SARS事件之回顧：臺灣護理臨床實務之探討

A Lookback on the SARS Outbreak: a Qualitative Examination of Taiwanese Nurses' Clinical Practice

本研究以「詮釋性研究」為研究架構，其目的係為深入探討嚴重急性呼吸道症候群（SARS）疾病爆發事件，對台灣護理臨床實務之影響與護理人員之需求。本研究共邀請六位護理照護SARS病患之護理工作人員參與研究。採半結構式、面對面訪談取得資料，將訪談內容謄寫成逐字稿；並以主題分析法作為資料分析與整理依歸。研究結果顯示護理人員照顧SARS病患所面臨的臨床照護問題與經驗共可分為「護理角色與職責的無奈」、「防護設備不足與不確定感」、「知識與照護經驗不足」、「被其他醫療團隊所排擠」及「同事間的支持與團結」。SARS事件後的反思與領悟上分為兩類，「經驗上的學習」與「臨床上的領悟」。護理人員對於SARS事件提出的建議有「感染疾病與控制知識的需求」及「充足設備供給」。本研究結果可作為醫院主管以及護理教育課程的規劃考量與方針，以提高護理人員照顧高度傳染疾病病患的意願，與增進對未知疾病處理之因應技能。

This research was conducted with interpretive research method. The purpose of the study was to investigate impacts and influences of the Taiwanese nurses' clinical practice and identify their needs for responding an infectious disease outbreak, which caused by SARS. Six nurses who had obtained experience of taking care of SARS patients participated in the study. All information was collected through face-to-face, semi-structured interviews with observation. Also, the interview content was video-taped based on participant's consent. Furthermore, all interviews were verbatim transcribed and analyzed, using the thematic analysis method. The principal themes suggested that the nurses' subjective experiences of caring for SARS patients were 'helpless to fulfill nursing role and obligation', 'insufficient in and doubtful of protective equipments', 'inadequafe of knowledge and caring experience', 'pushed out from medical groups' and 'colleagues' support'. Nurses also indicated some reflections and comprehension caused by SARS outbreak, which included 'experienced learning' and 'clinical comprehension'. Finally, the nurses also addressed on 'the demand for the knowledge of infection control' and 'sufficient supply of protective equipments' as their needs and suggestions. Nurses not only experienced the work-related impacts, emotional and social stress while they were taking care of SARS patients, but also were suffered the suspect and misunderstanding of their nursing role by human sociality. Thus, the finding of this research could be a direction or reference for directors of health system and nursing education system to map out an appropriate curriculum so as to achieve nurses' needs and improve their responding skills or willingness of caring for patients with infectious diseases.