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研究生:明金蓮
研究生(外文):Ming, Jin-Lain
論文名稱:臨床情境式教學促進護理人員因應職場暴力之成效研究-以台北市某醫學中心為例
論文名稱(外文):The Clinical Situation Teaching Program to Promote Nurses Effectiveness for Coping with Workplace Violence- Taking a Medical Center in Taipei as an Example
指導教授:董貞吟董貞吟引用關係
指導教授(外文):Tung, Chen-Yin
學位類別:博士
校院名稱:國立臺灣師範大學
系所名稱:健康促進與衛生教育學系
學門:教育學門
學類:專業科目教育學類
論文種類:學術論文
論文出版年:2017
畢業學年度:105
語文別:中文
論文頁數:101
中文關鍵詞:情境式教學護理職場暴力
外文關鍵詞:Situational teachingNursingWorkplace violence
相關次數:
  • 被引用被引用:2
  • 點閱點閱:662
  • 評分評分:
  • 下載下載:157
  • 收藏至我的研究室書目清單書目收藏:3
中文摘要
醫院是發生職場暴力的高風險環境,職場暴力又是目前醫療執業安全之重要議題,政府雖然在硬體設備及保全人力上有因應的相關政策,但從研究調查發現,多數護理人員在面對職場暴力時的處理技巧和因應都缺乏自信能力;情境式教學可以提供一個較真實的學習情境,讓學習者除了瞭解實用的知識外,還可藉由實地操作,應用到相關情境,不僅能有效提升學習者的認知能力,更可以培養問題的解決能力。本研究之目的為驗證「臨床情境式教學訓練課程」介入措施對護理人員職場暴力認知、態度及因應自信之成效,期望藉由提升護理人員對職場暴力之因應能力,來降低遭受職場暴力之風險及傷害。本研究以隨機分派實驗設計,樣本來自台北某醫學中心臨床護理人員,分配方式採亂數表隨機於母群體中抽樣,對照組及實驗組各200人,將「臨床情境式教學訓練課程」作為研究介入措施,兩組於介入措施前,以「臨床護理師職場暴力防制評量表」進行前測,內容包括:對於職場暴力認知能力、職場暴力態度與職場暴力因應自信等。實驗組於接受「臨床情境式教學訓練課程」之介入措施後進行後測,對照組無特殊介入,僅與實驗組同時間點接受後測。有效問卷392,回應率為98.0%。以SPSS V23,採用 GEE分析,檢驗兩組研究對象職場暴力認知、面對職場暴力時的態度、暴力情境因應自信之差異。結果顯示:經介入「職場暴力臨床情境式教學訓練課程」後,護理人員對於職場暴力認知、面對職場暴力時的態度、暴力情境中的因應自信,實驗組得分高於對照組,並達統計上顯著之差異(p<.001)。證明「職場暴力臨床情境式教學訓練課程」可加強臨床護理人員對於職場暴力認知、態度與因應自信。建議:⑴本介入措施課程於未來可針對特定的部門進行更細項規劃,或針對常見狀況進行套裝課程演練,如:急診、精神科、內外科病房和門診。(2)未來可開發相關職場暴力線上自學課程,藉由文字、實際案例影片,讓護理人員不受時間空間之限制,持續線上學習或複習職場暴力策略,定期舉辦臨床情境式演練課程,以便醫護人員強化自我防護能力。(3)院方組織應召集相關人員,定期舉行會議及擬定配套措施,使臨床工作人員得以承擔較複雜與病人互動之情境,提升緊急應變之能力,降低遭受職場暴力之風險與傷害。
Workplace Violence is a severe and global issues in healthcare theatre and beyond. Prevention focused situational education is somehow a good strategy to reduce and minimize the risk of workplace violence. The aim of this study was determining the perception, attitudes and confidence in dealing workplace violence following a situational educational intervention of an experimental design. Four hundred nurses were enrolled and randomly assigned into two groups. 392 of them completed program of the workplace violence prevention in the study. Data were analyzed by SPSS V.23 Generalized Estimating Equation. The results indicated that the situational education group’s participants had improve considerably in their perception, attitudes and confidence in dealing workplace violence at post-test (p<.001). Meanwhile, the participants in the post situational training program showed considerable improvements in their ability compared with control group. We concluded that using workplace violence prevention training can increase the Workplace Violence awareness, established the correct attitude for facing Workplace Violence, improve communication skills and confidence in the case of Workplace Violence. We recommended that situational teaching education of Workplace Violence prevention may be used as a standard training program for nurse staff. Implications for different department of healthcare setting practice and future studies were also suggested.
目次
表目次
表2-1 不同測量期間職場暴力盛行率 11
表2-2 不同臨床環境之職場暴力盛行率 13
表2-3 不同地區職場暴力盛行率 14
表3-1 研究設計 28
表4-1 研究對象背景變項 42
表4-2 研究對象遭受職場暴力經驗 43
表4-3 過去12個月內遭過職場暴力經驗 44
表4-4 職場暴力情境及時間相關因素 45
表4-5 職場暴力施暴者分析 47
表4-6 發生職場暴力事件處理 49
表4-7 職場暴力認知、態度、因應自信分析 51
表4-8 研究對象職場暴力認知前後測之差異 53
表 4-9 研究對象面對職場暴力的態度前後測之差異 55
表 4-10 研究對象職場暴力因應自信前後測之差異 57




圖目次
圖3-1研究架構 29
圖3-2 研究步驟 38




第一章 緒論 1
第一節 研究動機與重要性 1
第二節 研究目的 5
第三節 研究問題 5
第四節 研究假設 5
第五節 名詞操作型界定 6
第六節 研究限制 8
第二章 文獻探討 9
第一節 職場暴力的定義、類型、盛行率、來源與危險因子 9
一、 職場暴力的定義 9
二、 職場暴力的類型 10
三、 職場暴力的盛行率 11
四、 職場暴力的來源 15
五、 職場暴力的危險因子 16
第二節 職場暴力對護理人員的影響 18
第三節 職場暴力之因應策略與預防措施 20
第四節 情境式教學之應用與效果 24
第三章 研究方法與步驟 28
第一節 研究設計 28
第二節 研究架構 29
第三節 研究對象 30
第四節 研究工具 31
第五節 實施步驟 37
第六節 資料處理與統計分析 39
第四章 研究結果 41
第一節 研究對象背景變項分析 41
第二節 研究對象遭受職場暴力經驗分析 43
第三節 研究對象之職場暴力認知、態度、因應自信比較 50
第五章 討論 58
第一節 遭受職場暴力經驗 58
第二節 「臨床情境式教學訓練課程」之建構 60
第三節 「臨床情境式教學訓練課程」介入之成效 61
第六章 結論與建議 64
第一節 研究對象介入前職場暴力之認知、態度及因應自信現況 64
第二節 「臨床情境式教學訓練課程」之內容 64
第三節 「臨床情境式教學訓練課程」介入對提升護理人員職場暴力認知、態度與因應自信之成效 65
第四節 建議 66

參考文獻 69
中文部分 69
英文部分 71


附錄目錄 83
附錄一 護理人員因應職場暴力防制評量表 83
附錄二 專家效度鑑定函 89
附錄三 專家名單 90
附錄四 研究特性、職場暴力盛行率、來源與高風險因素、職場暴力之影響與因應流程篩選圖 91
附錄五 職場暴力臨床情境式教學訓練課程內容 92
附錄六 預試結果 93
附錄七 分組演練照片 99
附錄八 職場暴力臨床情境式教學訓練課程光碟 101
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