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Clarification of the antecedents of hospital nurse organizational citizenship behavior -- an example from a Taiwan regional hospital. 医院护士组织公民行为前因之厘清——以台湾某地区医院为例。
Pub Date : 2005-12-01 DOI: 10.1097/01.JNR.0000387554.73328.32
Cheng-I Chu, Ming-Shinn Lee, Hsiang-Ming Hsu, I-Chi Chen
Organizational citizenship behaviors (OCB) are deemed indispensable due to their importance in promoting positive relationships among employees and involving employees in the organization's activities. OCB is believed to facilitate attainment of a hospital's goals and enhance a hospital's performance. The aim of this study is to extend the work of previous studies by providing an integrated model of OCB and demonstrate its applicability in a non-Western culture. Questionnaires were completed by 314 non-supervisory hospital nurses, each of whom was given a supervisor rating for their OCB. Exploratory factor analysis was used to assess the convergent and discriminant validity of the variables in the model. Multiple regression analysis was used because it provided estimates of net effects and explanatory power. The results showed that job satisfaction, supervisor support, job involvement, and procedural justices had significant effects on the nurses' citizenship behaviors. Since the study used a non-Western site in one of Taiwan's health care institutions, its overall findings should contribute to further understanding of the cross-cultural aspects of OCB.
组织公民行为(OCB)在促进员工之间的积极关系和使员工参与组织活动方面具有重要意义,因此被认为是不可或缺的。人们相信,组织公民行为有助于实现医院的目标,提高医院的绩效。本研究的目的是通过提供一个整合的组织公民行为模型来扩展以往的研究工作,并证明其在非西方文化中的适用性。问卷调查由314名非主管医院护士完成,每位护士都被给予主管的组织公民行为评级。探索性因子分析用于评估模型中变量的收敛效度和判别效度。使用多元回归分析,因为它提供了净效应和解释力的估计。结果显示,工作满意度、主管支持、工作投入和程序公正对护士公民行为有显著影响。由于本研究使用了台湾一家医疗机构的非西方地点,其整体研究结果应有助于进一步了解组织公民行为的跨文化方面。
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引用次数: 70
Clinical follow-up study on diabetes patients participating in a health management plan. 糖尿病患者参与健康管理计划的临床随访研究。
Pub Date : 2005-12-01 DOI: 10.1097/01.JNR.0000387548.65705.A5
Pei Tang, W. Yuan, H. Tseng
The "Health Management Plan"(HMP) for caring diabetic patient was begun by the National Health Insurance (NHI) in Taiwan in order to maximize the effectiveness of limited medical resources. This study describes the clinical experience of the nurse-directed diabetic HMP program and analyzes factors associated with the outcome. One hundred and thirty-six patients, all of whom had participated in the diabetic HMP program at least 5 times, were enrolled in the study. The effect of the HMP was evaluated by comparing hemoglobin A1C status before and after %) maintained their hemoglobin A1C status over the course of HMP participation. Diabetic patients with regular exercise habits showed a 2.8-fold increased chance of outcome improvement compared with those who did not exercise regularly. The chance of outcome improvement in patients with complications was found to be one-third that of patients who had no complications (Odds ratio: 0.3, 95% CI: 0.1-1.0). This study found that specially trained nurses, following agreed upon protocols and algorithms and collaborating with medical team members, can effectively concentrate on providing comprehensive and effective diabetes care.
“健康管理计划”(HMP)是台湾全民健康保险(NHI)为了最大限度地利用有限的医疗资源而发起的糖尿病护理计划。本研究描述了护士指导的糖尿病HMP项目的临床经验,并分析了与结果相关的因素。136例患者均参加了至少5次糖尿病HMP项目。HMP的效果是通过比较在HMP参与过程中维持血红蛋白A1C状态的患者(%)前后的血红蛋白A1C状态来评估的。与不经常运动的糖尿病患者相比,有规律运动习惯的糖尿病患者结果改善的机会增加了2.8倍。发现有并发症患者预后改善的机会是无并发症患者的三分之一(优势比:0.3,95% CI: 0.1-1.0)。本研究发现,经过专门培训的护士,遵循商定的协议和算法,并与医疗团队成员合作,可以有效地集中精力提供全面有效的糖尿病护理。
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引用次数: 9
Psychological abuse behavior exhibited by caregivers in the care of the elderly and correlated factors in long-term care facilities in Taiwan. 台湾长期照护机构中照顾者的心理虐待行为及其相关因素。
Pub Date : 2005-12-01 DOI: 10.1097/01.JNR.0000387550.50458.BC
Jing-Jy Wang
This study explored the state and the correlated factors of psychological abuse behavior among caregivers in long-term care facilities in Taiwan. A cross-sectional design utilizing a descriptive-correlational approach was conducted. A sociodemographic sheet, Caregiver Psychological Elder Abuse Behavior Scale (CPEAB), and Caregiver's Burden Scale (CBS) were employed to collect data. A total of 114 caregivers completed the study, of whom 16.1% returned an CPEAB score greater than 40. The potential range of CPEAB scores ranged from 20 to 80, with the highest score indicating the greatest tendency toward psychological abuse behavior. Among the total of 20 CPEAB indicators, "Accuse him/her verbally", "Ignore his/her request", and "Insult him/her" received the highest item mean scores (M = 2.18, 2.12, 2.02; SD = 0.83, 0.84, 0.91). Significant relationships between the CPEAB and subject age, professional status, educational level, geriatric care training, and CBS score were found (p < .05 - .001). These results indicate that caregivers who are younger in age, less educated and lacking in geriatric training had a greater burden and displayed a tendency toward more abusive behavior. Another important finding was that nurses displayed more abusive behavior than their care attendant counterparts. Results of this study provide important information that may be used in medical and social interventions and policies aimed at improving quality of life for the institutionalized elderly.
摘要本研究旨在探讨台湾长期照护机构照顾者心理虐待行为的现况及其相关因素。采用描述性相关方法进行了横断面设计。采用社会人口学量表、照顾者虐待老人心理行为量表(CPEAB)和照顾者负担量表(CBS)收集数据。共有114名护理人员完成了这项研究,其中16.1%的人的CPEAB得分超过40分。CPEAB的潜在得分范围为20 - 80分,得分越高,心理虐待倾向越大。在总共20个CPEAB指标中,“口头指责”、“无视他/她的要求”和“侮辱他/她”三项平均得分最高(M = 2.18、2.12、2.02;Sd = 0.83, 0.84, 0.91)。CPEAB与受试者年龄、专业地位、教育程度、老年护理培训、CBS评分有显著相关(p < 0.05 ~ 0.001)。这些结果表明,年龄较小、受教育程度较低和缺乏老年培训的照顾者负担更大,并表现出更多的虐待行为倾向。另一个重要的发现是,护士比护理人员表现出更多的虐待行为。这项研究的结果提供了重要的信息,可用于医疗和社会干预和政策,旨在提高老年人的生活质量的机构。
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引用次数: 56
Enema prior to labor: a controversial routine in Taiwan. 临产前灌肠:台湾有争议的常规。
Pub Date : 2005-12-01 DOI: 10.1097/01.JNR.0000387549.42834.A9
Y. Tzeng, Y. Shih, Yu-Kuei Teng, C. Chiu, Meizhi Huang
While taking an enema to induce labor is a controversial issue worldwide, in Taiwan it remains a routine procedure in many hospitals in preparation for birth. Episiotomy is also a prevalent procedure performed during the birthing process. Some physicians believe that enemas help reduce the risk of feces contamination of the episiotomy incision and, therefore, are justified as a routine procedure. This study compared the neonatal infection rates, times to appearance of fetal head, times to first post-labor bowel movement, and rates of episiotomy dehiscence of women receiving a pre-labor enema against those who did not. A total of 534 women classified with low-risk pregnancies were recruited from a medical center in central Taiwan and assigned randomly into one of two groups for a six-month period. The first group (264 subjects) received routine enema procedures prior to delivery in the first 6 months. The second group (270 subjects) did not receive enemas. Study results revealed no significant difference between enema and non-enema groups in terms of infection rates in mothers or infants or in terms of average time to fetal head appearance. While labor duration was the same for the two groups in the first and third stages of labor, the enema group experienced a relatively shorter second stage. No significant difference was observed in times to first post-labor bowel movement or episiotomy dehiscence rates. The results of this study indicate that the administration of enemas as a routine practice prior to labor is not substantiated by medical necessity. However, limitations of the research design suggest that a randomized clinical trial be adopted in the future to explore further the scientific validity of study results.
虽然灌肠引产在世界范围内都是一个有争议的问题,但在台湾,它仍然是许多医院准备分娩的常规程序。在分娩过程中,会阴切开术也是一种普遍的手术。一些医生认为灌肠有助于降低粪便污染会阴切口的风险,因此,作为常规手术是合理的。本研究比较了新生儿感染率、胎头出现次数、分娩后第一次排便次数以及分娩前接受灌肠的妇女与未接受灌肠的妇女的会阴切开术开裂率。研究人员从台湾中部的一家医疗中心招募了534名低风险怀孕的妇女,并将她们随机分为两组,为期六个月。第一组(264名受试者)在分娩前6个月接受常规灌肠。第二组(270例)不进行灌肠。研究结果显示,在母亲或婴儿的感染率方面,灌肠组和非灌肠组之间没有显着差异,也没有在胎儿头出现的平均时间方面有显着差异。两组第一产程和第三产程持续时间相同,灌肠组第二产程相对较短。第一次分娩后排便时间和会阴切开术开裂率无显著差异。本研究结果表明,在分娩前给予灌肠作为常规做法是没有医学必要性的。然而,由于研究设计的局限性,建议未来采用随机临床试验,进一步探讨研究结果的科学有效性。
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引用次数: 5
A correlational study on health training program participation and influences upon communities volunteers in Taipei City. 台北市社区义工健康训练计划参与及影响之相关研究。
Pub Date : 2005-12-01 DOI: 10.1097/01.JNR.0000387547.65705.41
Ching-Ju Tung, Ching-Min Chen, Pi-Hsia Lee
This is a cross-sectional study that purposely selected healthy community centers (HCC) in Taipei City to explore factors affecting volunteers' health training program participation (HTPP). The major objectives were to: (1) examine volunteer's HTPP; (2) explore relationships among volunteers' HTPP, self-efficacy (SE) in healthy community building, and community activities participation (CAP); and (3) identify key factors affecting volunteers' HTPP. A self-developed instrument with validity (content validity index > .91) and reliability (alpha = .63-.87) was used. A total of 250 participants were recruited. Study results revealed that a majority of the volunteers were middle-aged women who held at least a high school education, worked part-time, held Buddhist religious beliefs, were married and were middle class in terms of income. The average HTPP value was 19, with Xin Yi, Zhong Zhen and Bei Tou HCCs exhibiting higher HTPP values. Those not currently employed and housewives volunteers had lower HTPP values. 66.4% of volunteers participated at community activities after training and contributed 60-120 service hours a year. Volunteers' SE in healthy community building was low (M = 2.01, SD = 1.01), which, however, could explain 21% variance of HTPP. Factors affecting HTPP included HCC site, SE and CAP, which accounted for 57% of variance. Study results indicated that SE and CAP could serve as training evaluation indicators and a well-organized training program could increase volunteers' SE. Standard health training programs should incorporate three programs, including volunteerism perception, health promotion, and middle aged and elderly care to thus further improve volunteers' participation in community health activities.
本研究以台北市健康社区中心(HCC)为研究对象,探讨影响志愿者健康训练计划参与的因素。主要目的是:(1)检查志愿者的HTPP;(2)探讨志愿者HTPP、健康社区建设自我效能感和社区活动参与的关系;(3)找出影响志愿者HTPP的关键因素。采用自行研制的效度量表(内容效度指数> .91),信度量表(α = .63 ~ .87)。总共招募了250名参与者。研究结果显示,大多数志愿者是中年女性,她们至少受过高中教育,有兼职工作,有佛教信仰,已婚,收入属于中产阶级。平均HTPP值为19,其中信义、中镇和北头的HTPP值较高。无工作人员和家庭主妇志愿者的HTPP值较低。66.4%的志愿者在培训后参加社区活动,每年贡献60-120小时的服务时间。志愿者在健康社区建设方面的SE较低(M = 2.01, SD = 1.01),但这可以解释HTPP 21%的方差。影响HTPP的因素包括HCC部位、SE和CAP,占方差的57%。研究结果表明,SE和CAP可以作为培训的评价指标,组织良好的培训计划可以提高志愿者的SE。规范的健康培训项目应包括义工意识、健康促进和中老年护理三个项目,从而进一步提高志愿者对社区健康活动的参与度。
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引用次数: 1
Physical activities and correlates of clinical nurses in Taipei municipal hospitals. 台北市立医院临床护士身体活动状况及相关因素分析。
Pub Date : 2005-12-01 DOI: 10.1097/01.JNR.0000387551.50458.F5
Yuh-Shwu Lee, Yi-ching Huang, Y. Kao
The purpose of this study was to investigate the physical activity profiles of clinical nurses in Taipei municipal hospitals. This study also explored the factors that influence physical activity, including personal background and social psychological factors. A total of 400 Taipei municipal hospital clinical nurses were selected using a randomized procedure to participate in a 3-day physical activity record assignment and fill in a structured questionnaire. Study results indicate that energy expenditure for clinical nurses on working days are higher than that on non-working days. Non-working days of clinical nurses are characterized by a lack of physical activity. Nurses who were required to take turns working in three shift rotation cycles, those with education at the junior college level or below, and those who were married tended to spend more energy on physical activity. Social psychological factors affecting the physical activities of clinical nurses include mainly exercise self-efficacy. Heavy work loading, poor health conditions, laziness, and lack of time tended to lower exercise self-efficacy. On non-working days, perceived barriers to exercise are the main issue area affecting moderate-to-vigorous physical activity. Nurses with greater perceived barriers to exercise spend less energy on physical activity. The main influencing factors for perceived barriers to exercise include laziness and lack of time.
摘要本研究旨在探讨台北市市立医院临床护士之身体活动状况。本研究还探讨了影响体育锻炼的因素,包括个人背景和社会心理因素。本研究采用随机方法,选取400名台北市立医院临床护士参与为期3天的身体活动记录分配,并填写结构化问卷。研究结果表明,临床护士在工作日的能量消耗高于非工作日。临床护士的非工作日的特点是缺乏体力活动。被要求三班轮流工作的护士、受过大专或以下教育的护士以及已婚的护士倾向于在体育锻炼上花费更多的精力。影响临床护士身体活动的社会心理因素主要包括运动自我效能感。繁重的工作负荷、糟糕的健康状况、懒惰和缺乏时间往往会降低锻炼的自我效能。在非工作日,运动障碍是影响中高强度体育活动的主要问题。认为运动障碍较大的护士在体育活动上花费的精力较少。人们认为阻碍锻炼的主要因素包括懒惰和缺乏时间。
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引用次数: 21
Physical and social predictors for pre-term births and low birth weight infants in Taiwan. 台湾早产儿与低出生体重儿之生理与社会预测因子。
Pub Date : 2002-06-01 DOI: 10.1097/01.JNR.0000347586.08328.D6
Yili Ko, Yi-Cheng Wu, P. Chang
The purpose of this study was to examine the risk factors associated with pre-term labor (PTL) (< 37 gestational weeks) and low birth weight (LBW) (< 2500 gm) infants in a healthy Taiwanese population. From December 1998 through June 1999, a total of 633 healthy pregnant women were recruited at three teaching hospitals in Taipei. Using a prospective study design, the pregnancy outcome information was followed up by telephone or from medical records during the first month postpartum. Data were statistically analyzed by multiple logistic regression. The prevalence of premature births was 5.4%, and the prevalence of LBW infants was 5.1%. Pre-term births were significantly associated with high self-reported fatigue scores (OR = 3.45); extreme maternal age (< 20 and >/= 35 years, OR = 2.38); history of abortion (>/= 2, OR = 3.11); maternal height (
摘要本研究旨在探讨台湾健康人群中早产(PTL)(< 37孕周)及低出生体重(LBW) (< 2500 gm)婴儿的相关危险因素。从1998年12月至1999年6月,台北三所教学医院共招募了633名健康孕妇。采用前瞻性研究设计,通过电话或产后第一个月的医疗记录跟踪妊娠结局信息。数据采用多元逻辑回归进行统计学分析。早产儿患病率为5.4%,低体重儿患病率为5.1%。早产儿与自我报告的高疲劳评分显著相关(OR = 3.45);极端产妇年龄(< 20岁和>/= 35岁,OR = 2.38);流产史(>/= 2,OR = 3.11);母体身高(
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引用次数: 20
A randomized controlled trial of early kangaroo care for preterm infants: effects on temperature, weight, behavior, and acuity. 一项早产儿早期袋鼠式护理的随机对照试验:对体温、体重、行为和视力的影响。
Pub Date : 2002-06-01 DOI: 10.1097/01.JNR.0000347592.43768.46
M. Chwo, G. Anderson, M. Good, D. Dowling, S. H. Shiau, Der‐Ming Chu
Kangaroo care (KC) has been the intervention for preterm infants in numerous published studies. However, most well designed studies to date have used a one-group repeated measure design. This methodology is not as definitive as an experimental design. Because of the absence of a comparable control group, change between pretest and posttest may be due to any other environmental variables or normal variation of subjects (Kirk, 1995). This randomized controlled trial (RCT) was done to test the hypotheses that KC infants would have higher mean tympanic temperatures, less weight loss, more optimal behavioral states, and lower acuity (length of stay). Thirty-four eligible mother-infant dyads were randomly assigned to the KC or the control group by computerized minimization on the day following birth. Stratification variables included infant gender, birth weight, delivery method, and parity. KC infants compared to control infants had higher mean tympanic temperature (37.3 degrees C vs. 37.0 degrees C), more quiet sleep (62% vs. 22%), and less crying (2% vs. 6%) all at p=.000. No significant difference was found for weight loss and acuity (length of stay). These findings can be used for evidence-based nursing practice in Taiwan. With the knowledge attained from this RCT, nurses can educate and motivate mothers to keep their stable preterm infants warm by skin-to- skin contact inside their clothing, thereby encouraging self-regulatory feeding.
在许多已发表的研究中,袋鼠式护理(KC)一直是早产儿的干预措施。然而,迄今为止,大多数设计良好的研究都使用了单组重复测量设计。这种方法不像实验设计那样确定。由于没有可比较的对照组,测试前和测试后的变化可能是由于任何其他环境变量或受试者的正常变化(Kirk, 1995)。本随机对照试验(RCT)旨在验证KC婴儿平均鼓室温度较高、体重减轻较少、行为状态更优、视力(住院时间)较低的假设。34名符合条件的母婴在出生后一天通过计算机最小化随机分配到KC组或对照组。分层变量包括婴儿性别、出生体重、分娩方式和胎次。与对照组婴儿相比,KC婴儿的平均鼓室温度更高(37.3摄氏度对37.0摄氏度),睡眠更安静(62%对22%),哭泣更少(2%对6%),p= 0.000。体重减轻和视力(住院时间)无显著差异。本研究结果可为台湾循证护理实务提供参考。有了从这项随机对照试验中获得的知识,护士可以教育和激励母亲通过衣服内皮肤对皮肤的接触来保持稳定的早产儿温暖,从而鼓励自我调节喂养。
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引用次数: 97
Cost and care quality between licensed nursing homes under different types of ownership. 不同所有制下持牌护理院的成本及护理质素。
Pub Date : 2002-06-01 DOI: 10.1097/01.JNR.0000347594.28520.61
Chun-Lan Lee, Tao Liu, Ling Wu, U. Chung, Liz Lee
In Taiwan, there is some uncertainty and concern regarding the quality and safety of unlicensed nursing homes, as they are typically crowded and poorly equipped. There are data insufficient regarding the quality of care in licensed nursing homes for the government to reliably assist unlicensed facilities to become licensed. The purpose of this study was to examine the relationship between the different nursing home ownership types and the following dependent variables: (1) operating cost per resident day, (2) RN to resident ratio, (3) facility size, (4) occupancy rate, and (5) quality of care amongst licensed nursing homes nationwide. The descriptive study used a survey design. Data were obtained from 28 licensed nursing homes using self-administered questionnaires, on-site interviews and record reviews. Data were analyzed by Kruskal-Wallis test, Mann-Whitney U test and Spearman s correlation. A positive and significant relationship existed between nursing home quality and the RN ratio per resident day. Chain/For-profit and Chain/Non- profit nursing homes tended to have higher operating costs and a better quality of service. Secondary research is still needed to examine the results by detailed cost analysis or by research oriented toward outcomes of residents care. These findings provide basic reference for the government for planning the operation of nursing home facilities and also to assist the many unlicensed nursing homes to ultimately become licensed. The results also present important data for developing reimbursement policies.
在台湾,无照养老院的质量和安全存在一些不确定性和担忧,因为它们通常很拥挤,设备也很差。关于有执照的养老院的护理质量的数据不足,政府无法可靠地帮助无执照的机构获得执照。本研究旨在探讨不同疗养院所有权类型与以下因变量之间的关系:(1)每住客日营运成本,(2)注册护士与住客比率,(3)设施规模,(4)入住率,以及(5)全国持牌疗养院的护理质量。描述性研究采用调查设计。数据来自28家持证养老院,采用自填问卷、现场访谈和记录回顾。数据分析采用Kruskal-Wallis检验、Mann-Whitney U检验和Spearman相关检验。养老院质量与每住客日护士护理比率之间存在显著正相关。连锁/营利性和连锁/非营利性养老院往往具有较高的运营成本和较好的服务质量。还需要通过详细的成本分析或以居民护理结果为导向的研究来检验结果。这些研究结果为政府规划养老院设施的运营提供了基本参考,也为许多无牌养老院最终获得牌照提供了帮助。研究结果也为制定报销政策提供了重要数据。
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引用次数: 6
The efficacy of problem solving strategies utilized in professional nursing concepts course to improve problem solving abilities in students enrolled in a two-year baccalaureate nursing program. 在专业护理概念课程中运用问题解决策略提高两年制护理学士学位学生解决问题能力的效果。
Pub Date : 2002-06-01 DOI: 10.1097/01.JNR.0000347590.36144.BD
Jing-Jy Wang, Chi-Hui Kao Lo, Kuei‐Min Chen, Jane Lee Hsieh, Y. Ku
Using problem solving strategies in professional nursing concepts course (PS-PNC) was a newly developed core course in a two-year baccalaureate nursing program in an institute of technology. The purpose of this study was to evaluate the efficacy of problem solving strategies used in this new course to improve students clinical problem solving abilities. Prior to the PS-PNC, 12 faculty who participated in the teaching received complete training, and then continued to receive supervision and to conduct group discussions during the whole period of the PS-PNC implementation. A one- group posttest design with repeated measures was used. In total 49 nursing students from one class agreed to be recruited as the study subjects. The PS-PNC was performed separately in three semesters. After each class learning, students would start their clinical practice, were advised by the same faculty group who participated in the PS-PNC, and were asked to submit three written nursing process recordings during each clinic. Assignments from the three practices were named post-test I, II, and III sequentially, and provided the data for this study. A coding strategy was developed by the investigators. Then, data were collected and analyzed by four selected faculty who had been involved in the PS- PNC. The overall score of problem solving indicated that the three post-tests significantly increased, meaning those students clinical problem solving ability improved. However, data on the sub-concepts of problem solving on nursing assessment, nursing diagnosis, nursing intervention, and nursing evaluation showed no constant improvement. It is inferred that teaching of professional nursing concepts utilizing problem-solving strategies may be useful for future nursing students but dignified control should be strengthened.
在专业护理概念课程中运用问题解决策略(PS-PNC)是一门新开设的理工学院两年制护理学士课程的核心课程。本研究的目的是评估问题解决策略在新课程中对提高学生临床问题解决能力的效果。在PS-PNC实施之前,12名参与教学的教师接受了完整的培训,然后在PS-PNC实施的整个过程中继续接受监督和小组讨论。采用重复测量的单组后测设计。一个班级共49名护生同意被招募为研究对象。PS-PNC分三个学期分别进行。每堂课学习结束后,学生将开始临床实践,由参与PS-PNC的同一教师小组提供建议,并要求在每次临床期间提交三份书面护理过程记录。这三个实践的作业被依次命名为后测试I、II和III,并为本研究提供了数据。研究人员开发了一种编码策略。在此基础上,选取4位参与PS- PNC的教师进行数据收集和分析。问题解决总分显示三次后测均显著提高,说明学生临床问题解决能力有所提高。然而,在护理评估、护理诊断、护理干预和护理评价的问题解决子概念方面的数据没有持续的改善。由此推断,运用问题解决策略的专业护理概念教学可能对未来的护理学生有用,但应加强尊严控制。
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引用次数: 5
期刊
The journal of nursing research : JNR
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