台灣地區中醫醫療機構人員對中醫護理業務的看法

The Views of Traditional Medicine Institutional Workers toward TCM Nursing Practice in Taiwan

本研究目的在了解台灣地區中醫醫療機構人員對中醫護理業務之看法。採問卷調查法，研究對象來自台灣地區中醫醫療機構，以分區分層抽樣方式選取22家中醫醫療機構。回收有效問卷119份，其中中醫師40名，護理人員29名，其他相關人員50名。資料收集乃利用自擬之結構式問卷。問卷經專家效度檢定，並進行預測，得Cronbach's α值為0.95，以SPSS+ 8.0版套裝軟體分析資料。結果如下：（1）多數贊同護理人員可運用中醫望、聞、問的技巧觀察評估病人，運用辨證方法確立病人護理問題及協助各項治療。（2）多數不同意護理人員評估脈象及自行執行拔罐、刮痧、穴位按摩、灸法、耳穴埋豆等技術，而認為應遵照醫囑執行。反對主要理由為能力、經驗和學識不足、不屬於護理業務偶法冷界定之問題。故建議（1）護理人員執行中醫護理業務前需接受中醫相關知識之訓練，尤其需加強診脈及中醫護理技術之練習，以因應實務需求。（2）推拿、指壓、刮痧、拔罐等技術衛生署不列入醫療管理行為，應可納入護理工作項目，且極待與中醫業務相關專家溝通，以取得共識與支持。

The purpose of this study was to explore the scope of Traditional Chinese Medicine (TCM) nursing from the perspectives of staff working in a TCM-related hospital. Stratified random sampling was used in this study. One hundred and nineteen staffs with a mean age of 35 years were recruited from 22 TCM hospitals and hospitals with TCM departments. The results of this study indicated that (1) nurses were expected to apply the knowledge and skills of TCM to assess and provide care for the patients; (2) most participants felt that nurses were not qualified to assess patients' pulse by the TCM method and that nurses needed to be supervised by doctors in order to perform negative pressure, scraping, acupressure, moxibustion, and ear-acupressure because of their lack of related skill, experience, and knowledge, and because these procedures are not within the scope of nursing practice. Recommendations for enhancing the scope of TCM nursing were: (1) nurses needed to receive training related to TCM, especially skills of TCM nursing, before working in TCM hospitals; (2) nurses needed to get support and consensus from doctors of Chinese medicine in order to perform moxibustion, acupressure, scraping, and negative pressure.