壓力監測系統導入新進護理人員輔導機制減壓成效之探討

Effects of Stress Reduction in Monitoring Mechanism for Novices Nurses with Stress Detecting System

龔文娟(Wen-Chuan Kung)

指導教授 ： 張怡秋

國立中正大學/管理學院/資訊管理系醫療資訊管理研究所/碩士(2015年)

摘要

現今的新進護理人員因年紀輕、專業知識及實習經驗有限、缺乏問題解決能力，其所承受的壓力非常高。這些職場新鮮人因抗壓性低，在如此高壓力的護理工作環境下，若無法有效的紓解壓力，常因身心疲憊而選擇逃避護理工作。
本研究採類實驗性研究、前後測重複測量。以壓力監測系統導入之放鬆技巧為介入措施，檢視介入措施對受試者壓力之影響。以隨機取樣方式，決定實驗及對照組，實驗組有接受壓力監測系統導入之放鬆技巧、對照組則無，主要目的在比較兩組新進護理人員壓力之變化。完成3個月壓力監測的人員共有21名(實驗組8名，對照組13名)。其研究工具包括：(1)個人背景資料表、(2) 心率變異分析儀、(3)壓力監測系統及減壓APP、(4)系統使用滿意度問卷、(5)深度訪談大剛等五部份。
研究結果顯示年齡大小、有無工作經驗、服務科別、有無院院外工作年資，其工作壓力並無顯著差異，以上結果與其他研究結論：年齡較小者工作壓力較高、專科以上教育程度壓力較大，未婚者大於已婚者，曾有院外工作經驗者壓力較低，有不同之結果。在本研究中於壓力超過閾值時，亦有SBP、DBP、HR、LF/HF上升，HRV、LF、HF下降的情形，與國外研究所述，壓力造成以上指標之變化，但在紓壓措施(冥想及肌肉放鬆)介入後，僅HRV在研究結果上呈現顯著差異，此與其他研究有所不同處。
壓力監測的結果顯示，使用減壓APP之實驗組，在介入前後HRV有顯著差異，亦表示在減壓APP使用後壓力下降有顯著不同。並以系統滿意度問卷了解減壓系統導入受試者之相關感受，由系統滿意度問卷敘述性統計可以得知，使用者多給予滿意之評價。輔以深度訪談了解系統使用成效，發現若人員自我壓力調適較差者，減壓APP對受試者會有較大的使用意願及滿意度。
本研究建議將紓壓技巧併入於兩年期新進人員輔導機制中，讓新人學習的過程中能維持身心平衡的狀態，提高學習期間之學習效果，並間接提高留任意願。

關鍵字

心率變異分析 ； 新進護理人員 ； 紓壓輔導

並列摘要

Novice nurses are under very high stress due to their young ages, limited professional knowledge and clinical experience, and lack of the ability to solve problems. Those who are unable to perform well in the stressful working environment may often feel exhausted and choose to evade their jobs if they cannot relieve the stress.
This study was carried out with repeating pre‐test and post‐test of the experiment design, which is a randomized controlled trial (quasi-experimental design). Data of the stress level and use of the relaxation techniques APP were collected and analyzed to confirm the effectiveness of the system intervention. The novices of the hospital were divided in experimental and control groups. The relaxation techniques APP were used on the experimental group but not on the control group. The purpose of this study is to confirm the effectiveness of the system intervention.
A total of 21 novice nurses completed the three-month stress monitoring (8 in the experimental group and 13 in the control group). This study included 5 tools to analyze the data: (1) individual background information, (2) heart rate variability analyzer, (3) stress monitoring system and relaxation techniques APP, (4) structural questionnaire, and (5) in-depth interview outlines.
The results of this study show that there is no significant difference in terms of age group, working experience, clinical background, and seniority, which are similar to the results of other studies. However, the results show a significant difference with respect to marital status and past working experience of the novice nurses. The results of this study also show that when the stress exceeds a threshold value, the value of SBP, DBP, HR, HF, and LF increase while the HRV decreases, which are similar to the results of other studies. After applying the relaxation techniques (meditation and muscle relaxing techniques), the HRV shows a significant difference between the experimental and the control groups. This finding is different from the prior studies. The experimental group shows high satisfaction of using the relaxation APP and is willing to continue using the APP.
The result of the stress monitoring shows that there is a significant difference in HRV before and after the experimental group used the relaxation technique. The structural questionnaire and in-depth interview evaluation show high satisfaction. Especially, those who coped with stress poorly are willing to use the relaxation techniques APP more often and express high satisfaction.
This study suggests incorporating the relaxation techniques APP into the two-year novice nurse guidance program to assist novice nurses to deal with stress and maintain the balance of their physical and mental status, and to enhance the learning outcomes and decrease the turnover rates.

並列關鍵字

relaxation technique Intervention ； heart rate variability analysis ； novice nurses

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