公共衛生護理人員充能教育歷程與介入成效評價研究

Abstract

國立台灣師範大學衛生教育學系博士班博士論文 公共衛生護理人員充能教育歷程與成效評價研究 學生：張麗春 指導教授：劉潔心 摘 要 本研究依據充能認知模式與組織充能等理論，形成員工心理充能認知模式，針對模式中之依變項設計教育課程，了解充能教育介入成效。研究設計係採「準實驗研究設計(Quasi-experimental study)」，根據不對等實驗組與控制組前後測設計方式，立意選取北部兩個衛生局，分派為實驗組與對照組。共計32位實驗組公共衛生護理人員接受四週，共24小時之充能課程與團體工作坊，對照組沒有接受任何實驗處理。於介入後4週進行後測以評價立即成效，並進行充能歷程分析。共計回收61份有效問卷(實驗組=29，對照組=32)。本研究之評量包括形成評量、過程評量及成效評量，以問卷調查、訪談、觀察記錄收集量性及質性之評量資料。研究結果顯示，「充能教育」對於公共衛生護理人員之心理充能與心理充能之自我效能次量表、影響次量表、工作生產力以及創新行為的有顯著成效，對於組織充能與工作滿意度則未能呈現介入效果。合併行動計畫歷程以及工作坊之充能歷程，合併情境脈絡與時間序列，架構本研究充能教育介入之充能歷程圖，學員從面對無力感開始，經過團體對談無力感感受後，學員計畫用更多省思、更投入並以更勇敢的心情回到工作之中，難忘的工作經驗在於與他人關係中看見自己，讓學員計畫更投入，再一次從關係中看見自己成功與失敗並有更多元的行動計畫，計畫更投入工作，與他人分享，並更愛工作，再一次覺醒，藉由覺察專業形象、重塑與行動的對談，學員產生個人的行動包含個人層級(有信心)、組織層級(協助單位、民眾需求、充能運用)以及社區層級(深耕社區)，團體之行動力亦在過程中產生，包含行銷、充能運用以及社區導向。 依據研究結果建議衛生單位應定期舉辨充能教育，以團體運作方式，讓公共衛生護理人員能在團體互動經驗中移除無力感，增進自我效能感受，以提生工作生產力與創新行為，此外，建議衛生局能將公共衛生業務重整，建立合適之溝通管道，以提升組織充能感受。未來相關研究可加入其他充能成效指標，合併多元研究法來呈現更多元之充能教育成效。

關鍵字：公共衛生護理、員工充能、充能歷程、創新行為、工作坊－ Analyzing the empowering process and the effectiveness of empowerment education for public health nurses－

A Doctoral Dissertation By Chang Li-Chun

ABSTRACT The purpose of this study was to analyze the effectiveness of empowerment education based on employee empowerment model that combined cognitive empowerment model and organizational empowerment. A nonequivalent experiment control group design was used in this study. 61 public health nurses from two health bureaus in Northern Taiwan were assigned as experimental group receiving empowerment education consisting of empowerment curriculums and group workshops lasting 4 weeks, twenty-four hours, while the control group received no treatment during the same period. Formation evaluation, process evaluation and outcome evaluation were taken with questionnaire surveys, interviews and observations to collect quantitative and qualitative data. A closed-ended pretest-posttest questionnaire were the instruments used to evaluate the outcome effects and the empowering process. The results in this study showed that the intervention of empowerment education had significant effectiveness on psychological empowerment and subscales of self-efficacy and impact, innovative behavior and work productivity but no effectiveness on organizational empowerment and job satisfaction for public health nurses. The action process drawn from action plan showed the cycle process consisting of individual, organizational and community levels. The empowering process drawn from combination of action plan and the interaction of group workshop showed more engagement in their job and courage to face powerless situation. From the dynamic process of group workshop, public health nurses have the chance to see themselves through building the relationship with others. In the supportive relationships, they have new insight on the successful and failure events of their jobs and then they could have more action plan to apply the concept. Through the process of awareness, they aware of their invisible image in public and take collective action to remodel the new professional image. Moreover, they also take action of individual, organizational and community levels to access organizational empowerment and transfer the actions into the perceptions of psychological empowerment. The results of this study suggested that health department should take empowerment education into in-serving education regularly as to improve employee’s empowerment and work productivity. Besides this, health department should redesign public health tasks and build communication channels to dismiss the vision and information from organization. For present more effectiveness for empowerment, the further should add other empowered indicators and combine other research methods.

Key Words: public health nursing, employee empowerment empowering process, innovative behavior, workshop.