以行動教學法教導老人靈性護理課程對護生靈性樣態之成效

Action Teaching Methods to Teach the Course of Spiritual Nursing for Elders to Nursing Students

文獻顯示人生回顧和懷舊治療可以促進老人的生命意義與目的，此乃老人靈性護理照護之內容，然而目前老人靈性護理課程中，尚未執行人生回顧和懷舊治療過程之教導。本研究目的乃探索融入人生回顧和懷舊治療之老人靈性護理課程，對提昇護生靈性樣態之成效。研究設計採行動教學法，於老人靈性護理課程中，第一個階段準備期，即由研究者與老人照護2位老師，及3位二技護生建構老人人生回顧和懷舊活動過程。第二個階段執行期，即由研究者於老人靈性護理課程中，使護生實際反思體驗每個單元的意義，此外，小組護生需操作運用第一個階段老人人生回顧和懷舊活動過程。第三個階段評值期以護生的靈性樣態，和分析護生的省思日誌。本研究採方便性樣本，即所有選修99學年度老人靈性護理課程的護生，共54位學生和6位老人，執行期間由2000年11月至2010年6月。四十一位護生參與老人靈性護理課程前後測，其自覺靈性狀況和老人靈性護理照護能力均呈現顯著地進步（p<.001）。分析護生省思日誌內容，發現其可將靈性元素和評估技巧，運用於老人人生回顧和懷舊活動中。本研究透過行動教學法使護生體會其自身重要元素，與老人所啟示之人生經驗，再藉由反思使護生更珍惜自己生命，也使老人完成人生統整和自我實現，即雙贏的靈性高峰狀態。本研究結果可提供教授老人長期照護課程的老師們帶領護生執行老人人生回顧和懷舊活動的流程指引。

Literature indicated life-review and reminiscence therapy could improve life meaning and purpose among elders, which was the content of spiritual nursing care for elders. However, it was still lack of conducting the life-review and reminiscence therapy in the spiritual nursing courses for elders recently. The purpose of this study was to explore the effect of merging life-review and reminiscence therapy into the course of spiritual nursing for elders to improve the spiritual status of nursing students.The study design incorporated the action teaching method into the course of spiritual nursing for elders. The first phase was a preparation period for the researcher and two faculties of the elderly care and three two-years nursing students to construct the process of lifereview and reminiscence activities for elders. The second phase was a conducting period for the researcher to inspire nursing students to reflect and experience the meaning of each unit in the course of spiritual nursing for elders. Additionally, a group of nursing students should conduct the method of action in the first phase of the process of life-review and reminiscence activities for elders. The third phase was an evaluation period for nursing students to self-evaluate spiritualstatus and analyze their reflection journals. The study used convenient samples of all nursing students who elected the course of spiritual nursing for elders during 99 semester with a total of 54 students and 6 elders being recruited and was conducted from November 2010 to June 2011. Fortyone nursing students completed pre- and post-tests in the course of spiritual nursing for the elders and self-perceived that their spiritual status and the abilities in spiritual nursing care for elders have signifi cantly improved (p<.001). Content analysis of refl ection journals from nursing students identifi ed that they have applied the spiritual component and assessment skills into the process of life-review and reminiscence activities for the elders. This study for nursing students helped them to recognize themselves as the important essence and life-experience inspired by the elders through action teaching method. By refl ection, nursing students could cherish their life and the elders could complete life-integrity and self-accomplishment. Therefore, the results can upward to the doublewinning in high spiritual status. The results could provide a protocol for teachers who teach the longterm care course and help them to lead nursing students to conduct life-review and reminiscence activities for the elders.