急性醫療機構護理人員，自覺長期照護能力及其相關因素之探討

Self-Perceived Long-Term Care Competency and Its Related Factors Among Nurses Working in Acute Care Facilities

背景：因應目前長期照護政策之推動，醫院護理人員除需有疾病照護專業知能外，同時亦須具備長期照護相關之護理能力。 目的：探討急性醫療機構護理人員自覺長期照護之護理能力及其相關因素。 方法：採橫斷性研究設計，以配額取樣在南部某醫學中心招募159位個案。研究工具包含人口學變項、長期照護服務現況（知識及服務實務）及長期照護護理能力量表，以t test、卡方檢定、ANOVA及皮爾森相關法分析變項間的相關，以迴歸分析影響長期照護護理能力之重要因子。 結果：本研究樣本平均年齡為30.86歲（± 3.38），現職工作單位以內科居多，教育程度大學占93.1%，臨床工作年資< 5年內占44%，有32.7%具備護理N3層級。整體長期照護護理能力與性別（t = 2.06, p = .041）、該院護理年資（F = 2.49, p = .046）、目前工作滿意程度（r = .28, p < .001）及長期照護服務實務（r = .227, p < .001）達顯著正相關。經由迴歸分析結果顯示對目前工作內容愈滿意則其自覺長期照護能力愈佳，且長期照護服務實務經驗愈豐富其長期照護能力愈佳。 結論／ 實務應用：依研究結果建議應將長期照護相關教育課程定期納入在職教育，增進護理人員對高齡者及失能者照護知能及態度，並持續追蹤已通過培訓的護理人員在長期照護領域之專業角色發展。本研究結果可作為急性醫療機構護理主管規劃護理師參與進階能力制度之參考，以及提供護理人員培訓或機構長期照護相關教育訓練之方向。

Background: In response to the promotion of long-term care policies, nurses in hospitals must not only have professional knowledge related to disease care but also be equipped with care competencies related to long-term care. Purpose: The purpose of this study was to explore the self-perceived competencies of nurses working in acute care facilities with regard to long-term-care and related factors. Methods: A cross-sectional research design with quota sampling was used. The participants were recruited from registered nurses employed at a medical center in southern Taiwan, and data from 159 valid, returned questionnaires were used in the analysis. The research instruments used included the long-term care competency scale and long-term care-related knowledge, and care intention. T test, Chi-square, ANOVA, and Pearson correlation coefficient were used to examine the relationship between the targeted variables and long-term care competency. Regression analysis was used to determine the important determinants of long-term care competency. Results: The average age of the participants was 30.86 years (± 3.38). Most currently worked in the internal medicine department, 93.1% were educated to the university level, 44% had worked for fewer than 5 years, and 32.7% were N3 level nurses. Long-term care competency was found to be significantly and positively correlated with gender (t = 2.06, p = .041), seniority at the facility (F = 2.49, p = .046), job satisfaction (r = .28, p < .001), and long-term care service practices (r = .227, p < .001). After the regression analysis, self-perceived long-term care competency was found to be positively related to job satisfaction and long-term care service practices. Conclusions / Implications for Practice: The results of this study suggest that a long-term care training should be incorporated into the regular in-service education program to improve the knowledge and attitudes of nurses with regard to older and disabled patients and to develop their professional role in long-term care. Furthermore, the results may be referenced by nursing supervisors in acute care facilities when making arrangements for nurses to participation in the Clinical Nursing Ladder Program and when arranging nursing staff training and setting the direction of long-term care-related education and training in healthcare facilities.