現實治療團體諮商對急重症護理人員之壓力反應與因應策略之影響

Reality Therapy Groups: It’s Effect on the Stress Reactions and Coping Strategies of Female Nurses in the Critical Care Units

本研究旨在探討現實治療團體諮商對急重症護理人員之壓力反應與因應策略之影響。研究場域為中 部某區域教學醫院，採單組前後測設計，用「工作壓力量表」篩選出七名高工作壓力之急重症護理 人員，對其進行為期八週、每週一次及每次兩小時之現實治療團體。團體開始前對這七名研究對象 進行「壓力反應量表」和「因應策略量表」前測。團體結束後，再對其實施「壓力反應量表」和「因 應策略量表」後測。將這兩份量表所得分數輸入統計軟體SPSS for Windows 12.0處理’進行無母數 魏克遜配對組符號等級考驗。此外，團體結束後行焦點團體訪談法，蒐集研究對象參與本研究之經 驗，協助探討現實治療團體對其工作壓力之影響。本研究發現有：（1)現實治療團體對急重症護理 人員之壓力反應和因應策略有正向諮商效果；以及（2)透過訪談分析出「共融關係」、「樂趣成長」、 「整體行為」和「評量性問句」等四個主題，可作為輔助支持現實治療團體對研究對象之影響。综合 研究結果，研究者提出對現實治療團體帶領者、護理行政主管與未來研究之建議，作為未來實務或 研究之參考。

The study was designed to examine how Reality Therapy affected the stress of the ER/ICU nurses in critical care units， and to develop suitable medical treatments in accordance with the research findings. Applying the one-group pretest-posttest design， seven participants who matched the criteria were selected from a regional teaching hospital located at the central region of Taiwan. Participants received Reality Therapy two hours a week for eight weeks. Quantitative data were collected by using the Working Pressures Sheet and the Stress reactions Sheet in the pre-test and the Coping Methods Sheet and the Stress reactions Sheet in the post-test. We conducted wilcoxon matched-pairs signed-rank test to explore parts of research findings. Also， using the Focus Group approachwas used to collect qualitative data on the perceptions of participation in the academic research， which helps to demonstrate the effectiveness of the Reality Therapy in reducing participants’ occupational stress. The results showed that the Reality Therapy had positive effect either to stress of the ER/ICU nurses in critical care units or the corresponding strategies. Furthermore， four pillars of the consultative subjects which include love and belonging， fun， total behavior and self-evaluation may be serve as valuable auxiliaries when putting the Reality Therapy into practice. Recommendations based on the results were addressed for future research.