戰後臺灣護理教育與專業發展(1945-1991)

Nursing Education and Professionalization in Post-war Taiwan(1945-1991)

蕭雅宏(Ya-Hung Hsiao)

指導教授 ： 邱馨慧 ； 劉士永

國立清華大學/人文社會學院/歷史研究所/博士(2014年)

摘要

本論文以戰後臺灣護理教育與專業發展為題，1945年起臺灣由於政治社會的變化，中國大陸護理背景、日本殖民傳統與西方外援影響，彼此錯綜複雜交互作用，影響戰後護理專業化的發展。本論文試圖從政治因素、社會變遷、教育制度與醫護環境等項，重新理解歷史脈絡下，戰後臺灣出現過各種形形色色的護理面貌，並探討發展迄今若干困境。研究年代則斷限於1991年，因該年〈護理人員法〉立法實施，象徵護理發展從教育、考試、證照到專業認定，其權益終於被規範保障。
透過研究，初步得到下述結論：一、護理的政治面向。從1950年代以降，隨著反攻動員，「護理即後勤」觀念灌輸於學校教育、護理與軍訓、民防、婦聯會、援外、教會醫療等，皆可看出政治力操作無孔不入。二、學制的變化。1970年代前後，在高中與大學護理教育以外，曾出現三專、二專、四年助產、在職班與五專等多樣化學制，部分雖已淘汰，有則仍為主力，研究指出這些學制並非過渡或雜亂之急就章，存在實有其必要性。三、專業化的建立。護理在日治時代是一項職業，戰後受到技術演進與現代觀念影響，逐漸形成一項專業。而早年受限環境，所培養之助理護士、代用護士、保健員與非正規教育出身者，在專業化約略建立同時，也隨之淘汰；取而代之者，為正統護理科系背景，經國家考試取得執業證照之護士與護理師。末章從政治外緣切入，檢視護理教育內涵到專業化的核心歷程，可謂臺灣護理史的寫照。

關鍵字: 護理史, 護理教育, 護理專業, 政治面向

關鍵字

護理史 ； 護理教育 ； 護理專業 ； 政治背景

並列摘要

The thesis focuses nursing education and professionalization in Post-war Taiwan. After 1945, simultaneous, complex changes occurred throughout Taiwanese politics, the Chinese nursing industry, Japanese colonial practices, and the influence of Western foreign aid. These influenced postwar professional development in nursing. This paper attempts to understand various postwar nursing aspects and explores lasting difficulties through historical contexts of political factors, social change, education, and health care. The postwar period covers 1945 to 1991, when the “Nursing Personnel Act” was legislatively implemented. The act is a symbol of development in nursing education, exams, professional licensing, and professional identification. At this point, nursing rights were standardized and secured.
Research has presented the following preliminary conclusions. First, there were politics aspects of nursing. During the 1950s, the Republic of China (ROC, Taiwan) wanted to retake China, and thus the concept of "nursing is support" was instilled in school education, nursing classes, military training, civil defense, women’s associations, foreign aid, and medical treatment from churches. They all showed pervasive political forces. Second, there were changes in education. Around 1970, in addition to nursing classes in high school and college, there were two to five-year colleges, four-year midwifery schools, on-the-job training programs, and other diverse educational systems. Eventually, some of these schools were deemed unnecessary and eliminated; others, supported by studies, have remained to the present day as established and necessary institutions of learning. Third, of note is professional establishment. Nursing during the Japanese colonial era was considered a career choice. After the war, it was influenced by technological evolution and modern concepts, and thus gradually became a profession. From 1950 to 1970, trained assistant and substitute nurses, health workers, and medical care workers with informal backgrounds were gradually eliminated from the field following the establishment of a specialized nursing educational system. Those with formal nursing backgrounds and those who took national exams to become licensed nurse practioners took over. The final chapter of this study, which starts with foreign political influence and ends with the development of the field, inspects the specialized core courses of nursing education, which can be described as portraying the history of Taiwan nursing.

Keywords: Nursing History、Nursing Education、Nursing Profession、Political Perspective

並列關鍵字

Nursing History ； Nursing Education ； Nursing Profession ； Political Perspective

參考文獻

6.「行政院衛生署檔案」國史館藏

「臺灣省政府委員會議檔案」國史館臺灣文獻館藏

「經合會檔」中央研究院近代史研究所檔案館藏

行政院衛生署編，《護理，台灣》，臺北：行政院衛生署，2008。

張朋園、羅久蓉，《周美玉先生訪問紀錄》，臺北：中央研究院近代史研究所，1993