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系統識別號 U0026-2607201014021600
論文名稱(中文) 社區護理人員處理兒童虐待之臨床能力-以台灣南部診所、衛生所護理人員為例
論文名稱(英文) Community Nurses’ Clinical Competency in Child Abuse: Public Health Centers and Outpatient Clinics in Southern Taiwan as an Example
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 98
學期 2
出版年 99
研究生(中文) 陳宜彣
研究生(英文) Yi-Wen Chen
學號 t2696407
學位類別 碩士
語文別 中文
論文頁數 114頁
口試委員 指導教授-馮瑞鶯
口試委員-呂宗學
口試委員-黃志中
中文關鍵字 社區護理人員  兒童虐待  臨床能力 
英文關鍵字 Community nurses  Child abuse  Clinical competency 
學科別分類
中文摘要 背景:社區護理人員在兒童虐待議題的角色功能多元,包括評估高風險家庭之健康問題,及時適切之照護措施,如親職技巧等。瞭解台灣社區護理人員處理兒虐的臨床能力的現況,為發展適切本土文化的相關教育之基石。
研究目的:了解社區的護理人員處理兒童虐待之臨床能力現況。
研究方法:橫斷性、描述性、相關性研究,以方便取樣選取650位台灣南部診所及衛生所護理人員為研究對象。自擬式結構式問卷作為資料收集的工具,包含專業知識、專業技能、賦能、團隊合作及個人反思等五個次量表。
研究結果:共回收有效問卷為588份。個案多數為女性且已婚,平均年齡為39歲。79%為衛生所護理人員、20%為診所護理人員。20%者之親友為受虐兒。僅有4.6%曾有舉報經驗。僅有93人(15.8%)社區護理人員答對所有專業知識題項,多數的社區護理人員傾向同意自己具備專業技能、賦能、團隊合作及個人反思等能力。除專業知識外,診所護理人員在專業技能、賦能、團隊合作及個人反思之得分高於衛生所護理人員。臨床能力與年齡、工作年資呈負相關。專業知識僅與團隊合作、個人反思呈正相關,其他臨床能力次概念則彼此具有正相關。
結論:社區護理人員對兒虐知識仍不足,僅有少數護理人員有舉報經驗且接受兒虐相關教育。多數受虐兒仍隱藏於社區中,未被發現與舉報。未來社區護理人員之在職教育需加入兒虐知識相關訓練且納入繼續教育,以增進其敏感度及臨床能力。
英文摘要 Background: Community nurses play various significant roles in child abuse, ranging from assessing health problems for children in the high risk family to providing appropriate interventions to resolve complex family difficulties. Understanding nurses’ clinical competency in child abuse and related factors is the essence for developing a culturally and clinically appropriate training program. Purpose: The purpose of this study was to explore community nurses’ clinical competency in child abuse.
Methods: The research design is a cross-sectional, descriptive and correlational study. A convenience sampling was used to recruit 650 nurses from the communites in southern Taiwan. A structured questionnaire with 5 subscales, knowledge, skills, techniques, empowerment, team collaboration and self-reflection was developed and used for data collection.
Results: A total of 588 questionnaires were returned and used for analysis. Most nurses were female, and married with a mean age of 39. About 79% of nurses worked in public health centers while 20% of nurses worked in outpatient clinics. Nearly 20% reported having acquaintance with a maltreatment history. Only 4.6% had experience of reporting child abuse case. Only 93 (15.8%) nurses correctly answered all items of knowledge scale. Most nurses perceived that they were skillful, possessed the abilities of empowerment, team collaboration and self-reflection. Except for knowledge subscale, outpatient clinic nurses scored higher for the other 4 subscales. Nurses’ clinical competence in child abuse was negatively correlated with nurses’ age and working experience. Nurses’ knowledge in child abuse was significantly and positively correlated with team collaboration and self-reflection. The rest of 4 subscales of clinical competence in child abuse were positively correlated with each other.
Conclusion: Community nurses were not knowledgeable on child abuse. Very few nurses had experiences of reporting suspected child abuse cases. The hidden number of child abuse victims in the community cannot be overlooked. Training programs on child abuse in nursing continous education is needed to improve community nurses’ sensibility and clinical competence to manage child abuse in the community.
論文目次 目錄
摘要 I
英文摘要 III
致謝 V
第一章 緒論 1
第一節 研究動機及背景 1
第二節 研究重要性 4
第三節 研究目的 5
第四節 研究問題 5
第五節 名詞定義 6
第二章 文獻查證 8
第一節 社區護理人員於兒童虐待之角色 8
第二節 醫護人員於面臨及處理兒虐事件之臨床能力 10
一、臨床能力 10
二、醫護人員處理兒虐事件之臨床能力 15
第三節 影響兒童虐待之臨床能力的相關因素 19
第三章 研究方法 26
第一節 研究設計與架構 26
第二節 研究對象 27
第三節 研究工具 28
第四節 資料分析 32
第五節 資料收集及程序 32
第六節 倫理考量 33
第四章 研究結果 35
第一節 前驅研究結果 35
第二節 建構效度 39
第三節 研究結果 48
第五章 討論 63
第一節 研究結果詮釋及與過去文獻之比較 63
第二節 研究限制 71
第六章 結論 74

表目錄
表一 正式施測問卷之記分方式 31
表二 內在一致性及再測信度 36
表三 專家內容效度指標(CVI) 37
表四 題項修訂摘要表 38
表五 因素修正內容 41
表六 樣式矩陣 42
表七 項目分析摘要表 46
表八 人口學資料 49
表九  臨床能力的描述性分析結果 52
表十 專業知識各題之答對率 52
表十一 診所及衛生所護理人員之臨床能力的T檢定分析結果 54
表十二 個人特質、專業特質與臨床能力間的關係 56
表十三 不同個人特質與臨床能力之差異 57
表十三 不同個人特質與臨床能力之差異(續) 58
表十三 不同個人特質與臨床能力之差異(續) 59
表十四 不同專業特質與臨床能力之差異 61
表十五 內在一致性 62

圖目錄
圖1 研究架構 27
圖2 因素陡坡圖 40

附件一 國立成功大學醫學院附設醫院人體試驗委員會同意臨床試驗證明書 91
附件二 前驅研究一般審查受試者同意書 92
附件三 主研究一般審查受試者同意書 94
附件四 專家效度之審查名單 96
附件五 研究問卷修改細項說明 97
附件六 正式施測問卷 107

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