護理人員關懷照護行為與護理品質之相關研究

Association between Caring Behavior of Nursing Staff and Nursing Quality

張美娟(Mei-Chuan Chang)

指導教授 ： 毛莉雯

高雄醫學大學/健康科學院/公共衛生學研究所碩士在職專班/碩士(2005年)

摘要

研究目的：
本研究主要目的是瞭解護理人員是於不同公私立醫院其護理關懷照護行為的差異情形，進而探討是那些因素影響了護理人員的關懷照護行為，且護理人員之關懷照護行為是否預測了護理品質 。

研究方法：
本研究採橫斷性研究設計立意取樣，針對大高雄地區兩家地區醫院護理人員為主要研究對象，採結構式問卷調查法。主要研究工具是由Cronin 與Harrison於1988年根據Jean Watson 人性關懷理論關懷要素所發展的關懷行為評估量表(Caring Behavior Assessment; CBA)後，經馬淑清於2002年以雙翻譯成中文問卷。兩院有效樣本為206份，有效回收率為91.6%。

研究結果：
公私立兩家醫院護理人員經卡方檢定在人口學資料無差異情形下，經獨立樣本T檢定兩家醫院護理人員的關懷照護行為有顯著差異，且公立醫院高於私立醫院。經ANOVA分析也發現護理人員的教育程度、人格特質、執照會影響關懷照護行為，而工作環境中的病房特性、護理人員被支持程度，也會影響護理人員關懷照護行為。經由線性迴歸分析，發現護理人員的人格特質、執照及醫院權屬別會影響護理關懷照護行為。經皮爾森相關分析發現護理人員關懷照護行為與護理品質之意外事件發生率及院內感染率成負相關，與護理服務滿意度成正相關。
結論與建議：
依據研究結果已達研究目的，也支持了本研究假設，可得出結論為護理關懷行與護理品質相關，也驗證了Roy(1973)給護理品質下的定義「它是一項關心、護理的中心」，及Kosa(1989)認為真正有效的護理品質包含一為臨床面、一為關懷面，此乃一實證研究。建議護理行政管理者應整合關懷及管理的理論，建立關懷性領導，提供護理人員支持，進而影響護理人員關懷之動機，並建立一套關懷照護執行手冊，當作臨床上執行護理的標準。

關鍵字

意外事件發生率 ； 人格特質 ； 護理服務滿意度 ； 院內感染率 ； 護理關懷行為 ； 護理品質

並列摘要

Research Purpose:
The aim of this research was to find out the differences of nursing caring behaviors between the nursing staff in different public and private hospitals, furthermore to discuss what are the factors that influence their nursing caring behaviors and whether their behaviors predict the nursing quality.

Research Method:
This research used purposive sampling, and a cross-sectional study was conducted with the method of structured questionnaire survey among the nursing staff of two local hospitals in Kaohsiung as the research object. The main research tool was the Caring Behavior Assessment (CBA), which was developed by Cronin and Harrison in 1988 according to Jean Watson’s Theory of Human Caring, and was translated into a Chinese survey by MA, Shu-ching in 2002. From the two hospitals we obtained an effective sample size of 206, the effective response rate is 91.6%.

Research Finding:
The nursing staff of the public and the private hospital via chi-square test in accordance with non-difference of demographic data, through independent samples t-test there was a notable difference between the caring behavior of the nursing staff from these two hospitals, and the public hospital nursing staff had higher caring behavior than the private hospital one. Through ANOVA analysis we also found that their education levels, characters, and licenses had influences on their caring behaviors, and then the ward quality in their working environment as well as the support rating toward the nursing staff also influenced their caring behaviors. From our linear regression analysis, we found that the nursing staff’s characters, licenses, and hospital ownership had effects on their caring behaviors. Via Pearson correlation analysis we found that the nursing staff’s caring behaviors and nursing quality had a negative correlation with the rate of accident occurrence and the nosocomial infection rate, and then had a positive correlation with the nursing satisfaction.

Conclusion and Suggestion:
We have achieved our research purpose according to the research findings which also supported our hypothesis, thus we obtained the conclusion that nursing caring behavior is related to nursing quality, this proved Roy’s definition toward nursing quality, “It’s a consideration, the core of nursing”, and also proved his opinion that the real effective nursing quality has its clinical aspect and caretaking aspect; this is an empirical research. We suggest that the nursing administration supervisor should integrate caretaking theory with administration theory to set up a caretaking guidance and offer support to the nursing staff, furthermore to affect their motif of caretaking and create a caring implementation manual as the standard of clinical nursing practice.

並列關鍵字

nursing satisfaction ； infection rate ； character ； nursing quality ； rate of accident occurrence ； nursing caring behavior

參考文獻

參考文獻

一、中文部份

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王震武等（2001），心理學，學富，台北。