精神科護理人員因應策略與自覺職業危害之探討

A study of coping strategies 、perceived occupational hazards of psychiatric nurses in acute wards

王懿琨(I-KUN WANG)

指導教授 ： 李選

中山醫學大學/醫學院/醫學研究所/碩士(2005年)

https://doi.org/10.6834/CSMU.2005.00097

摘要

本研究目的在探討精神科護理人員因應策略與自覺職業危害之現況、及護理人員人口學變項間之關係。採用橫斷式研究設計，以立意取樣，針對台中地區六家醫療院所之精神科急性病房護理人員進行普查，以自擬之『精神科護理人員自覺職業危害量表』與『因應策略量表』〔JCS〕為工具收集資料，共計136份有效問卷。資料以描述性統計、t檢定、單因子變異數分析、卡方檢定、Pearson correlation等統計方法進行分析。研究結果：1. 樣本以女性居多，平均年齡30.2歲（介於22至53歲），近一年內的職業危害中：86.1%曾遭言語攻擊為最多，51.1%曾遭肢體攻擊次之；每週實際工作時數平均為43.84小時。2. 從事精神科護理工作後之職業傷害依序為：肌肉骨骼酸痛、下背痛、焦慮、暴力摔傷、扭傷、瘀青、失眠、缺乏自主權、被恐嚇污蔑、內分泌失調、月經混亂。3. 樣本最常使用的前三項因應策略為：面對問題、自恃、樂觀；最少使用的前三項因應策略為：情緒、緩解、逃避。「因應策略」因：性別、宗教、婚姻、學歷、公私立醫院屬性而顯現差異，達統計上顯著意義。「自覺職業傷害」量表與公私立醫院屬性、面臨處理暴力意外事件壓力數值、面臨處理自殺意外事件壓力數值 、面臨處理性騷擾意外事件壓力數值等有顯著相關。宿命式、逃避式、緩解式與情緒式因應策略與自覺職業傷害間之關係，達到統計上顯著差異。研究結果可作為護理實務、教學、研究及未來執行改善精神科護理職場政策參考之依據。

關鍵字

精神科護理人員 ； 因應策略 ； 自覺職業危害

並列摘要

There are plenty of occupational hazards happening during the routine medical practices in the wards, among which the psychiatric department encounters characteristic features that both physical and mental hazards commonly coexist. The purpose of this study is to investigate current status of coping strategies and perceived occupational hazards of nurses in psychiatric wards , and to analyze their correlations in various nursing populations. Cross-sectional method is utilized, with convenience sampling of the nurses of acute psychiatric wards from six hospitals in Taichung. “Perceived occupational hazard scale for psychiatric nurses” and “Coping strategies scale” are offered for data collections, and one hundred and thirty-six questionnaires are eligible. The data is calculated by methods of descriptive statistics, t-test, one-way ANOVA, chi-square, and Pearson’s correlation.
The results demonstrate some characteristics as following: 1. the median age is 30.2 ( from 22 to 53 ), among whom 75% had ever experienced ergonomic occupational hazards within one year, 60% had psychological occupational hazards, and 30% had biologic occupational hazards. 2. the common occupational hazards in order are: musculoskeletal pain, low back pain, anxiety, violent abrasion, strain, insomnia, threat, endocrine disorders, and dysmenorrhea. 3. the most commonly utilized coping strategies are: controntive, self-reliant, and optimistic coping styles, while the least utilized are: emotive, palliative, and evasive coping styles. 4. coping strategies show significant differences with respect to some personal and hospital characteristics. There are significant differences between the perceived occupational hazards and fatalistic, evasive, and emotive coping styles, indicating samples who developing these styles obtain the propensity of the hazards. Accordingly, in order to promote the ability of accidental management and reduce the risks of occupational hazards for the nursing staff, psychiatric safety training programs should be enhanced in hospital occupational educations. This study provides the reference information for nursing practice, teaching, research and future improvement on strategy of psychiatric nursing working environment.

並列關鍵字

psychiatric nurses ； perceived occupational hazards ； coping strategies

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