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研究生:陳蕙琦
研究生(外文):Hui-ChiChen
論文名稱:安寧緩和醫療護理師工作壓力與因應方式之探討
論文名稱(外文):The Qualitative Study of Job Stress and Coping Strategies among Nurses in Hospice and Palliative Care.
指導教授:翁慧卿翁慧卿引用關係
指導教授(外文):Hui-Ching Weng
學位類別:碩士
校院名稱:國立成功大學
系所名稱:老年學研究所
學門:其他學門
學類:其他不能歸類之各學類
論文種類:學術論文
論文出版年:2019
畢業學年度:107
語文別:中文
論文頁數:96
中文關鍵詞:安寧緩和醫療護理師工作壓力因應
外文關鍵詞:Hospice and Palliative CareNurseWorking StressCoping
相關次數:
  • 被引用被引用:4
  • 點閱點閱:276
  • 評分評分:
  • 下載下載:0
  • 收藏至我的研究室書目清單書目收藏:2
背景與目的:安寧緩和醫療的目標是幫助與陪伴病人與家屬度過身心靈社會等各樣痛苦,令病人圓滿善終使家屬與病人無憾。但過程中安寧護理師常會面臨病人病況轉變與過世、病人及家屬心理/社會層面的反應、團隊內外溝通協調等方面的壓力源。本研究旨在描繪安寧護理師的臨床工作壓力與壓力調適方法。希望藉此協助安寧護理師及時感知壓力與因應,進而提升工作品質及服務效能。
方法:以質性研究深度訪談法邀請同意接受訪談之現職2年以上之安寧護理師計12位。
結果:依據訪談結果分析安寧緩和醫療護理師工作壓力有二個主題,六個次主題,分別為主題一內在因素:1.缺乏安寧照護的經驗、2.找不到意義與價值;主題二外在因素:1.與病人家屬照護認知不同、2.團隊內效能不佳、3.不同科別專業認知落差、4.缺乏組織後援。壓力因應有三個主題,九個次主題,分別為主題一情緒性支持:1.病人及家屬回饋、2.情緒發洩的多元管道、3.生活與工作平衡;主題二工具性支持:1.前輩帶領與同儕協助、2.多元的對話管道、3.組織人力資源管理、4.增加對病人照護問題的解決能力;主題三反思與轉化:1.心態調整與調適、2.自我成長與改變。
結論:受訪者陳述主要與其工作環境相關的壓力,具體而言,缺乏安寧照顧經驗、找不到工作的意義與價值、組織與團隊效能疲弱、與家屬或不同科別間認知落差是安寧護理師們最常遇到的問題。訪談中發現安寧護理師面對工作壓力每個人都有一套自己調節的方法,了解個人的限制及周邊可利用的資源,也會決定自己可以採用調適壓力的方式。
討論:安寧護理師面對工作壓力如以消極態度因應時,過程中的多重壓力和情緒將會一再被遮蔽,這樣不僅會增加壓力,也可能無法開啟自我反思之路;但如能積極面對自身感受及限制,透過反思、學習與調整的過程而達到自我成長,促使個人專業知能的提升,體悟到健康、親情、時間的可貴及生命的意義與價值。再則,人力是組織的資本,組織支持是職場工作重要的一環,除了既定安排的教育訓練外,如何增進員工的專業知能外更保有員工的身心健康,提供一個友善的工作環境是重要的。
The goal of hospice and palliative care is to help and accompany patients and their families. That will let patients have good death, then family members and patients have no regrets. In the process, the nurses will face a lot of pressure. In particular, the lack of experience in hospice care, can't find meaning and value in their jobs, the poor performance of organization and team, and the gap in family members or different medical departments are the most common problems faced by nurses. We found that when the nurses face work stress, everyone has a self-regulating method by themselves. Knowing the limitations of individuals and the resources available around them will also determine how they can adapt to stress. The study suggests that if nurses can face their own feelings and limitations actively. Through the process of reflection, learning and adjustment, they will grow up by themselves. At the same time, it will promote the improvement of personal professional knowledge, and let them realize the value of health, affection, time and life. Furthermore, human resources are the capital of the organization. Organizational support is an important part of the work. In addition to arranging educational training, it is important to enhance the professional knowledge, to maintain the physical and mental health of employees and to provide a friendly working environment.
考試合格證明
i
摘要
ii
誌謝
v
目錄
vi
圖目錄
vii
表目錄
vii

1 章 第一章 緒論 1
第一節
研究背景與動機 2
第二節
研究目的與研究問題 8
第三節
名詞解釋 9

2 章 第二章 文獻探討 12
第一節
安寧療護的發展與理念 12
第二節
安寧緩和醫療工作壓力對安寧護理師工作的影響 18
第三節
安寧護理師工作壓力因應方法 26
第四節
小結 30

3 章 第三章 研究設計與實施 31
第一節
研究設計與架構 31
第二節
研究方法 34
第三節
研究對象 36
第四節
研究工具 44
第五節
資料分析 45
第六節
研究品質 46
第七節
研究倫理 48

4 章 第四章 研究結果 49
第一節
安寧緩和醫療護理師 的工作壓力 49
第二節
安寧緩和醫療護理師工作壓力因應方式 58

5 章 第五章 結論與討論 67
第一節
研究結論 67
第二節
綜合討論 71
第三節
研究限制 79
第四節
未來研究建議 80
參考文獻
84
附錄一
人體研究倫理審查會同 意計畫修正證明書 89
附錄二
同意人體研究證明書 90
附錄三
研究說明及同意書 92
附錄四
訪談大綱 95
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