臺灣博碩士論文加值系統

目的:燒傷加護病房護理師照護著體無完膚的病人，承擔著繁忙沉重的業務，及病人和家屬過度的期待，易陷入悲憫疲憊的狀態中。本研究目的即在探討燒傷加護病房護理師悲憫疲憊因應的經驗。
方法:採質性研究，立意取樣於南部某醫學中心燒傷加護病房，收案期間為2019年9月至2020年3月，以半結構式問卷進行一對一訪談。研究對象為臨床年資二年以上，有實際參與照護嚴重燒燙傷病人、且有悲憫疲憊經驗之護理師。共收案5位，以內容分析法進行資料之分析。
結果:研究結果以四個面向呈現:一、身心休息，主題包括:遠離情境及安靜獨處；其中遠離情境又萃取出三個次主題，分別為:離開醫療照護環境、轉換心思、及睡覺。二、自我調適，主題包括:1.認清事實-內含三個次主題為:接受自我限制、接受必須工作、及接受既成的事實；2.領悟人生-內含二個次主題為:看透生死及領悟苦難的正向意義。三、尋求外援，主題包括:1.感受同事的支持，內含二個次主題為:專業能力的肯定及專業諮詢的協助；2.感受團隊的相挺，內含二個次主題為:同仁間的主動關懷及同心協力的照顧。四、積極盡責，主題包括:堅守專業義務、承擔分內責任、主動尋求突破。
結論:研究結果有助於瞭解燒傷加護病房護理師因應悲憫疲憊的經驗，作為在職教育及友善職場政策制定之參考，進而優化合諧共處之執業環境，共同提升專業表現。

Purpose
Nurses in the burn intensive care unit are easily fall into the state of compassion fatigue, because they have to simultaneously face patients’ serious defect skin conditions, overwhelming care loading, and family’s excessive expectation. Therefore, the aim of this study is to explore the coping experience of compassion fatigue among the nurses in burn intensive care unit.
Method
This was a qualitative research. Purposive sampling was applied to recruit nurses from the burn intensive care unit at a medical center in the southern Taiwan from September 2019 to March 2020. Face to face interview with a semi-structured questionnaire was used for data collection. The recruiting criteria included nurses who had more than two years of clinical experience, provided direct care for patients with severe burns, and had experienced compassion fatigue. A total of 5 nurses were recruited, content analysis was used for data analysis.
Result
The results of this study presented in four aspects: First aspect—rest physically and psychologically. This aspect includes two themes: being away from the situation and being still and alone. Being away from the situation contains three sub-themes, namely: leaving the medical care environment, changing the mind, and sleeping. Second aspect—Self adjustment, this aspect includes two themes: 1. recognize the facts which includes three sub-themes, accept self-limitation, accept the necessity of working, and accept the reality; and 2. comprehend the meaning of life which contains two sub-themes: see through life and death and perceived positive meaning of suffering. Third aspect—reach out for help. This aspect includes two themes: 1. Perceived the support from colleagues which includes two sub-themes: the affirmation of one’s professional ability and consulte the senior professionals; 2. Perceived the strength of the team work which includes two sub-themes: perceived caring from colleagues and perceived the collaboration within team work. Fourth aspect—actively fulfilled responsibilities. This aspect includes three themes: persist the thought of carrying out professional obligations, assume the care duties, and actively seek for self-breakthrough.
Conclusion
The results help us to understand the burn intensive care unit nurses’ coping experience in successfully responding to compassion fatigue. The findings of this study can be used as the reference for the in-service education and policy making to establish more friendly workplace, as to optimize the harmonious of the clinical practice environment and to enhance the nursing professional quality of care.

目錄
摘要……………………………………………………………………………………… Ⅰ
致謝……………………………………………………………………………………… Ⅳ
目錄……………………………………………………………………………………… Ⅴ
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……………………………………………………………………2
第三節 研究問題……………………………………………………………………2
第四節 名詞定義……………………………………………………………………2
第二章 文獻查證…………………………………………………………………………3
第一節 悲憫疲憊之簡介……………………………………………………………3
第二節 護理照護悲憫疲憊之現況…………………………………………………7
第三節 悲憫疲憊的相關影響因素……………………………………………… 12
第四節 悲憫疲憊的因應策略…………………………………………………… 17
第三章 研究方法……………………………………………………………………… 20
第一節 研究設計………………………………………………………………… 20
第二節 研究場域和研究參與…………………………………………………… 20
第三節 研究工具………………………………………………………………… 21
第四節 前驅研究………………………………………………………………… 24
第五節 資料收集過程…………………………………………………………… 24
第六節 資料分析………………………………………………………………… 26
第七節 研究嚴謹度……………………………………………………………… 27
第八節 研究倫理考量…………………………………………………………… 28
第四章 研究結果……………………………………………………………………… 30
第一節 研究對象基本資料……………………………………………………… 30
第二節 研究結果………………………………………………………………… 31
第五章 討論…………………………………………………………………………… 40
第六章 研究結論與建議……………………………………………………………… 50
第一節 研究結論………………………………………………………………… 50
第二節 研究建議………………………………………………………………… 51
第三節 研究限制………………………………………………………………… 52
後文……………………………………………………………………………………… 53
參考文獻………………………………………………………………………………… 54
附件一、訪談大綱……………………………………………………………………….60
附件二、同意人體研究證明書………………………………………………………… 61
附件三、人體研究說明及同意書……………………………………………………….63
附件四、資料分析歷程……………………………………………………………………66

中華民國內政部消防署全球資訊網(2020，6月5日)．火災統計
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