建構社區精神衛生護理能力－危機管理

The Construction of Essential Competence of Community Psychiatric Mental Health Nursing-Crisis Management

10.6847/TJPMHN.201212_7(2).0004

蘇淑芳(Shu-Fang Su)；戎瑾如(Jiin-Ru Rong)；蕭淑貞(Shu-Jen Shiau)；黃英如(Ying-Ru Huang)；陳惠敏(Hwei-Min Chen)；林桂菁(Guei-Ging Lin)

社區精神衛生護理 ； 危機管理 ； Community psychiatric mental health nursing ； crisis management ； essential nursing competence

精神衛生護理雜誌

7卷2期（2012 / 12 / 01）

23 - 31

繁體中文

本研究目的在發展精神衛生護理人員於社區協助精神病患建立危機管理之實務能力範疇與行為操作定義，本研究採行動研究法，並以內容分析法進行資料分析，研究對象為實務工作者亦即研究者，三位社區精神衛生專家（包括醫院護理主任，社區精神衛生護理長、社區精神衛生基礎能力鑑定合格護理人員各一位）以及一位精神護理教師，以危機管理理論及相關文獻，由社區精神護理專家及資深護理師進行社區危機管理實證歷程，透過實證進行省思、修正與驗證「危機管理」之照護過程，並紀錄分析照護過程中護理人員呈現的護理能力範疇與行為操作定義。研究結果顯示「危機管理」之能力範疇可分為五個主要項目：（一）危機情境之評估（二）確認危機處置之目標（三）危機處置前之準備（四）執行危機處理機制（五）評值危機管理結果，此結果可提昇社區精神護理照護之策略，進一步發展實務能力培訓與認證制度之參考。

The Purpose of this study was to develop the scope and operational definitions of ”Crisis Management” essential competence of community psychiatric mental health nursing. The method adopted in this study was action research method. Based on the Theories and studies of Crisis Management programs set for the outpatients who have suffered from psychosis in the community, the competence of Crisis Management skills was thus confirmed by nursing process, focus groups, and expert discussions. The targets in the study were both clinical participants and researchers including three clinical nurses who excel in community care and two nursing faculty members. Content analysis was used to analyze the recordings in the process. The results turned out that the scope and performance of ”Crisis Management” to construct clinical competence were classified as the following five main items: 1. assessments of crisis situations; 2. confirmation of the goal for crisis intervention; 3. prior preparation for the crisis intervention; 4. implementation of crisis management mechanism; 5. The evaluating results of crisis management. Finally, we conclude that the results of this study could serve as a basis guideline for nurses to promote the nurse's crisis management skills, and to develop a model of training and accreditation of competence for psychiatric community health nursing.