精神科護理課程實施服務學習在提升關懷照護行為之成效

The Effects of Service-Learning Programs in Psychiatric Nursing Courses on Improving Humanistic Care

人文關懷被認為是護理人員的專業特質，如何培養護生擁有此特質一直是教學過程中努力的方向。本研究目的在於探討護理科系學生在精神科護理課程中經由服務學習體驗活動的安排，能否有效提升關懷照護行為。以北部某大專院校護理科系學生為研究對象，參與學生人數188人，去除問卷填答不完整者，有效問卷為186份。在精神科護理學專業課程中安排服務學習體驗活動，運用反思及關懷行為量表進行問卷施測，結果發現：學生在「瞭解病患需求」層面的關懷照護行為得分最高，而以「病人權益的維護」層面的關懷照護行為得分最低；五年制護理科學生關懷照護行為高於四年制護理系學生，顯示年齡或學制差異在表現關懷照護行為上是有所不同的；參與服務學習體驗活動學生在關懷照護量表總得分雖高於未參與服務學習體驗活動學生得分，但未達統計上顯著差異，顯示學生參與服務學習體驗活動對於其整體關懷照護能力的強化是沒有顯著影響，但從學生自我反思的結果發現學生對於精神病患的刻板印象改變了，且加強他們面對患者的信心，本研究的結果可用於改善未來精神護理的課程設計。

Humanistic care is an indispensable element of health care professionals; the lack ofability to provide humanistic care does not aid the recovery process of patients in both bodyand soul. This study aims to evaluate the changes of caring behavior by providing a servicelearningprogram in the psychiatric nursing course. Mixed methods were adopted in thisstudy: the Caring Behavior Scale (CBS)was used to measure caring behavior by 4 sub-scores,with self-reflection applied simultaneously to understand their experiences during the program.There were both bachelor and diploma students participating in this study for a total of 186participants. The results of the CBS showed that the sub-score, 'Understanding Patients'Needs', was among the highest, while the lowest was 'Maintaining Patients' Rights'. TheCBS scores of diploma students were significantly higher than that of bachelor students,suggesting age differences may play a role in influencing caring behavior. The students whoparticipated in the program showed higher CBS scores than the students who did not attendthe program. However, the student t test (p>.05) confirmed that the service-learning program did not improve caring behavior significantly. Findings of self-reflection consisted of twomajor themes: reflecting on their own stereotypes of patients with mental disorders andstrengthening their confidence during encounters with such patients. The findings of thisstudy can be used to improve the design of the psychiatric nursing course in the future.