傾聽、同理、陪伴技能教案於三個護理課程之成效探討

Exploring the Effectiveness of Listening, Empathy, and Presence (LEP) Skills Teaching Material in three Nursing Courses

背景：安寧護理、靈性護理和質性研究等課程中缺乏傾聽、同理、陪伴等技能的教導，然而傾聽、同理、陪伴的技能可提升護生的專業護理素養，且為質性研究訪談員之重要技能。
目的：本研究目的乃透過安寧療護、靈性護理、和質性研究課程中，融入傾聽、同理、陪伴技能教案，達到提升護生傾聽、同理、陪伴技能的目標，並評值其成效。
方法：本研究採類實驗研究法，於安寧療護、靈性護理、和質性研究課程中，將傾聽、同理、陪伴技能教案進行課堂中實作和體驗，教案共4小時，三階段教授，第一階段為引發學習動機，第二階段教授傾聽、同理、陪伴技能，第三階段實際操作傾聽、同理、陪伴技能。三個班的護生於技能教案前後，進行傾聽、同理、陪伴自覺量表的自評，此量表乃顧、吳、和曾於107-108年間發展，進行二階段的專家效度達.87。本研究為提升教師改進教學專題研究補助計畫(FYU1008-109-04)，執行期限由109年3至10月。
結果：傾聽、同理、陪伴技能教案融入安寧護理、靈性護理和質性研究法等課程後，結果顯示教案專家內容效度達86.3分，透過3X2 Factorial ANOVA分析傾聽、同理、陪伴技能教案前後，於安寧護理(N=50)、靈性護理(N=40)、和質性研究(N=9)三門課程的差異曲線圖，顯示無論大護生或研究所護生，其傾聽、同理、陪伴技能均呈現顯著地進步，然而以靈性護理課程的護生平均分數最高，進步最大，其次為安寧護理的護生，而質性研究課程的碩士班護生的分數最低。
結論／實務應用：安寧護理、靈性護理和質性研究法三個班級護生均表示自己於傾聽、同理、陪伴技能教案後，其反思體會到不一樣的學習歷程，且發現自己缺乏的技能，也願意日後更加精進自己不足的技能，並運用於臨床照護病人的過程中，此乃本研究發現最珍貴之處。

Background: Hospice Nursing, Spiritual Nursing, and Qualitative Research courses often lack teaching on listening, empathy, and presence (LEP) skills, despite their importance in promoting the professional essence of nursing students and their significance as vital skills for qualitative research interviewers.
Purpose: This study aimed to promote LEP skills among nursing students by incorporating LEP teaching materials into the courses of Hospice Nursing, Spiritual Nursing, and Qualitative Research and evaluating its effectiveness.
Method: A quasi-experimental research design was employed, with participants practicing and experiencing the LEP skills teaching materials in the three courses. The teaching materials spanned three stages, totaling four hours. The first stage aimed to induce learning motivation, the second stage focused on teaching LEP skills, and the third stage involved practical application of LEP skills. Before and after the teaching material, nursing students in the three courses self-evaluated their LEP scores. The LEP scale, developed by Ku, Wu, and Tseng in 2018-9, with two stages of expert validity of 0.87, was used.
Results: After incorporating LEP skills teaching materials into the courses, the content validity of the teaching material was found to achieve a score of 86.3. Analyzing the results through 3x2 factorial ANOVA before and after LEP skills teaching material, it was observed that in the three courses of Hospice Nursing (N=50), Spiritual Nursing (N=40), and Qualitative Research (N=9), both bachelor and master nursing students demonstrated significantly improved LEP skills. However, among the bachelor nursing students, those in the Spiritual Nursing course showed the most significant improvement with the highest average score, followed by the Hospice Nursing course, while master nursing students in the Qualitative Research course showed the lowest scores.
Conclusion and Clinical Implication: Nursing students in the three courses of Hospice Nursing, Spiritual Nursing, and Qualitative Research reported experiencing different learning processes for LEP skills and acknowledged their areas of weakness. They expressed willingness to improve these skills for application in the process of providing clinical care to patients, which is a valuable aspect of research findings.