探討護生最後一哩實習之壓力、因應行為及就業規劃

Stress, Coping, and Career Planning in Nursing Students' Last-Mile Practicum

背景：護理系學生最後一哩實習之壓力、因應及其就業規劃甚為重要，可能影響新畢業生就業率。
目的：探討護生實習壓力、因應行為及對未來就業規劃。
方法：採質量性混合研究設計，招募112學年度完成最後一哩實習之四技護理系學生，自填實習壓力、因應行為量表，以皮爾森積差相關分析壓力與因應行為間之相關性。同意參與訪談者進行一對一半結構式訪談，並運用Colaizzi（1978）理論分析訪談資料。
結果：共有88位研究對象參與本研究，89.8%為女性。最後一哩實習壓力總表平均得分為2.06（標準差0.72），因應行為平均分數以問題導向（3.43）高於情緒導向（2.51），因應行為與壓力總分呈現正相關（p < .001）。12位研究對象的訪談內容分析呈現最後一哩實習之正向感受包括受肯定的成就感、護理角色的認同感及解決問題的自信感；92%受訪者規劃至臨床護理工作。
結論/實務應用：護生實習之正向感受及因應行為宜被視為就業規劃之重要變項，本研究結果可做為未來提升護生畢業後就業率研究之參考。

Background: Stress, coping behaviors, and career planning during nursing students’last-mile clinical practicum may influence the employment outcomes of new nursing graduates.
Purpose: This study aimed to explore stress levels, coping behaviors, and career planning among nursing students during their last-mile clinical practicum.
Methods: A mixed-methods design was employed. Nursing students who completed their last-mile clinical practicum during the 2023 academic year were recruited. Participants completed self-administered questionnaires measuring stress and coping behaviors. Pearson’s correlation coefficient was used to examine the relationship between stress and coping behaviors. In addition, one-on-one semi-structured interviews were conducted with selected participants, and data were analyzed using Colaizzi’s (1978) method to extract key themes.
Results: A total of 88 students participated in the study, with 89.8% identifying as female. The average stress score during the last-mile practicum was 2.06 (SD = 0.72). The average score for problem-focused coping was 3.43, higher than the 2.51 average for emotion-focused coping. A significant positive correlation was found between stress and coping behavior (p < .001). Qualitative analysis of interviews with 12 participants revealed that students reported positive experiences during their practicum, including a sense of achievement, identification with the nursing role, and increased confidence in problem-solving. Additionally, 92% of interviewees expressed plans to pursue a clinical nursing career.
Conclusions/Implications for Practice: The positive emotions and coping strategies experienced during the last-mile practicum should be considered important factors in nursing students’career planning. These findings provide valuable insights for future research and may inform strategies to enhance the employment rate of new nursing graduates.