急診護理人員面對暴力之壓力反應、壓力調適及相關因素之探討

Violent Stressors, Coping Measures, and Related Factors of Nurses in Emergency Department

本研究目的在瞭解急診室護理人員面對暴力時的壓力反應、壓力調適及其相關因素。以某教學醫院之所有急診護理人員為研究對象，採問卷方式調查及方便取樣進行收案，共計65份有效問卷。研究工具包括護理人員基本資料表、護理人員面對暴力之壓力反應及暴力壓力調適量表，以四分法計分。結果顯示：1)基本資料中N1、N2及N3均佔21人(32.3％)為多數；平均年齡26.8歲；平均急診工作年資3年3個月；曾遭暴力攻擊有65人(100％)，其中以語言暴力佔58人(89.2％)居多。2）面對暴力時的壓力反應總平均2.40分，其中以生氣(3.49分)最高。3)面對暴力時的正向壓力調適總平均2.97分，其中以尋求安全人員或警衛協助處理3.57分最高。再者，面對暴力時的負向壓力調適總平均2.41分，其中以藉由菸酒紓解自己3.68分最高。4）護理人員壓力反應與負向壓力調適有顯著負相關(r=-.56, p<.001)；實際急診工作年資與負向壓力調適有顯著正相關 (r=0.27, p<.05)。基於急診護理人員的工作安全考量，期望此研究結果能提高行政單位針對第一線護理人員面對暴力事件的重視、做為護理人員面對暴力相關處理及應對及做為在職教育規劃與警衛人員配置之參考。

The purposes of the study were to understand response to stressors, coping measures, and related factors of violence in emergency department (ED) nurses. The sample for the study consisted of 65 ED nurses in a teaching hospital. The questionnaire used in this study included demographic data, violent stressors, and violent coping measures. The stressors and coping measures were measured on the Likert 4-point scale. The results showed that: 1) the clinical nurses (including CN1, CN2, and CN3) were the majority of the sample (21 in each category). The average age was 26.8 and the average ED working experience was 3 years and 3 months. All of the nurses (100 ) had experienced the violent attack, most of the nurses (89.2 ) had been verbally abused. 2) The total average score of response to violent stressors was 2.40 points, and the highest score was anger (3.49 points). 3) The total average score of positive violent coping measures was 2.97 points, and the item with the highest score was looking for help of the security personnel or security guards (3.57 points). On the other hand, the average of negative violent coping measures was 2.41 points, the item with the highest score was using smoking and drinking to relax (3.68 points). 4) The response to stressors and negative coping measures of violence were significantly and negatively correlated r=- .56, p< .001). In addition, the duration of ED working experience and negative violent coping measures were significantly and positively correlated (r = .27, p< .05). The results of this study provided administrator with the information to emphasize and manage the violence in ED and ensure the safety of nurses working in this department. In addition, the results could serve as a reference for designing in-service training program and arranging security guard manpower in ED.