急診護理人員於SARS期間的工作壓力與因應行為

Work-related Stress and Coping Behaviors during SARS Outbreak Period among Emergency Nurses in Taiwan

台灣爆發SARS疫情後，導致多位醫護人員感染死亡，使醫護人員壓力劇增，特別是位於第一線的急診護理人員。本研究探討急診護理人員於SARS期間的工作壓力與因應行為，採質性研究法，在南部某醫學中心以立意取樣收案，利用錄音及深度訪談十一位護理人員。結果顯示工作壓力來自兩方面，個人方面的壓力來自：（一）害怕感染後傳給家人。（二）面對職業烙印的無奈。（三）與家人關係改變。（四）隨時準備被隔離後殉職。工作方面的壓力有：（一）著防護裝備的身心壓力（包括：身體的不適、心理的壓力）。（二）發燒站篩檢的困境（包括：防疫單填寫不易、發燒站抱怨連連、擔心漏網的案例、醫療用品不足）。（三）同事間意見分歧。（四）額外工作負荷過重。（五）急診操作流程改變頻繁。在因應行為方面包括：（一）自我的調適。（二）感受家人與同事的支持。（三）增進SARS相關知識。結果除提供臨床護理人員參考外，亦可提供醫院行政人員與護理專業團體制定護理相關政策時之參考。

Since the outbreak of SARS in Taiwan, some health professionals had been infected and died. These incidents significantly increased the stress level among nurses working in the front-line of emergency units. This study explored the work-related stress and coping behaviors of nurses working at an emergency unit in a medical center in southern Taiwan during SARS outbreak period. We conducted an in-depth interview with a purposive sample of eleven emergency nurses. The contents of interview were tape-recorded and transcribed. The findings showed that there were personal and work-related stresses. Personal stress included (1) fear of transmitting SARS to family members, (2) social stigma of the occupation, (3) altering relationship with the families, and (4) preparing to be quarantined and dead possibly. Work-related stress included (1) stress while wearing protective devices (including physical discomfort and psychological stress), (2) dilemmas of fever screen station (including being difficult to fill out the quarantine forms, family’s complaints of fever screen station, worry about missing possible cases, and insufficient medical equipment), (3) conflicts between colleagues, (4) too much overloaded work, and (5) frequent change in operation procedures. Coping behaviors included: (1) self-adaptation, (2) support from the family and colleagues, and (3) increasing knowledge about SARS. Nursing staff and management teams can take these findings into consideration when making relevant medical policies.