情境模擬溝通課程對提升新進護理人員溝通自信心之研究

The Effect of a Scenario-Based Communications Course on Self-Confidence in Novice Nurse Communications

背景：護理人員輪流24小時照護住院病人，必須掌握病人病情相關資訊，並在臨床中扮演著醫師和病人間的橋樑，此需藉著護理人員的敏銳觀察力和運用良好的溝通技巧，來確認及解決病人的問題，由此可見溝通技巧是護理人員於臨床實務中必備的知能。
目的：本研究探討情境模擬溝通課程介入後對新進護理人員溝通自信心之改變。
方法：本研究為類實驗性實驗組與控制組前後測設計，非隨機叢集取樣北市某醫學大學附屬A和B醫院為控制組，C醫院為實驗組，到職未滿一年之護理人員（n = 118）為研究對象，實驗組接受3小時之「情境模擬溝通教學課程」，控制組則接受2小時之「一般課室溝通教學課程」。本研究以「溝通自信心自評表」測量情境模擬溝通課程介入後之成效，研究資料使用SPSS 17.0 Window套裝軟體進行各項統計分析。
結果：控制組與實驗組前後測相依樣本t檢定護理人員的自評平均溝通自信心達統計上顯著不同（p < .001），顯示兩組教學課程之介入，均有助於提昇護理人員溝通自信心。ANCOVA分析發現溝通自信心自評平均分數在實驗組（48.92, SD = 5.04）與控制組（48.18, SD = 5.14）無統計上之顯著差異（p = .14）。
結論：兩組教學課程之介入，均有助於提昇護理人員溝通自信心，但情境模擬溝通課程對護理人員溝通自信心之提昇，並未大於一般課室溝通教學課程。

Background: Nurses are expected to have keen observation skills to monitor inpatient conditions and good communication skills to facilitate doctor–inpatient communications. Communication skills are thus a core attribute required of professional nurses.
Purpose: This study explored the effectiveness of a scenario-based communication course on increasing the self-confidence of novice nurses in communicating with inpatients.
Methods: This study used a quasi-experimental pre-test and post-test study design based on non-random cluster sampling and tests were administered on 118 novice nurses with less than one year of clinical experience at one of three training hospitals in Taipei City. The control group (nurses working at hospitals A and B) received a two-hour standard course in communications; The experimental group (nurses working at hospital C) received a three-hour scenario-based communications course. Data was provided by subjects via a self-rated scale that assessed respondent self-confidence in communicating with inpatients. Statistical analyses were performed using the SPSS statistical software package for Microsoft Windows (version 17.0).
Results: Results of a dependent paired t-test show that average posttest scores for both groups were significantly higher (p < .001) than average pretest scores. This demonstrated that both interventions were effective raising nurse confidence with inpatient communications. An ANCOVA showed no significant difference (p = .14) in average self-rated Confidence in Communication Scale scores between the two groups (experimental: 48.92, SD = 5.04; control: 48.18, SD = 5.14).
Conclusions: Findings suggest the positive effect of both courses in increasing nurse confidence in communicating with inpatients. The scenario-based communications course was no more effective than the ordinary classroom communications course in making nurses more confident in communicating with inpatients.