照顧新型冠狀病毒肺炎病人護理師的準備與心理建設－以北台灣某醫學中心為例

The Readiness and Mental Construction of Nurses Caring for Patients With COVID-19: An Example From a Medical Center in Northern Taiwan

蘇瑞源(Jui-Yuan SU) ； 黃子珍(Tzyy-Jen HUANG) ； 明金蓮(Jin-Lain MING) ； 穆佩芬(Pei-Fan MU)

《護理雜誌》 67卷6期 (2020/12) Pp. 18-24

https://doi.org/10.6224/JN.202012_67(6).04

摘要

新型冠狀病毒肺炎（COVID-19）疫情的持續延燒，國際間陸續傳出第一線醫護人員因堅守工作崗位、提供臨床照護工作而不幸染疫的消息。台灣的護理師基於過去SARS期間的慘痛經驗，以超前部署的概念建構感染防護的照護標準。但國際間的公衛專家對於COVID-19病毒的傳染力及變異性至今仍無法確實掌握，無形增加第一線護理師執行照護工作時的心理壓力。本文以北部某醫學中心為例，應用JBI COVID-19臨床指引及感控照顧經驗，從護理師個人的意識（awareness）、感知的支持（perceived support）、和自我效能／感知的力量（self-efficacy/power）進行防疫準備及心理建設，將感染防護的實證照護指引應用於臨床實務。此外，強化護理師的心理賦權與反思，提升對護理角色的認同及自我價值肯定，建立團隊意識，強化防護概念。此外，將感控概念與常規護理模式兼容並蓄，形成防疫陣線，有效阻絕病毒擴散，維護民眾的健康。

關鍵字

新型冠狀病毒肺炎 ； 準備度 ； 心理壓力 ； 感染防護 ； 心理賦權

並列摘要

The COVID-19 epidemic continues to spread, and frontline health professionals have unfortunately contracted this virus because of exposure while providing clinical care. Based on the painful experience of the previous SARS epidemic in Taiwan, nurses have adopted a standard of care for infection protection that incorporates early prevention and detection. However, international public health experts remain unable to control the infectivity and variability of the COVID19 virus, which increases the mental stress on frontline nurses when performing care. In this paper, which uses a medical center in the north of Taiwan as an example, JBI clinical guidelines, infection control experience, and nurses' awareness, perceived support, and self-efficacy are applied to suggest ways to improve epidemic prevention and mental construction, enhance nurses' psychological empowerment and refection, promote role identity in nursing and self-value, establish health team awareness, strengthen infection protection concepts, and integrate infection control concepts into the nursing models to develop effective standard operating procedures for epidemic prevention management and effectively prevent the spread of the virus and maintain public health.

並列關鍵字

COVID-19 ； readiness ； metal stress ； infection prevention ； psychological empowerment

參考文獻

馮明珠、武香君、林慧姿、雷　蕾、趙嘉玲、陸椿梅、楊婉萍（2020）．面對全球新冠肺炎爆發台灣護理人員之壓力、心理困擾與緩解方式探討．護理雜誌，67（3），64–74。[Feng, M.-C., Wu, H.-C., Lin, H.-T., Lei, L., Chao, C.-L., Lu, C.-M., & Yang, W.-P. (2020). Exploring the stress, psychological distress, and stress-relief strategies of Taiwan nursing staffs facing the global outbreak of COVID-19. The Journal of Nursing, 67(3), 64–74.] https://doi.org/10.6224/JN.202006_67(3).09

Billings, J., Ching, B. C. F., Gkofa, V., Greene, T., & Bloomfield, M. (2020). Healthcare workers experiences of working on the frontline and views about support during COVID-19 and comparable pandemics: A rapid review and meta-synthesis. medRxiv. https://doi.org/10.1101/2020.06.21.20136705

Boston-Fleischhauer, C. (2020). Chief nurse executive readiness for the here and now. JONA: The Journal of Nursing Administration, 50(6), 307–309. https://doi.org/10.1097/NNA.0000000000000889

Chen, W., & Huang, Y. (2020). To protect healthcare workers better, to save more lives with COVID-19. Anesthesia & Analgesia, 31(1), 97–101. https://doi.org/10.1213/ANE.0000000000004834

Cluss, P. A., Chang, J. C., Hawker, L., Scholle, S. H., Dado, D., Buranosky, R., & Goldstrohm, S. (2006). The process of change for victims of intimate partner violence: Support for a psychosocial readiness model. Women's Health Issues, 16(5), 262–274. https://doi.org/10.1016/j.whi.2006.06.006