加護病房護理人員其正念程度對睡眠障礙與專業生活品質的調節效果探討

現今護理環境面臨人力短缺與流動的問題，若可提高護理人員的專業生活品質，不但可以降低離職率，還可以提升整體的照護品質。而睡眠障礙一直是加護病房護理人員普遍面臨的問題，且易對專業生活品質產生負面的影響。而研究指出正念程度與專業生活品質有極大關係，若能提升正念程度，可增進護理人員的整體專業生活品質。故本研究目的欲探討加護病房護理人員基本屬性、睡眠障礙、正念程度與專業生活品質的相關性，以便了解正念程度對專業生活品質與睡眠障礙是否具調節效果。本研究採橫斷式研究設計，以結構式問卷調查，方便取樣的方式收集資料，針對北區某醫學中心內外科加護病房護理人員為研究對象，進行問卷收集。研究工具包括：基本屬性量表、專業生活品質量表、匹茲堡睡眠品質量表、五因素正念量表。收案人數為97人，收案期間為2018年10月至12月。以描述性統計、獨立樣本t檢定、單因子變異數分析、皮爾森績差相關、階層迴歸分析進行資料的分析探討。透過本研究結果可知，北區加護病房護理人員其專業生活品質:悲憫滿足、次級創傷壓力與專業倦怠皆屬於中程度；有80%的護理人員有睡眠障礙的問題，正念程度的平均分數為121.94±9.93分。而睡眠障礙越嚴重的護理人員其專業生活品質的次級創傷壓力（r=0.256，p=0.011）與專業倦怠程度越高（r=0.251，p=0.013）；正念程度較高的護理人員其專業生活品質的悲憫滿足程度較高（r=0.305，p=0.002），次級創傷壓力（r=-0.325，p<0.001）與專業倦怠（r=-0.493，p<0.001）的程度較低。把正念程度當成調節因子，無法對睡眠障礙與專業生活品質有調節效果，顯示睡眠障礙對加護病房護理人員專業生活品質的影響，無法靠正念就可提升改善。本研究結果無法支持正念為有睡眠障礙的加護病房護理人員改善專業生活品質的調節因子。期許未來臨床或可再深入分析可以改善護理人員睡眠障礙的原因與專業生活品質間的關係，正念或許不是改善的關鍵，但可當成輔助角色，使護理人員從臨床照護中體會更多正能量，期改善加護病房護理人員的專業生活品質，提升整體醫療照護品質。

關鍵字

加護病房護理人員；專業生活品質；睡眠障礙；正念程度

並列摘要

Professional quality of life is associated professional well-being and performance. Therefore, it is very important to improve nurses’ professional quality of life in order to have a better quality of care. How to find ways to improve it is a global concern. However, sleep disturbance has been a common problem for nurses in intensive care unit (ICU), which influences the professional quality of life. The purpose of this study was to investigate the relationship between the sleep disturbance, mindfulness and professional quality of life among nurses working in ICU. Also, the aim of this study was to understand the effect of mindfulness on the professional quality of life and sleep disturbance, as a moderator. A cross-sectional study design was conducted to collect data by a structured questionnaire with convenient sampling. The participants, ICU nurses were recruited from a medical center in Taipei City. The data was collected by four questionnaires including characteristics questionnaire, Professional Quality of Life-5, Pittsburgh Sleep Quality Index, and the Five Factor Mindfulness Questionnaire. 97 subjects were recruited in this study from October 2018 to December 2018. The statistics analysis (SPSS 18th) includes descriptive statistics, independent sample t-test, ANOVA, Pearson’s correlation, and hierarchical regression. In this study, we found that scores of both positive (Compassion satisfaction) and the negative (Secondary Traumatic Stress & Burnout) components of the professional quality of life were around medium, indicating these are needed to be improved. About 80% of nurses in ICU have sleep disturbance, and the average score of mindfulness is 121.94±9.93. The results showed that sleep disturbance was positively correlated with secondary traumatic stress(r=0.256，p=0.011) and burnout(r=0.251，p=0.013). In addition, mindfulness was positively correlated with compassion satisfaction (r=0.305，p=0.002), and negatively correlated with secondary traumatic stress(r=-0.325，p<0.001) and burnout(r=-0.493，p<0.001). Mindfulness wasn’t a moderator on the professional quality of life and sleep disturbance. We may not support mindfulness is a moderator to improve professional quality of life among nurses with sleep disturbance. However, we found mindfulness could help nurses to have more positive feelings toward their work in providing care to patients, which might help them to improve their professional quality of life. Further studies should focus on strategies to improve sleep disturbance among ICU nurses in order to improve their professional quality of life.