專科護理師護理能力及其相關因素之探討

A Study on the Factors Influencing Nursing Competence for Nurse Practitioners

背景：民國94年專科護理師諮詢委員會定位專科護理師的功能與職責，包括病人之直接照顧者、健康教育者、醫療照護之協調者、病人照護品質監測者。依此，專科護理師表現其專業的護理能力於照顧病人的工作上。
目的：本研究探討臨床專科護理師之護理能力及其相關因素。
方法：以中部十家區域性等級以上教學醫院的專科護理師為研究對象，採立意取樣及結構式問卷調查，有效問卷共166份，研究工具為護理能力量表，其信度Cronbach’sα係數為.958。
結果：本研究樣本平均年齡為35.0歲（±4.8），專科護理師年資平均為6.4年（±4.2），大學佔74.7%。護理能力平均得分為3.82分（±.76），六項構面包含照顧、溝通、教學、管理、研究、自我與專業成長能力平均得分依序為4.13分（±.69）、4.13分（±.71）、3.88分（±.72）、3.77分（±.75）、3.23分（±.05）、3.58分（±.84）。教育程度、專科護理師年資、子女數、護理能力進階層級、專科護理師證照在護理能力表現上均呈顯著差異。專科護理師年資、教育程度與護理能力有顯著正相關，且為總護理能力之最佳預測變項，可解釋變異量為17.2%。
結論／實務應用：此量表包含六個專科護理師的護理能力構面，即照顧、溝通、教學、管理、研究、自我與專業成長能力，研究結果作為護理主管規範專科護理師參與進階能力制度之參考，以及提供專科護理師培訓或機構教育訓練之方向。

Background: The functions and responsibilities of the nurse practitioners specified by the advisory board of nurse practitioner in 2005, including the direct care to patients, health educator, coordinator of medical care and quality improvement of patient care. Therefore, the nurse practitioners perform their professional nursing competence on taking care of the patients.
Purpose: This study was designed to investigate the nursing competence of nurse practitioners and its related factors.
Methods: The participants were recruited from ten regional teaching level hospitals and the above level ones in the central part of Taiwan. A purposive sampling and a structured questionnaire were used to collect data. There were 166 nurse practitioners to take part in this study, and the valid recovery questionnaire were also 166 copies. The nursing competence scale is used as a research tool reported a good reliability with Cronbach’s α coefficient of .958.
Results: The mean age of the sample was 35.0 years (± 4.8) and the mean seniority of the nurse practitioners was 6.4 years (± 4.2). Total 74.7% of their education was university degree. The mean score of the nursing competence was 3.82(± .76) and its six dimensions include caring, communication, teaching, management, research, and self-professional development. The mean score for each dimension was 4.13 (± .69), 4.13 (± .71), 3.88 (± .72), 3.77 (± .75), 3.23 (± .05),and 3.58 (± .84), respectively. The factors that significantly influence the nursing competence include education, seniority, numbers of children, clinical nursing improvement level and the nurse practitioners’ license. The seniority and education of the nurse practitioners had significant positive correlation with the nursing competence, and were the best predictors for the comprehensive nursing competence, and this result could account for 17.2% of variance.
Conclusions / Implications for Practice: The six dimensions of this scale could evaluate the nursing competence of the nurse practitioner, including caring, communication, teaching, management, research, and self-professional development. The results of this study could provide the nursing supervisors the reference for regulating the nurse practitioners taking part in the nursing clinical improvement system, and show the nurse practitioners training or the related institutional education the direction.