花東地區公共衛生護理人員之知識技能與實務需求差異及繼續教育相關因素探討

Abstract

公共衛生護理工作隨著社會變遷，面臨更多元複雜的照護問題，需要不斷地充實新的知識技能，以因應工作實務面所需。本研究為了解目前實務工作者，當社區健康面臨各種全新挑戰，第一線社區健康照護人員，對於照護知識技能有何需求，在職教育或進修課程中所提供的知識技能，是否滿足實務所需，執照更新制度對花東地區公共衛生護理人員知識技能之影響。本研究欲探討花東公共衛生護理人員知識技能與實務需求差異之現況分析，及其相關影響因素，希望藉由探討偏鄉及弱勢族群比率偏高的花東地區，做為類似情況地區的護理人員，未來繼續教育課程設計之參考。研究設計為橫斷式、相關性研究，以單次結構式問卷做為研究工具，問卷內容是根據研究者參考相關文獻而自擬的「花東地區影響公共衛生護理人員之知識技能與實務需求差異之因素」量表。問卷效度採專家內容效度，研究對象為花蓮、台東地區之公共衛生護理人員，共160名（回收率70.2%）。研究結果顯示，本研究對象之各項知識技能分數，得分介於「2分/只能做到一部分」及「3分/能做到大部分」之間，知識技能分數居中，偏向護理實務技巧的能力，公共衛生護理人員自評較佳，但領導及管理方面之行政能力，自評較差。覺得缺乏的課程，前三名分別為「分析與評估」、「政策發展與活動計畫執行」及「溝通實務方面」。近一年參加在職教育類型，最多的為「公共衛生方面」及「社區實務方面」，較少的為「領導與管理」、「文化方面」及「財政管理方面」。社區工作年資及年齡越小者，因執照更新理由而參加在職教育者越高。迴歸分析顯示，參與在職教育種類量較少者，其參與理由較多是為了執照更新。現今因推動執照更新制度，護理人員參與在職教育之比率已較過去提升，建議將來要辦理在職教育課程時，課程設計可多加辦理領導及管理方面之課程，使得護理人員不只有參與量增加，質也能符合需求並有所提升。

Along with social change, public health nurses face more complex care issues and need to constantly improve new knowledge and skills to cope with the nursing practices required. This study aimed to understand the primary community health care practitioners in Hualien and Taitung, in facing a variety of new community health challenges and license renewal, what is in-service education needed for knowledge and skills for practice. To explore continuing education need in remote and disadvantaged areas of eastern Taiwan, will be the reference for similar district in the future. A cross-sectional, correlation study design with structured questionnaire research method was used. The questionnaire was developed by the researchers. Questionnaire validity used expert content validity. 160 public health nurses completed the questionnaire with a response rate 70.2%. The results of this study show a moderate level of knowledge and skills scores. Ability of nursing practice skills is good, but the administrative capacity of leadership and management is poor. Feel a lack of courses included ""analysis and assessment"", ""policy development and implementation of activities planned"" and ""practical aspects of communication."" In recent one year in-service education, the most were ""public health"" and ""practice aspects of the community."" Fewer courses were ""leadership and management"", ""culture"" and ""financial management."" For those nurses with less years of community work experiences and the younger, license renewal as a reason to attend courses were higher. Regression analysis showed, participants of license renewal as main reason had less amount of in-service education. As a impact of license renewal, in-service education involvement have been enhanced over the past. It is recommended in the future when designing in-service education program, curriculum can be more addressed to leadership and management courses. In-service education not only increases in the quantity but also quality.