探討復原力介入對護生臨床實習調適之成效

The Effects of Resilience Intervention on the Adaptation of Nursing Students in Clinical Practice

目的：本研究採復原力介入，探討對護生臨床實習壓力、實習焦慮與復原力之成效。方法：本研究為類實驗性研究設計，採方便取樣，收案對象為南部某區域醫院一般病房臨床實務實習的50位五專護理科護生，透過非隨機抽樣分配護生實驗組（24位）及對照組（26位）。實驗組接受每週一次20~30分鐘、為期四週的復原力介入策略教學，對照組採傳統實習教學，未提供復原力介入，並於介入前後進行「實習壓力量表」、「臨床護理實習焦慮情境量表」、「青少年復原力量表」測量。使用描述性統計、Mann-Whitney U test及Wilcoxon Signed Ranked test等進行資料分析。結果：實驗組及對照組於實習結束後實習壓力、實習焦慮皆有顯著改善；實驗組在青少年復原力總分顯著增加大於對照組（p = .003），尤其是「問題解決與認知成熟」（p = .001）、「希望與樂觀」（p = .027）兩構面，而對照組無顯著差異。結論：復原力介入策略能改善護生實習的壓力及焦慮，並提升青少年復原力。期望本研究結果可供護理教育之參考，透過臨床實習之外的指導計畫來鼓勵護生的專業支持，增加未來職場留任率。

Objective: This study uses resilience intervention to explore the impact of clinical internship stress, internship anxiety, and resilience on nursing students. Methods: This study is a quasi-experimental study with convenience sampling. The case subjects were 50 nursing students at a 5-year junior college who were doing clinical practice in the general ward of a regional hospital in southern Taiwan. The nursing students were assigned to an experimental group（24 students）and a control group（26 students）through nonprobability sampling. The experimental group received 20-30 minutes of resilience intervention once a week for four weeks, while the control group received traditional practice teaching and did not receive resilience intervention. Four weeks before and after the intervention, both groups completed pretests and posttests for the“Clinical Practice Stress Scale,”“Inventory of Anxiety Situations in Clinical Nursing Practicum,”and“Inventory of Adolescent Resilience”. Statistical methods comprised descriptive statistics, the Mann-Whitney U test, the Wilcoxon signed-rank test was used to analyze the data. Results: After the clinical practice, the total score of practice stress and anxiety in the experimental group and the control group was significantly improvement. Moreover, the experimental group's total score of adolescent resilience increased, and the score of increased reached a significant difference between the experimental group and the control group（p = .003）, especially the ''problem-solving and cognitive maturity''（p = .001）and ''hope and optimism''（p = .027）in the two dimensions, while there was non-significantly difference in the control group. Conclusion: Resilience intervention can improve the stress and anxiety of nursing students and enhance the resilience of adolescents. This study's results can provide a reference for nursing education and encourage professional support of nursing students through mentoring programs other than clinical internships to increase future career retention.