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系統識別號 U0026-0812200915052407
論文名稱(中文) 護理人員參與人際互動課程方案之反思歷程
論文名稱(英文) The reflection process of nursing staffs participate in the Interpersonal Interaction Program
校院名稱 成功大學
系所名稱(中) 護理學系碩博士班
系所名稱(英) Department of Nursing
學年度 97
學期 1
出版年 98
研究生(中文) 張薰文
研究生(英文) Hsun-wen Chang
學號 t2695109
學位類別 碩士
語文別 中文
論文頁數 115頁
口試委員 口試委員-許麗齡
口試委員-張瑩如
指導教授-徐畢卿
中文關鍵字 護理  批判反思  反思  課程方案 
英文關鍵字 critical reflection  nursing  reflection  interpersonal interaction program 
學科別分類
中文摘要 反思問題的能力在現今護理知識擴張及健康醫療系統快速轉變環境中,是護理人員所必備的。若要有效處理日趨錯綜複雜的臨床問題,護理人員除了要具有豐富的護理專業知識外,還必須具反思問題的能力;反思是一種心智的活動,透過反思能夠對於事物的情境深入分析及釐清自己對事情的理解程度,並修正觀點與觸發新的想法,進而產生由內而外的改變。透過反思護理人員可以增加對病人情境的領悟與理解,經由反思增強自我的洞察力(self-awareness),將自己當成關懷工具,以提升照護品質。因此,反思能力的塑造與培養是讓目前臨床實務工作得以更進一步深入發展的要素。
本研究旨在探討『人際互動課程方案』施行對護理人員之反思與批判反思能力之轉變歷程。本研究以技職體系之臨床指教師、臨床護理長、病房小組長、臨床資深人員及研究生為參與之研究對象。課程主要以團體討論方式進行,分兩組團體,每組參與人數分別為11人與10人,每個團體共計七次。經由團體領導者引導,在團體中引發成員討論,讓成員藉由團體進行過程中之相互意見交換,產生反思能力的改變。
本研究採質性研究法,在資料方收集方面包括研究生反思日誌、團體進行過程觀察與紀錄(錄音、錄影)、參與者每次參與團體後所書寫的札記,團體結束後評量表以作為資料分析。研究資料經內容分析法分析後,可歸納出三個主題「啟動覺醒的匙鑰」、「開展反思的組曲」、「批判思維能力的展現」;每個主題下包括數個次主題,「啟動覺醒的」包括:覺察自己與自己的關係、覺察自己與異己的關係、覺察自己與環境的關係、覺察自己與時間的關係、覺察自己與護理的關係;「開展反思的組曲」包括:
分析自己的特質、修正自己的個性、分析時間的運用、質疑職場的內規;「批判思維能力的展現」包括:跳脫框架的束縛、探詢事物的分野、勿做表淺的判斷、去除主觀的判斷。
此結果代表本課程方案之教學策略對於護理人員之反思能力與批判思考能力具有正向之效果,故可作為臨床實務中資深護理人員,與技職體系護理臨床指導教師在職訓練方案之參考。
英文摘要 The ability of reflection is necessary for nurses due to the expanding of nursing knowledge and the rapid changing of medical system. In order to solve the complicated problems in clinical practice effectively, nurses need not only have enough professional knowledge, but also have to develop the ability of reflection. Reflection is a mental activity; it could help nurses to analyze their nursing care further more and to clarify the level of what they have understood in their clinical practice. New points of view and ideas which can help nurses to change their mind internally and externally could be generated during the process of reflection. Reflection can increase nurses’ understanding about what their patients situated and intensify their self-awareness. The quality of nursing care then will be improved. In short, the formation and development of reflection ability is a critical element for nurses to improve their caring with much more quality in clinical practice.
The purpose of this research was to discuss the changing process of nurses’ reflection and critical reflection upon implementing the “program of interpersonal interaction”. Participants recruited in our study included the clinical teachers of junior colleges, clinical nurse leaders, experienced clinical staff, and graduate students. The program of interpersonal interaction was carried out by group discussion. These participants were divided into two groups in which 11 and 10 people in each group respectively. Seven times of discussion were held in each group. Through the guidance of the group leader, the participants exchanged their opinions initially and then transformed their reflection ability during the discussion process finally.
This study was adopted qualitatively. Data was conducted by using reflection diaries of the graduate students, observation records (cassettes or video) of the discussion process, the notes written by the participants after the discussion, and group evaluation sheets. Three main themes emerged after content analysis: starting in self-awareness naturally, establishment of reflection process, and performance of critical thinking. Sub-themes were also generated in each main theme. Starting in self-awareness naturally referred to that participants were aware the relationship between one and oneself, oneself and others, oneself and the environment, oneself and the time and oneself and their nursing job. Establishment of reflection process referred to that participant could analyze her own characteristics; modify her personality, applicant her time, and question her routine job. Performance of critical thinking mentioned about escaping away the existing frame, inquiring the diversity of thing, making deeper thinking when facing with judgment, and abandoning subjective comments.
論文目次 中文摘要-----------------------------------------------------------Ι
英文摘要-----------------------------------------------------------Ⅲ
誌謝---------------------------------------------------------------Ⅴ
第一章 緒論---------------------------------------------------------1

第一節 研究背及重要-----------------------------------------------1
第二節 研究目的---------------------------------------------------5
第三節 研究問題---------------------------------------------------5

第二章 文獻查證-----------------------------------------------------6

第一節 反思的概念-------------------------------------------------6
第二節 批判思考意涵-----------------------------------------------15
第三節 反思與批判思考能力之相關性---------------------------------20
第四節 反思與護理實務---------------------------------------------26

第三章 研究方法----------------------------------------------------34

第一節 研究設計---------------------------------------------------34
第二節 研究對象及研究過程-----------------------------------------34
第三節 研究生的背景與角色-----------------------------------------37
第四節 研究流程---------------------------------------------------38
第五節 資料蒐集與編碼---------------------------------------------40
第六節 資料分析---------------------------------------------------42
第七節 研究的嚴謹度-----------------------------------------------43
第八節 倫理考量---------------------------------------------------44

第四章 研究結果----------------------------------------------------45
第一節 團體基本資料----------------------------------------------45
第二節 人際互動團體成員之反思歷程--------------------------------47
第三節 研究生的反思----------------------------------------------67

第五章 討論-------------------------------------------------------78
第一節 團體對話促進反思------------------------------------------78
第二節 批判思維能力之學習----------------------------------------80
第三節 反思的內涵------------------------------------------------82

第六章 結論及建議-------------------------------------------------82
第一節 結論------------------------------------------------------82
第二節 建議------------------------------------------------------84
第三節 研究限制--------------------------------------------------84
中文參考資料-------------------------------------------------------86
英文參考資料-------------------------------------------------------89
附件一 人際互動課程方案內容---------------------------------------100
附件二 自擬課程評量表---------------------------------------------109
附件三 研究參與同意書---------------------------------------------112
附件四 人體試驗委員會同意臨床試驗證明書---------------------------115
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