比較專科護理師自覺重要角色能力與實際執行角色能力之看法：以Q方法探討

背景：專科護理師（nurse practitioner, NP）之進階護理角色在臨床期盼上仍有落差，導致NP自身對角色能力期待與發展產生困境。目的：本研究藉由調查NP角色能力之自覺重要性與實際執行現況，來探討理想與實務層面下的差異性及其影響因素。方法：以橫斷性研究設計，利用Q方法進行資料收集。測量工具以「專科護理師角色能力問卷量表」共56題，二個研究問題相隔二週做調查。研究對象共40名，含內科21位（52.5%）與外科19位（47.5%）。結果：NP自覺重要角色能力與實際執行角色能力有顯著差異的結構面有：醫療輔助（t = -5.62, p ＜ .001）、臨床研究（t = 4.14, p ＜ .001）、專業諮商（t = 2.29, p = .027）及直接照護（t = 2.21, p = .033）。基本屬性中，在教育程度（t = -2.17, p = .036）與是否加入專科護理師學會（t = -2.36, p = .017）達顯著差異，顯示學歷愈高或具專科護理師會員者，對重要角色能力抱持高度自我期許。結論：專科護理師在面臨角色期望仍有不符，尤其在實務面極重在醫療輔助上，專科護理師需回歸及落實進階護理的角色與功能，以利護理專業之提升。

關鍵字

專科護理師；角色能力； Q方法

並列摘要

Background: The gap between the expectation and the development of role competency is a dilemma that nurse practitioners (NPs) face in clinical settings. Purpose: This study was designed to explore the perceived importance and actual practice of the role competencies of NPs and to compare the differences between the ideal and practical domains as well as related factors. Methods: This cross-sectional design study used Q-sort to collect data. A 56-item ＂Nurse Practitioner Role Capacity Questionnaire＂ was used as the research tool. Two questionnaires: Perceptions of Important Role Competencies and Actual Execution of Role Competencies were distributed to NPs twice, at times that were 2 weeks apart. A total of 40 participants were recruited, including 21(52.5%) internal medicine NPs and 19 (47.5%) surgical medicine NPs. Results: The significant differences that were identified in this study between the perceived importance and actual practice of role competencies were, by domain: medical assistance (t = -5.62, p ＜ .001), clinical research (t = 4.14, p ＜ .001), professional consultation (t = 2.29, p = .027), and direct care (t = 2.21, p = .033). The correlative factors for these differences were: education level (t = -2.17, p = .036) and membership in the Nurse Practitioner Association (t = -2.36, p = .017). NPs with higher levels of education and with membership in the Nurse Practitioner Association earned higher scores for self-expectation in important clinical competency. Conclusions: NPs face discrepancies in their role expectations, in important part due to their role as providers of medical assistance in clinical practical settings. NPs need to learn and demonstrate the roles and functions of advanced nursing practice to enhance nursing professionalism profoundly.

並列關鍵字

nurse practitioner ； role competency ； Q-sorts

參考文獻

童恒新、蔡秀鸞、王采芷（2010）．台灣專科護理師執業現況調查．台灣醫學，14（3），264–271。[Tung, H. H., Tsay, S. L., & Wang, T. J. (2010). Scope of practice for nurse practitioner in Taiwan. Formosan Journal of Medicine, 14(3), 264–271.] https://doi.org/10.6320/FJM.2010.14(3).03

王潤清、林靜蘭、柯舜娟、張艾玲、陳月枝、李雅文（2014）．某醫學中心專科護理師對工作範疇的看法．長庚護理，25（2），137–148。[Wang, R. C., Lin, E. C. L., Ko, S. C., Chang, A. L., Chen, Y. C., & Lee, Y. W. (2014). The views of nurse practitioners toward the scope of their work in a medical center. Chang Gung Nursing, 25(2), 137–148.] https://doi.org/10.3966/102673012014062502002

汪　蘋、盧美秀（2006）．專科護理師執業現況與角色任務期望之探討．榮總護理，23（2），157–170。[Wang, P., & Lu, M. S. (2006). The performance and tasks of nurse practitioners-The actuality and expectation. VGH Nursing, 23(2), 157–170.] https://doi.org/10.6142/VGHN.23.2.157

邱慧洳、蔡秀鸞、童恒新（2017）．專科護理師的新時代．護理雜誌，64（1），11–16。[Chiu, H. J., Tsay, S. L., & Tung, H. H. (2017). The new era of the nurse practitioner. The Journal of Nursing, 64(1), 11–16.] https://doi.org/10.6224/JN.000003

唐婉如、葉清惠（2007）．專科護理師角色的發展—我見我思．護理雜誌，54（2），85–90。[Tang, W. R., & Yeh, C. H. (2007). Nurse practitioner development: From the perspective of the author. The Journal of Nursing, 54(2), 85–90.] https://doi.org/10.6224/JN.54.2.85

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比較專科護理師自覺重要角色能力與實際執行角色能力之看法：以Q方法探討

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