多媒體教育介入對精神科新進護理人員治療性人際關係及精神症狀評估能力之成效

背景：精神科護理人員與病人發展治療性人際關係及專業的精神症狀護理評估是非常重要的，護理人員具備專業溝通技巧及精神症狀評估能力，才能有效收集病人的資料及提升照護品質，透過多媒體設計教學，可滿足新進護理人員在職場專業的學習。目的：探討精神科新進護理人員參與「治療性人際關係及精神症狀評估多媒體教育」前後其治療性人際關係及精神症狀評估能力增進之成效。方法：本研究採實驗研究設計，以台灣南部某精神專科醫院之新進護理人員為研究對象。28位新進護理人員被隨機分派到實驗組及對照組。實驗組之新進護理人員接受多媒體的課程教育訓練，對照組的新進護理人員則未接受任何常規的教育訓練，實驗組在多媒體教育介入前(T1)、介入後兩週(T2)及介入後四週(T3)，與對照組一樣，受試者皆會接受客觀結構式臨床技能測驗(Objective Structured Clinical Examination, OSCE)，以比較實驗組新進護理人員治療性關係建立及精神症狀評估能力增進之成效以及兩組在此兩項能力上之差異。結果：經多媒體教學介入後，實驗組受試者在建立治療性人際關係能力的第一次後測(RT2)和第二次後測(RT3)結果皆顯著高於前測(RT1) (F=13.14, p<.001)；其精神症狀評估能力的第一次後測(AT2)和第二次後測(AT3)的結果亦皆顯著高於前測(AT1) (F=68.42, p<.001)。對照組受試者在兩項能力的前測、第一次後測及第二次後測結果的比較，均無顯著差異。實驗組建立治療性人際關係的能力兩次前後測的改變量(RT2-RT1 & RT3-RT1)皆顯著高於對照組兩次前後測的改變量；其精神症狀評估能力的三次前後測改變量(AT2-AT1 &AT3-AT1&AT3-AT2)皆顯著高於對照組的三次前後測改變量。結論：多媒體教學對精神科新進護理人員治療性人際關係及精神症狀評估能力有顯著的學習成效，故建議各醫院的精神科未來可多利用多媒體教學作為新進護理人員教育訓練之方式。

關鍵字

多媒體教育；治療性人際關係；精神症狀評估；客觀結構式臨床技能測驗

並列摘要

Background The abilities to develop therapeutic relationships with patients and assess patients’ psychotic symptoms are very important to new psychiatric nurses. Nurses would effectively collect patients’ data and provide better quality of care for patients, if they possess the professional communication skills and the assessment capability of psychotic symptoms. In order to meet new nurses’ needs of professional learning in psychiatric nursing, multimedia education program would be a considerable way to work. Purpose The purpose of this study was to explore the effects of multimedia education program about therapeutic relationship and the skills of psychotic symptoms assessment on the clinical capacity of new psychiatric nurses. Methods An experimental research design was adopted in this study. Twenty eight new psychiatric nurses were recruited from a psychiatric hospital in southern Taiwan; all of them were randomly assigned into either the experimental group or the control group. Fourteen new psychiatric nurses in the experimental group received the multimedia education courses about therapeutic relationship and the skills of psychotic symptoms assessment, whereas the other new psychiatric nurses who were randomly assigned into the control group did not take the training program at the same time. Three times of the Objective Structured Clinical Examination (OSCE) were used to examine the abilities of therapeutic relationship development and psychotic symptoms assessment for the participants in both groups at before (T1), two weeks after the training program intervention (T2), and four weeks later (T3). Comparison of both abilities between the experimental group and the control group has been shown in the results of this study. Results In the experimental group, the clinical capacity of therapeutic relationship development at time 2 (RT2) and time 3 (RT3) were significantly better than pretest at time 1 (RT1) (F=13.14, p<.001); the clinical capacity of psychotic symptoms assessment at time 2 (AT2) and time 3 (AT3) were also significantly better than pretest at time 1 (AT1) (F=68.42, p<.001). However, no significant differences in the abilities of therapeutic relationship development and psychotic symptoms assessment were found among time 1 (pretest), time 2, and time 3 in the control group. Two mean differences in the abilities of therapeutic relationship development (RT2-RT1 & RT3-RT1) and psychotic symptoms assessment (AT2-AT1 & A3-AT1) in the experimental group were found significantly higher than the control group. Moreover, the mean difference in the ability of psychotic symptoms assessment between time 2 and time 3 (AT3-AT2) in the experimental group were significantly higher than the control group as well. Conclusions The effects of multimedia educational intervention about therapeutic relationship development and psychotic symptoms assessment on the clinical capacity of new psychiatric nurses were substantially verified. The application of the multimedia educational courses is strongly recommended for the new nurses training program in psychiatric departments/hospitals.

並列關鍵字

Multimedia education ； Therapeutic relationship ； Psychotic symptoms assessment ； OSCE

參考文獻

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