運用情境模擬訓練，提升產科護理師協助母乳哺餵溝通技巧

Using Scenario-Based Training to Improve the Communication Skills of Obstetric Nurses in Assisting Breastfeeding

本研究旨在運用溝通情境模擬訓練，提升產科病房護理師協助母乳哺餵溝通技巧之成效。本研究採取類實驗設計方式，從2018年12月到2019年12月間，以產科病房護理師36位為對象，由護理長及1位具有母乳支持團體帶領經驗之護理師擔任指導者，以情境模擬訓練為介入措施，比較介入措施前後，產科病房護理師協助母乳哺餵溝通技巧之成效。結果發現，情境模擬訓練護理師協助母乳哺餵之溝通自信心能力，及協助母乳哺餵溝通技巧運用，是有提升的，且具顯著差異。除此之外，初產婦對護理師協助母乳哺餵溝通技巧之滿意度，也有顯著提升。研究結果證實，介入情境模擬訓練後，透過角色扮演讓護理師深入了解產婦的需求與感受，並可觀察到語言及非語言的溝通方式有助於反思，從觀察學習中加上正向的態度，提升護理師協助母乳哺餵之溝通自信心能力，及協助母乳哺餵溝通技巧運用，且提升產婦對於照護之滿意度。未來除了定期舉辦情境模擬訓練，使護理師維持護理師溝通技巧的熟練度，助於提升其滿意度外，未來也可以從產婦的需求中，擬訂臨床教案，讓護理師能夠更同理及理解產婦的感受，提供更正向的鼓勵及支持，促進產婦能更有信心達成母性角色，提升親子關係之連結，另外，也可增進護理師在臨床照護之成就感，提升更專業之照護之品質。

"This study aims to examine the effectiveness of using scenario-based communication training to improve the nurses’communication skills in assisting breastfeeding in the obstetric ward. This study adopted a quasi-experimental design. From December 2018 to December 2019, 36 nurses in the obstetric ward were selected as the subject of the scenario-based communication training. The head nurse and a nurse with experiences in leading breastfeeding peer support groups were the instructors. The effectiveness of the study was measured by comparing nurses’communication skills in assisting breastfeeding before and after the intervention. The results showed that scenario-based communication training does greatly improve both nurses’self-confidence and communication skills in assisting breastfeeding. In addition, the satisfaction of primiparas is significantly improved. The study results confirmed that after the intervention (scenario-based communication training), the nurses can understand the needs and feelings of the parturient through role-playing. Also, they can observe that verbal and non-verbal communication are helpful for their reflection. Through observational learning and positive attitudes, the nurses can enhance their self-confidence and communication skills in assisting breastfeeding. Furthermore, the satisfaction of mothers regarding nursing care rises. In the future, in addition to holding regular scenario-based communication training (which helps nurses to maintain the proficiency of communication skills and thus improves patients’satisfaction and avoids medical disputes), clinical teaching plans can be drawn from the needs of mothers so that the nurses can be more empathic and thus understand the feelings of the parturient and provide positive encouragement and support. In this way, the parturient may show more confidence in their maternal role, which can also help improve their connections with the child. On the other hand, nurses may achieve greater sense of accomplishment in clinical care, which can help cultivate a more professional and qualified medical care."