照護行動的立場－－護理倫理課堂之對話

The Positionality of Caring Action: Small Group Dialogue in a Course on Nursing Ethics

背景：護理倫理教育通常著重外在行為規範，較未提及個體的內在體驗與倫理態度的關係。目的：本文目的是由小組教學的對話情境，探究照護行動的內在體驗，找出照護立場的內容，以充實護理倫理教育的內涵。方法　研究者以參與觀察的方式，擔任某次護理倫理課程的主要負責設計與任課教師。以反思分析方法處理的文本資料，包括小組對話紀錄、教師反思團體紀錄、及10位學生的30份心得作業。結果　照護行動立場包含三類項目，分別為：（一）相信的態度，包括選擇相信與深層理解；（二）價值的釐清，包括情感的覺知與立場的覺察；（ 三）自我的陶養，源自自我對話與人我對話。結論／實務應用　「相信的態度」可促進人際間的信任關係；「價值的釐清」使照護經驗獲得整體的意義；「自我的陶養」鍛鍊出倫理的自我。

Background: The content of nursing-ethics education has typically focused on the external standards of caring behavior and neglected the relationship between the ethical attitudes and internal experiences of caregivers. Purpose: To explore the embodied experience in order to define the positionality of caring action, which is necessary to enrich the content of nursing ethics through small-group-learning-based dialogue. Methods: The researcher, as a participant observer, teaches a course on nursing ethics. Reflective analysis was used to analyze the data from the process of small group learning, a reflective group of faculty members, and 30 reflective journals submitted by 10 students. Results: The results identified three items that were related to the positionality of caring action: the attitudes of belief, including the choice to belief and deep understanding; articulating the value system, including exploring affectivity and positionality; and cultivating the self through self-dialogues and dialogues with others. Conclusion: The attitudes of belief promote trust in interpersonal relationships. Articulating the value system deepens the meaning of caring. Cultivating the self may facilitate the ethical self.