專科護理師執業現況與角色任務期望之探討

The Performance Tasks of Nurse Practitioners - The Actuality and Expectations

本研究為一橫斷式調查研究，探討專科護理師執業現況與角色任務之期望程度，研究對象為北部兩家執行專科護理師制度之醫學中心所屬專科護理師、相關科系專科醫師與臨床護理人員共計356名。將專科護理師執業範圍內容定位之「病人照護、護理專業發展、一般醫療服務及專科醫療服務」四面向共92項工作範圍為研究工具，結果如下：(一)專科護理師執業範圍之自覺執行現況，以病人照護最高(2.82±1.03)，其次是一般醫療服務(2.41±1.25)、護理專業發展(2.01±1.11)與專科醫療服務(1.07±1.00)；專科護理師對其角色任務之期望程度，以病人照護面(3.21±.74)最高，護理專業發展次之(2.93±.82)，一般醫療服務(2.64±.96)與專科醫療服務(1.701±1.14)期望程度最低，各面向之自覺執行程度與角色任務期望程度均呈顯著正相關，僅5項屬侵入性治療之專科醫療服務項目是專科護理師現況執行頻率極少且極不期望之執業範圍且現況與期望間無顯著相關。（二）專科護理師、專科醫師及臨床護理人員三者間對專科護理師角色功能有高度期待，專科醫師期望其能在專科醫療服務上更精進，臨床護理人員則認同其為護理專業角色之拓展，期望專科護理師能兼具病人照護及護理專業發展，專科護理師本身則對病人照護有較高的期望程度，三者間之期望程度在各面向有顯著差異存在，僅侵入性治療項目期望程度低觀點一致。本研究冀藉經瞭解醫療團隊成員對現職專科護理師之執業現況及未來角色任務之期望，凝聚對專科護理師此一新興角色共識，提供政策制訂者制定專科護理師業務範疇之參考。

The purpose of this study was to explore the current status of nurse practitioners'performancein Taiwan. The expectations from medical professionals toward the roles and the tasks of nursepractitioners in medical centers are also examined. This study undertook descriptive and crosssectionaldesign. The sample consisted of 356 medical professionals, including nurses, nursepractitioners, and clinicians from different specialties, at two medical centers located in northernTaiwan. There are four dimensions within nurse practitioners'performances: primary patient care,professional development, general medical service, and specific medical service. The findings ofthis study were as follows: The performance perceived by nurse practitioners included: (1) 'primarypatient care' and 'general medical service' were most frequently performed among fourdimensions and the frequencies of these two performances were between 'usually' and 'seldom'.(2) The expectations toward the role and the task perceived by nurse practitioners themselves:'primary patient care' was the role and the task expected to be performed the most, and followedby 'professional development', 'general medical service' and ' specific medical service'respectively.The comparison among the perceptions from nurses, nurse practitioners, and the cliniciansfrom different specialties toward the four dimensions were shown as follows: (1)The perceptionstoward the performances: nurse practitioners, and the clinicians from different specialties perceivedmore frequently performed in 'primary care' 'professional development' and 'generalmedical service' than the nurses did. There was no difference in the perception of 'specific medicalservice' dimension among three types of professionals. (2)The perceptions toward the expectationsof the role and the tasks: in the 'primary patient care' dimension, there was no significantdifference among three types of professionals. In the 'professional development' dimension, theexpectation of nurses was higher than that of nurse practitioners. In the 'specific medical service'dimension, the expectation of clinicians among different specialties was higher than that of nursepractitioners. The results of this study can provide implications in building up the tasks and rolesregarding nurse practitioners'performances in the future.