高齡模擬體驗對臨床護理教師的老化知識、態度、同理心及照顧意願之成效

Effects of Elderly Simulation Experience on Aging Knowledge, Attitudes, Empathy, and Willingness to Care for Seniors in Clinical Nurse Preceptor

10.6386/CGN.202309_34(3).0002

楊雲帆(Yun-Fan Yang)；高淑華(Shu-Hua Kao)；謝素英(Suh-Ing Hsieh)；王琤(Jeng Wang)；周燕芳(Yan-Fang Zhou)；陳淑賢(Sue-hsien Chen)；廖美南(Mei-Nan Liao)

臨床護理教師 ； 模擬體驗 ； 高齡者 ； clinical nurse preceptor ； simulation module ； elderly

長庚護理

34卷3期（2023 / 09 / 01）

14 - 26

繁體中文;英文

背景：台灣65歲以上的老人口佔16.2%，而面對要滿足更多住院老年人的需求則面臨越來越多的挑戰。臨床護理教師擔負教育護理師和護生之重要任務與榜樣，故臨床護理教師瞭解老年人經歷老化的過程與面對這些挑戰至關重要，但國內、外鮮少有臨床護理教師與高齡擬真模擬體驗的相關研究。目的：評估台灣臨床護理教師對老年人老化知識、態度、照顧意願與同理心情形，及驗證接受高齡模擬體驗模組後的成效。方法：採類實驗性研究設計，研究對象是桃園市某地區醫院的臨床護理教師，實驗組39位接受高齡模擬體驗模組，控制組51位則無介入。成果測量包含老化知識、對老年人態度、照顧意願與同理心，資料使用描述性統計、卡方與費氏精準校正檢定、獨立t檢定與重複測量共變數分析。結果：高齡模擬體驗後，整體的組間效應分析顯示實驗組與控制組的知識得分具顯著差異（p=.001），事後分析顯示第一次（p=.001）與第二次後測（p=.001）實驗組知識得分顯著高於控制組；整體的組內效應分析顯示有顯著差異（p=.035），事後分析顯示第二次後測得分顯著大於第一次後測（p=.012）；且組內與組間交叉效應分析達顯著差異（p<.001）。另整體的組間效應分析顯示兩組的照顧意願無顯著差異，但事後分析顯示實驗組的第一次（p=.048）與第二次後測（p=.047）照顧意願顯著大於控制組。結論：高齡模擬體驗模組提升護理臨床教師的老化知識與照顧老年人的意願並具長時間效應，藉以提供臨床老人護理教育之參考，知老、敬老、護老從高齡體驗開始。

Background: Taiwan's elderly population aged 65 and above accounts for 16.2% of the total population. As this demographic continues to grow, the healthcare system faces escalating challenges in meeting the needs of hospitalized elderly individuals. Clinical nurse preceptors play a pivotal role in educating nurses and nursing students, serving as important role models. It is, therefore, important for clinical nurse preceptors to comprehend the aging experience and the challenges faced by the elderly. Surprisingly, literature that investigates the effects of aging simulation on clinical nurse preceptors is limited. Purpose: The study assessed the knowledge and attitudes of clinical nurse preceptors in Taiwan towards the elderly, their willingness to provide care for the elderly, and their level of empathy. This study also evaluated the impact of an aging simulation module on these aspects. Methods: This quasi-experimental research used a convenience sampling method to recruit clinical nurse preceptors from a regional hospital in Taoyuan. The experimental group (n=39) received an aging simulation module, while the control group (n=51) did not receive any intervention. The research instruments included assessments of aging knowledge, attitudes, empathy, willingness to care for the elderly, a satisfaction scale regarding the elderly simulation experience, and reflection records. Data analysis included descriptive statistics, chi-square and Fisher's exact test, independent t-test, and repeated measures ANCOVA. Results: Aging knowledge was significantly different between the experimental and control groups (p= .001). Post hoc analysis demonstrated that both the first (p= .001) and second post-test scores (p= .001) of the experimental group were higher than those of the control group. The overall within-subjects effect analysis of aging knowledge showed significant differences, with post hoc analysis indicating that the second post-test scores were higher than the first post-test scores (p= .012). Additionally, the within and between interaction effect analysis demonstrated significant differences (p< .001). While the overall between-subjects effect analysis of willingness to care for the elderly did not reveal significant differences, post hoc analysis indicated that both the first (p= .048) and second post-test scores (p= .047) of the experimental group exceeded those of the control group. Conclusion: The aging simulation module improves the aging knowledge and willingness of clinical nurse preceptors to care for the elderly, with a delayed effect. These findings can serve as a reference for clinical elderly nursing education, emphasizing the importance of understanding, respecting, and caring for the elderly, which begins with the first-hand experience of senior citizens.

1. Bamakan, Z. M.,Nasiriani, K.,Madadizadeh, F.,Keshmiri, F.(2021).Effect of an aged wearing suit on nursing student’s knowledge and attitude.Biomed Central Nursing,20(1),1-8.
2. Bowden, A.,Chang, HC. R.,Wilson, V.,Traynor, V.(2021).The impact of ageing simulation education on healthcare professionals to promote person-centred care towards older people: A literature review.Journal Nurse Education in Practice,53
3. Bowden, A.,Wilson, V.,Traynor, V.,Chang, H. C.(2020).Exploring the use of ageing simulation to enable nurses to gain insight into what it is like to be an older person.Journal of Clinical Nursing,29,4561-4572.
4. Bowden, A.,Wilson, V.,Traynor, V.,Chang, H. C.(2022).The impact of ageing simulation education on qualified acute care nurses’empathy towards older people: A mixed methods study.Journal of Clinical Nursing,1,1-16.
5. Castellano-Rioja, E.,Botella-Navas, M.,López Hernández, L.,Martínez-Arnau, F. M.,Pérez-Ros, P.(2022).Caring for the elderly enhances positive attitudes better than knowledge in nursing students.Medicina,58(9),1201.
6. Chen, S. R.,Chiu, H. T.,Lin, L. M.,Lin, P. C.(2019).Preceptors' subjective competency ratings in acute care hospitals in taiwan.Journal Continuing Education in Nursing,50(2),69-78.
7. Fedele, R.(2020).How to be a good preceptor.Australian Nursing and Midwifery Journal,5
8. Fernandez-Gutierrez, M.,Bas-Sarmiento, P.,Pino-Chinchilla, H. d.,Poza-Mendez, M.,Marin-Paz, A. J.(2022).Effectiveness of a multimodal intervention and the simulation flow to improve empathy and attitudes towards older adults in nursing students: A crossover randomised controlled trial.Journal Nurse Education in Practice,64,103430.
9. Haghani, M.,Mandegari, Z.,Dehghani Tafti, A.,Nasiriyani, K.,Entezari, A.(2022).The effect of teaching fundamentals of geriatric life on nurses' knowledge and attitudes toward aging.Elderly Health Journal,8(1),49-55.
10. Hovey, S.,Dyck, M. J.,Reese, C.,Kim, M.(2017).Nursing students' attitudes toward persons who are aged: An integrative review.Nurse Education Today,49,145-152.
11. Kim, S.,Roh, H. J.,Sok, S.(2021).Empathy and self-efficacy in elderly nursing practice among Korean nurses.International Journal of Environmental Research and Public Health,18(6),3072.
12. Lan, X.,Chen, Q.,Yi, B.(2019).Attitude of nurses toward the care of older adults in China.Journal of Transcultural Nursing,30(6),597-602.
13. L'ecuyer, K. M.,Hyde, M. J.(2018).Preceptors' perception of role competency.The Journal of Continuing Education in Nursing,49(5),233-240.
14. Lee, C. Y.,Hsu, H. C.,Lee, C. H.(2016).Effects of aging simulation program on nurses’attitudes and willingness toward elder care.Taiwan Geriatr Gerontol,11(2),105-115.
15. Levett-Jones, T.,Cant, R.,Lapkin, S.(2019).A systematic review of the effectiveness of empathy education for undergraduate nursing students.Nurse Education Today,75,80-94.
16. Martinez-Arnau, F. M.,López-Hernández, L.,Castellano-Rioja, E.,Botella-Navas, M.,Pérez-Ros, P.(2022).Interventions to improve attitudes toward older people in undergraduate health and social sciences students: A systematic review and meta-analysis.Journal Nurse Education Today,110,1-16.
17. Okuyan, C. B.,Bilgili, N.,Mutlu, A.(2020).Factors affecting nursing students' intention to work as a geriatric nurse with older adults in turkey: A cross-sectional study.Nurse Education Today,95,104563.
18. Orique, S. B.,Phillips, L. J.(2018).The effectiveness of simulation on recognizing and managing clinical deterioration: Metaanalyses.Western Journal of Nursing Research,40(4),582-609.
19. Plathe, H. S.,Solheim, E.,Eide, H.(2020).Nursing students’ and preceptors’ experiences with a structure for feedback and reflection in supervision and learning in clinical practice a pilot study with a qualitative exploratory and descriptive design.Research Square,1-24.
20. Rababa, M.,Al-Dwaikat, T.,Almomani, M. H.(2021).Assessing knowledge and ageist attitudes and behaviors toward older adults among undergraduate nursing students.Gerontology Geriatrics Education,42(3),347-362.
21. Rajaguru, V.,Park, J.(2021).Contemporary integrative review in simulation-based learning in nursing.International Journal of Environmental Research amd Public Health,18(2),726.
22. Rush, K. L.,Hickey, S.,Epp, S.(2017).Nurses' attitudes towards older people care: an integrative review.Journal of Clinical Nursing,26,4105-4116.
23. Salin, S.,Hautsalo, K.,Vanni, K.,Seitsamo, S.,Yli-Koivisto, L.(2020).Finnish nurse students' attitudes towards older adults and the teaching of gerontological nursing–a survey study.Nurse Education Today,88,1-6.
24. Teferra, A. A.,Mengistu, D.(2017).Knowledge and attitude towards nursing clinical preceptorship among ethiopian nurse educators: An institution-based cross-sectional study.International Journal of Africa Nursing Sciences,7,82-88.
25. Torkshavand, G.,Khatiban, M.,Soltanian, A. R.(2020).Simulation-based learning to enhance students’ knowledge and skills in educating older patients.Nurse Education in Practice,42,1-6.
26. 行政院主計總處(2021，3月2日)．國情統計通報(第037號)。[The Chief Accounting Office of the Executive Yuan (March 2, 2021). National Statistics Bulletin (No.037).] https://www.stat.gov.tw/public/Data/ 132162358VPAVQ8D.pdf
27. 高潔純, C. C.(2018)。應用Kolb體驗學習圈改善護生對高齡者的態度。澳門護理雜誌，16(1-2)，1-6。
28. 陸洛, l.,高旭繁, S. F.(2009)。台灣民眾對老人的態度：量表發展與信效度初探。教育與心理研究，32，147-171。
29. 劉立凡, L. F.(2003)。由文獻查證與實證的角度看一份短式老年知識問卷的應用。立德學報，1(1)，112-129。
30. 鄭榮峰, J. F.,賴育民, Y. M.,蔡宗益, T. Y.(2011)。傑佛遜同理心量表─醫護人員版之中文化及信效度檢定。護理雜誌，58(2)，41-48。
31. 謝廣全, K. C.,楊國德, K. T.(2009)。技職校院學生老化知識、對老人態度與服務老人意願關係之研究。弘光人文社會學報，11，49-84。