實習護生接受安寧療護教育課程之成效

Effects of a Hospice Palliative Care Education Program for Nursing Students

10.6537/TJHPC.201711_22(3).002

顧艶秋(Yan-Chiou Ku)；林麗英(Li-Ying Lin)；蔣秀容(Shiow-Rong Jeang)；王珮珩(Pei-Hern Wang)；高紀雅(Chi-Ya Kao)

安寧療護 ； 實習護生 ； 知識 ； 態度 ； 自我效能 ； Hospice Palliative Care ； Nursing Students ； Knowledge ； Attitude ； Self-efficacy

安寧療護雜誌

22卷3期（2017 / 11 / 01）

273 - 287

繁體中文

研究目的：本研究旨在瞭解安寧療護教育課程對提升實習護生在全人照護的知識、態度與自我效能的效果，增進護生在照護末期病人之能力。材料與方法：本研究設計為類實驗性研究，以2015 年南部某醫學中心內外科、婦兒科等十四個病房單位實習四週的護生為收案對象共計148 人，依病房科別屬性配對，分為實驗組與對照組。實驗組於實習第一天進行安寧療護教育課程。結果：護生在安寧療護知識方面，實驗組在後測一（立即後測）、後測二（實習結束第四週之後測）進步之幅度比對照組顯著且達統計差異（p ＜ 0.001）。在態度方面，實驗組在後測一進步之幅度比對照組顯著且達統計上差異（p ＜ 0.001）。在自我效能方面，實驗組在後測一、後測二進步之幅度比對照組顯著且達統計上差異（p ＜ 0.01）。結論：研究結果顯示安寧療護教育課程介入後，護生對於安寧療護照護知識提升，對提供全人照護更具自信且正向態度。

Purpose: The study purpose is to understand the effects on hospice palliative care education programs in the knowledge, attitude, self-efficacy, and behavior, as well as to improve nursing students’ ability to take care of terminal patients. Research Subjects and Method: The study used quasi-experimental design to enroll nursing students engaging in internship at a total of 14 units, such as Department of Internal Medicine, Department of Surgery, and Divisions of Gynecology and Pediatrics, in a certain medical center in the southern Taiwan in 2015 as the research subjects, with a total of 148 subjects enrolled. In addition, this study divided the subjects into the experimental group and control group according to the properties of divisions. The nursing students in the experimental group received the educational training of hospice palliative care on Day 1 of internship. Results： For nursing students' knowledge of hospice palliative care, the improvements in the posttest 1 and posttest 2 of the experimental group were more significant those of the control group, and reached statistical differences (p ＜ 0.001). For attitude, the improvement in the posttest 1 of the experimental group was more significant than that of the control group, and reached statistical difference (p ＜ 0.001). For self-efficacy, the improvements in the posttest 1 and posttest 2 of the experimental group were more significant than those of the control group, and reached statistical differences (p ＜ 0.01). Conclusion：The research results showed that after the intervention of educational training, nursing students' knowledge of care for terminal patients was improved and they were more confident in and held a positive attitude towards providing holistic care.

1. Yang, HL,Wu, CY,Chang, M,Chang, QW,Hu, WY(2011).Hu WYThe content and development of Chinese nursing textbooks in Taiwan: A bio-psycho-social perspective of end-of-life care.Journal of Medical Education,15(3),245-256.
   連結：
2. 胡文郁,張媚(2015)。安寧緩和護理之教育觀。護理雜誌，62(2)，25-33。
   連結：
3. 葉德豐,陳玟伶,王佳雯,張美幸,黃惠美,張育嘉(2007)。護理系學生安寧緩和醫療課程教育介入成效之研究。醫學教育，11(4)，266-274。
   連結：
4. 趙可式(2015)。安寧療護是普世價值且為護理的本質。護理雜誌，62(2)，5-12。
   連結：
5. 顧艶秋,蔣秀容,王珮珩,黃鳳玉(2017)。新進護理人員接受安寧療護教育訓練之成效。榮總護理，34(1)，9-20。
   連結：
6. AACN . Peaceful death: Recommended competencies and curricular guidelines for end-of-life nursing care. Available at: http://www.aacn.nche.edu/elnec/publications/peaceful-death, 2009.
7. Bandura, A.(2004).Health promotion by social cognitive means.Health Educ Behav,31(2),143-164.
8. Bandura, A.(1997).Self-efficacy: The exercise of control.New York:W. H. Freeman and Company.
9. Bandura, A,Caprara, GV,Barbaranelli, C,Pastorelli, C,Regalia, C(2001).Sociocognitive self-regulatory mechanisms governing transgressive behavior.Journal of personality and social psychology,80(1),125-135.
10. Glover, TL,Garvan, C,Nealis, RM,Citty, SW,Derrico, DJ(2017).Improving end-of-life care knowledge among senior baccalaureate nursing students.The American journal of hospice & palliative care,2017,1-8.
11. Jeffers, S,Ferry, D(2014).Nursing care at the end of life: a service learning course for undergraduate nursing students.Nurse educator,39(6),307-310.
12. Kelman, HC(1961).Processes of opinion change.Public Opinion Quarterly,25(1),57-78.
13. Korzeniewska-Eksterowicz, A,PrzysłoŁ,Kędzierska, B,Stolarska, M,Młynarski, W(2013).Młynarski W. The impact of pediatric palliative care education on medical students' knowledge and attitudes.The Scientific World Journal,2013
14. Kotler, P.(2000).Marketing Management.New Jersey:Prentice-Hall.
15. Nonaka, I(1994).A dynamic theory of organizational knowledge creation.Organization Science,5(1),14-37.
16. Ramachaudran, VS(Ed.)(1994).Encyclopedia of Human Behavior.New York:Academic Press.
17. Ramjan, JM,Costa, CM,Hickman, LD,Kearns, M,Phillips, JL(2010).Integrating palliative care content into a new undergraduate nursing curriculum: the University of Notre Dame, Australia--Sydney experience.Collegian,17(2),85-91.
18. Robinson, E,Epps, F(2017).Impact of a palliative care elective course on nursing students' knowledge and attitudes toward end-of-life care.Nurse educator,42(3),155-158.
19. Sarabia-Cobo, CM,Alconero-Camarero, AR,Lavín-Alconero, L,Ibáñez-Rementería, I(2016).Assessment of a learning intervention in palliative care based on clinical simulations for nursing students.Nurse education today,45,219-224.
20. Spicer, S,Heller, R,Troth, S.(2015).Hospice clinical experiences for nursing students: living to the fullest.Journal of Christian nursing,32(1),46-49.
21. 王秀紅（編輯）(2008).護理,台灣.台北:行政院衛生署.
22. 李尹暘,林曉佩,林君怡(2007)。自我效能理論之分析與應用。澄清醫護管理雜誌，3(2)，46-52。
23. 李英芬,劉景萍,蔡麗雲,賴允亮,張澤芸,杜金錠(2003)。實施安寧病房深度參訪成效之初探。安寧療護雜誌，8(4)，381-392。
24. 胡文郁,曾建寧,王浴,翁瑞萱(2004)。護理系學生接受安寧緩和醫學臨床實習教育介入之成效。安寧療護雜誌，9(1)，1-20。
25. 孫嘉玲,王秀香,陳佩英,郭素青,黃美瑜,宋梅生(2004)。安寧療護課程對護生死亡恐懼與態度之影響。安寧療護雜誌，9(4)，353-364。
26. 孫嘉玲,顏慶雲,陳施妮,郭素青,陳佩英,黃美瑜(2005)。安寧療護課程對二專在職班護生死亡恐懼與態度之影響。元培學報，12，53-66。
27. 翁黃玲,陳蕙玲,胡月娟(2007)。以病人為中心的全人照護教學。護理雜誌，54(3)，24-32。
28. 梁淑媛,蔡秀鸞,莊宇慧,吳淑芳,童恆新,王采芷,李慧貞(2013)。淺談自我效能信念及測量工具。馬偕護理雜誌，7(2)，7-12。
29. 陳瑞娥,楊均典(2012)。護生於安寧病房實習之專業核心能力自我察覺探討。安寧療護雜誌，17(2)，173-186。
30. 蔣立琦,郭雅雯,林綽娟(2004)。自我效能之概念分析。護理雜誌，51(2)，67-72。
31. 賴維淑,楊婉萍,趙可式(2009)。護的教育─護生、一般護理人員及專科護理師。護理雜誌，56(1)，11-16。
32. 藍育慧,趙淑員,陳淑齡,莊照明,郭容美(2007)。非安寧單位護理人員安寧認知、死亡恐懼與情緒困境之探討。安寧療護雜誌，12(2)，156-171。

1. 顧雅利,郭世明,許瓊尹,吳佳珍(2023)。傾聽、同理、陪伴技能教案於三個護理課程之成效探討。長庚護理，34(2)，1-14。
2. 歐淑玲,倪麗芬(2021)。運用自我效能提升護生專業知識與技能、批判思考及溝通合作力。長庚護理，32(2)，28-40。
3. 鍾宜宸,謝至鎠,陳思穎,唐婉如,方俊凱(2022)。利用多元教學策略進行安寧療護課程改革。安寧療護雜誌，26(2)，120-134。