好的護理－－護理人員的觀點

Good Nursing from the Perspective of Nurses

本研究的目的在以深度訪談法了解護理人員觀點的「好的護理」。以平衡性分層取樣法（balanced stratified sampling）取得分佈台灣南北地區18家醫學中心和區域醫院的83位護理人員為研究對象。訪談員為15位於進修碩士學位課程時受過質性研究法訓練的護理從業人員，於2002年1月至5月進行資料收集，訪談過程全程錄音並寫成敘事體逐字稿。訪談資料經內容分析法分析後，發現受訪者所描述之「好的護理」行為內涵可歸納為「良好專業的決策與執行能力」、「熟巧的技能」、「良好的病護關係」、和「成熟的自我」四大主題。本研究發現「好的護理」之意涵在照護品質上可表現出「護理如專業」之審慎和「護理如藝術」之人際創意。惟，在專業層面上，實證研究之概念需加強；藝術層面上，自我成熟宜由外求轉為內化。本研究之發現及討論對建構護理教育和臨床護理工作的意義相當重要，建議繼續針對「好的護理」的相關議題做進一步的探討。

This qualitative study used an in-depth interview method to explore nurses' perspectives on good nursing practices. A balanced stratified sampling approach was employed to recruit 83 nurses from 18 hospitals that were relatively evenly distributed around Taiwan. Fifteen nurses educated to the masters' level and well trained in the in-depth interview approach collected research data from January through May 2002. Interviews were audiotaped and transcribed in verbatim narratives. Content analysis was used to identify good nursing practices common across narratives. Four good nursing practice categories emerged inductively. These included (1) good decision making and execution, (2) dexterous professional skills, (3) good patient-nurse relationships, and (4) a mature self. Findings present quality nursing care as a relationship that combines professionalism and humanism. In order to provide better care, a nurse must incorporate knowledge from empirical research into his or her practice and internalize his or her value as a nurse. A discussion of the process of self-maturation acquisition and reflective learning offers new insights to guide the construction of nursing education curricula and activities for clinical nursing practice. Further research in good nursing is suggested.