我們需要更多原住民籍護理師嗎？

過去四十多年來，臺灣原住民族的平均餘命與國人相較，仍有約八到十年的差距，顯示健康不平等的現象未能得到有效的改善。相關的討論很多，包括衛生政策的規劃和執行未能考量原住民族群特性和生活模式、醫療資源分配上仍以地理位置為原則，以及探究原住民族健康因素仍未能納入殖民歷史脈絡下創傷事件的衝擊等。因此，本文將針對醫療資源中的護理人力為焦點，先從原住民族健康和護理人力現況介紹開始，接著回顧原住民籍護理人力比例偏低的相關研究，在結論中我們點出了原住民在相關政策制定時的「被動」和在傳統知識與其價值中的「消失」情況。多元族群的社會，需要跨族群的護理人力以反映和回應各族群的醫療照護需求，方能實踐全人照護的理想。

關鍵字

健康不平等；原住民族健康；護理人力；護理教育

並列摘要

Data collected over the past four decades show the life expectancy of indigenous Taiwanese to be 8 to 10 years lower than the general, predominantly Han Chinese, population. This suggests the persistence of inequities in the public health system in Taiwan. Several facets of this issue, including lack of consideration of the characteristics and lifestyle of ethnic populations in health policy planning and implementation work and the continued location-based focus of medical care resource distribution policies, are being actively discussed. However, investigations of factors related to the relatively poor health status of indigenous Taiwanese have not considered the traumatic and lingering effects of colonisation. This article briefly introduces the health status of indigenous Taiwanese and the indigenous nursing workforce and then presents a review of the literature on factors related to the under-representation of indigenous Taiwanese in nursing programs and the nursing workforce. Indigenous Taiwanese were found to be absent from public-health policymaking. Moreover, indigenous-related traditional knowledge and values are not being effectively transmitted to younger generations. A diverse nursing workforce should reflect and respond to not only indigenous peoples but also the general population in Taiwan.

並列關鍵字

health inequity ； health status of indigenous Taiwanese ； nursing workforce ； nursing education

參考文獻

扈克勛、李維仁、康啟杰、李建廷、陳秀敏、蘇清泉（2004）．醫療給付效益提升計畫之人力資源彈性運用—以屏東縣琉球鄉、泰武鄉、牡丹鄉為例．東港安泰醫護雜誌，10（2），57–69。[Hu, K.-H., Lee, W.-J., Kang, C.-C., Lee, C.-T., Chen, S.-M., & Su, C.-C. (2004). Workforce flexibility in IDS's operation-examples from Lyiouciyiou, Taiwu, and Mwudan Township Health Center, Pingtung, Taiwan. T.S.M.H. Medical & Nursing Journal, 10(2), 57–69.] https://doi.org/10.7078/TSMHMNJ.200406.0057

鴻義章、林慶豐、彭玉章、呂淑妤（2002）．臺灣原住民醫療衛生政策之回顧．台灣公共衛生雜誌，21（4），235–242。[Hong, A. I. C., Lin, C.-F., Peng, E. Y.-C., & Lyu, S.-Y. (2002). A review of aboriginal health policy in Taiwan. Taiwan Journal of Public Health, 21(4), 235–242.] https://doi.org/10.6288/TJPH2002-21-04-02

葛應欽、劉碧華、謝淑芬（1994）．台灣地區原住民的健康問題．高雄醫學科學雜誌，10（7），337–351。[Ko, Y.-C., Liu, B.-H., & Hsieh, S.-F. (1994). Issues on aboriginal health in Taiwan. The Kaohsiung Journal of Medical Sciences, 10(7), 337–351.] https://doi.org/10.6452/KJMS.199407.0337

Adams, M., Aylward, P., Heyne, N., Hull, C., Misan, G., Taylor, J., & Walker-Jeffreys, M. (2005). Integrated support for aboriginal tertiary students in health-related courses: The Pika Wiya Learning Centre. Australian Health Review, 29(4), 482–488. https://doi.org/10.1071/AH050482

Anonson, J. M., Desjarlais, J., Nixon, J., Whiteman, L., & Bird, A. (2008). Strategies to support recruitment and retention of First Nations youth in baccalaureate nursing programs in Saskatchewan, Canada. Journal of Transcultural Nursing, 19(3), 274–283. https://doi.org/10.1177/1043659608317095

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