臺灣博碩士論文加值系統

背景：反思被認為是分析護理臨床實務的重要工具，反思可以幫助學生在臨床環境中培養必要的技能和能力，臨床實習老師在指導學生實習的過程中若不瞭解學生的反思現況及影響學生反思的因素為何，將如何引導學生於實習中進行臨床反思?這是值得進一步探討的。
目的：旨在探討護理系學生之反思層次現況及影響反思層次的相關因素。
方法：本研究為橫斷式、描述性研究設計，採方便取樣，利用Kember等人（2000）反思層次量表為研究工具獲得資料，以中部某科技大學護理系進修部二技已完成內外科實習，且最後兩科實習選擇有臨床實習指導教師指導的學生為研究對象。共收案161位，並以SPSS 21.0版電腦套裝軟體進行描述性、獨立樣本t檢定（t-test）、單因子變異數分析（one-way ANOVA）等進行統計分析。
結果：本研究護理系進修部二技學生以女性居多佔96%，護理臨床工作年資大多為滿1-2（含）年佔49%，有醫療相關工作者佔66.5%，無護理進階層級者佔57.8%，選擇集中式實習的有67.7%，反思層次得分「習慣性行動」12.88±3.26，「理解」16.80±1.97，「反思」16.75±1.78，「批判性反思」15.92±2.12。在護理進階方面，無護理進階層級者在批判性反思層次上得分顯著高於有進階層級者，在實習模式方面，集中式實習者在理解層次及批判性反思層次上得分顯著高於分散式實習者，在實習科別方面，有實習急診加護者在理解層次、反思層次及批判性反思層次上得分顯著高於無實習急診加護者。
結論：研究對象反思層次表現大多屬於「理解」層次，其次為「反思」層次、「批判性反思」層次及「習慣性行動」層次；護理系學生的護理進階層級、實習模式及實習單位與反思層次呈顯著相關。無護理進階層級者、選擇集中式實習者及有實習急診加護單位者之反思層次表現較好。

Background:
Reflection is considered to be an important tool for analyzing clinical nursing practice. Reflection can help students to develop the necessary skills and abilities in a clinical environment. When guiding students through the internship process, if instructors do not understand students' state of reflection and the factors influencing students' reflection, it would be difficult to properly guide the students exercising clinical reflection. This is a topic worthy of further exploration.
Objective:
This study aims to explore the levels of reflection exercised by nursing students and the related factors influencing such levels of reflection.
Methods:
This study is a cross-sectional, descriptive research by design. It utilizes Kember (2000) reflection level chart as a research tool to collect information. The target of this study consists of students of a two-year nursing program in a science and technology university in central Taiwan. These students have already completed their internal medicine and surgical internship. They have all chosen their last two clinical internship classes with instructor-guided setting. The total number of students is 161. The collected data was analyzed with SPSS 21.0 version computer module for descriptive statistics, independent sample test (t-test), and single factor variation study (one-way ANOVA).
Results:
In this study, 96% of the students are female, 49% of them have about 1 to 2 years of clinical nursing experience. 66.5% of the students have some medically related work experience. 57.8% lacks advanced nursing experience. 67.7% chose a centralized internship setting. The reflection level scores are: "habitual action" 12.88+/-3.26, "understanding" 16.80+/-1.97, "reflection" 16.75+/-1.78, "critical reflection" 15.92+/-2.12. As to the factor of advanced nursing, students without advanced nursing score significantly higher than those with advanced nursing in the area of "critical reflection". As to the factor of internship setting, students choosing centralized internship score significantly higher than those choosing decentralized internship in the area of "level of understanding" and "critical reflection". As to the factor of internship area, those who have urgent care and ICU experience scores significantly higher than those without such experience in the area of "level of understanding" and "critical reflection".
Conclusion:
The level of reflection exhibited by research participants mostly settle at "understanding" level, followed by "reflection" level, "critical reflection" level and "habitual action" level. The factors of advancement level, internship setting and internship location are substantially related to reflection level. Students without advanced level nursing training, practicing under centralized internship setting and equipped with urgent care experience exhibit a better level of reflection.

第壹章 緒論 1
第一節 研究動機及重要性 1
第二節 研究目的 3
第三節 研究問題 3
第四節 名詞解釋 4
第貳章 文獻查證 5
第一節 護理教育 5
第二節 反思概念 8
第三節 反思的相關研究 15
第參章 研究方法 26
第一節 研究架構 26
第二節 研究設計 27
第三節 研究工具 29
第四節 資料處理與分析 33
第肆章 研究結果 35
第一節 研究對象基本資料分析 35
第二節 研究對象反思層次之分析 38
第三節 研究對象基本屬性與反思層次之關係 40
第伍章 討論 66
第一節 研究對象反思層次之情形 66
第二節 研究對象基本屬性與反思層次之差異分析 68
第陸章 結論與建議 70
第一節 研究結論 70
第二節 研究限制 71
第三節 研究建議 72
參考文獻 73
中文文獻 73
英文文獻 75
附錄一、問卷 79
附錄二、人體試驗委員會免審同意書 81

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