護理人員多元文化照護能力初探

An exploratory analysis of nurses' multicultural caring competence

目標：來台外籍人士及聯外婚姻倍增，病人多元文化背景除影響醫療照護服務的需求、期待與就醫行為，護病關係也更形複雜。本研究旨在探討臨床護理人員多元文化照護能力現況及其影響因素，期有助提升護理人員多元文化照護能力，減少健康不均等、降低健康差異。方法：本研究為一橫斷性研究，以「護理人員多元文化能力量表」收集資料，使用驗證性因素分析及逐步迴歸，探討影響護理人員多元文化照護能力的因子。結果：護理人員整體多元文化能力中等，以不同構面的能力來看，文化知識與文化技巧構面能力，則仍有待提升。影響護理人員整體多元文化能力及其四個構面的顯著因子包含：年齡、婚姻狀態、學歷、學校屬性、護理工作資歷、護理專業能力職級、服務單位、照護外籍人士經驗、語言檢定考試、上過多元文化課程，及出國經驗。結論：護理人員多元文化能力有待提升。建議護理人員提升語言溝通能力；醫院提供多元文化照護主題教育訓練；學校教授多元文化照護課程，提升護理人員多元文化照護能力。

Objectives: Many foreigners reside in Taiwan. Patient diversity may affect patients' needs/expectations regarding healthcare, healthy behaviors, and patient outcomes, and jeopardize the relationship between patients and healthcare personnel. The aim of this study was to explore nurses' multicultural caring competence and the factors that influence it. Methods: This was a cross-sectional study which collected data with the 'Nurses' Multicultural Caring Competence Scale' to survey nurses working in a government-owned, regional teaching hospital in central Taiwan. Confirmatory factor analysis and stepwise regression were used to explore the factors associated with overall multicultural caring competence and its four dimensions. Results: Nurses have a middle level of multicultural caring competence, but higher levels of cultural knowledge and cultural skills need to be developed. Significant factors associated with overall multicultural caring competence and its four dimensions included age, marital status, type of school, years worked as a nurse, clinical ladders, work units, experiences in caring for foreigners, language proficiency, exposure to a multicultural curriculum, and overseas experience. Conclusions: Recommendations to promote nurses' multicultural caring competence include improving nurses' language proficiency, offering ready-to-use on-the-job training regarding culturally competent nursing care, and providing a multifaceted cultural nursing curriculum as part of nursing education.