables and demography was also discussed. The study was designed by a cross-sectional method. By purposive sampling, a questionnaire was collected in April and May of 2005 from the psychiatric nurses in acute wards of Psychiatric Center Hospitals Department of Health in central and southern Taiwan based on “Psychiatric Nurse’s Self-efficacy in Caring Aspect Questionnaires” and the “Perceptional Occupational Hazards Questionnaires”. One hundred and forty-five questionnaires were received. Data was analyzed with the methods of descriptive statistics, t-test, one way ANOVA, and Pearson correlation.
Seven major findings of this study were summarized in following. 1. The result shows that the psychiatric nurses had 80% confidence on self- efficiency of patient care. This confidence is found to be over 70% practically. It shows that psychiatric nurses are positive on their professional capability. 2. Age, working experiences and marriage were significantly on the expectation of self-efficacy and self-efficacy in nursing practice. 3. The highest perception of psychiatric nurses on occupational hazards is “Biologic, chemical & psysical hazard” with an average score of 3.87. 4. Working experiences and perceptional occupational hazards were negatively related. Different professional titles had significantly on occupational hazards of “Psychosocial hazard”. 5. In the past year, the major type of occupational hazards that samples subjected is violent attack. 6. The assistance from colleague is the common handling of occupational hazards. 7. Among the re-occurrence of hazardous events, the highest pressure, with a score of 7.46, is the experience of human injury including putting patients’ life in danger and medical treatment arguments when dealing with patient escaping. 8. Psychiatric nurse’s major “Biologic, chemical & psysical Injuries ” is insomnia (37.8%), while the major “Ergonomic Injuries” is muscular pain (59.3%) and “Psychosocial Injuries” is anxiety(48.3%).
In summary, age and experience are two important factors of self-efficacy of patient care and their perceptional occupational hazards. Non-routine nursing care of psychiatric nurses’ self-efficacy needs to be enhanced. Violent attack dominates the psychiatric nurse’s perceptional occupational hazards and occupational injuries. This study provides the reference information for nursing practice, teaching, research and future improvement on strategy of psychiatric nursing working environment.

並列關鍵字

Psychiatric nurses ； Self-efficiency of patient care ； perceived occupational hazards.

參考文獻

王精文、賴明德(2000)•輪班人員工作生活品質與工作適應關聯性研究•科技學刊，9（4），309-318。

毛家舲、張玨(1997)•精神科急診照顧•護理雜誌，44(5)，89-95。

余靜雲、鍾信心(2004)•門診精神分裂症患者生活事件之自我效能探討•護理雜誌，51(1)，45-51。

林麗華、林清文(2003)•國中生數學科學習之目標導向、社會比較、自我效能與課業壓力關係研究•彰化師大輔導學報，53，87-132。

侯伯勳、林志堅、卓良珍、陳展航、闕清模（1999）•精神科急性病房意外事件危險因素之回溯性分析•慈濟醫學，11（3），271-278。