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下列為98-1論文統計/寫作之諮詢問答整理,僅作為參考使用。點選下方關鍵句可直接跳至該筆問答記錄喔 ^^

統計方面

寫作方面

Two-way ANOVA的基本觀念


問:我的研究具有兩個自變項都是屬於類別變項,而單一個依變項是屬於連續變項,請問我這樣的資料型態適合跑Two-way ANOVA嗎?在什麼情況之下才能夠跑Two-way ANOVA?
 
答:您的研究適合跑Two-way ANOVA。在Two-way ANOVA中,會有兩個自變項,也就是一次可以操弄兩個自變項,進而探討它們對依變項的影響。使用Two-way不但可以檢驗每一個自變項的主要效果,也可進一步的檢驗自變項對依變項的交互作用效果。如果交互作用項顯著的話,代表他們之間具有交互作用,此時我們就需要做單純主要效果比較,如果單純主要效果的比較也顯著的話要繼續的做單純主要效果的事後比較。反之,當交互作用項不顯著時,就要做主要效果比較(ANOVA、獨立樣本t檢定)如果顯著的話,就需要做事後比較。

統計TA 吳昇祐整理/ 回頁首


單因子變異量分析的基本觀念

問:我的研究對象是高中生,欲瞭解不同年級的學生對教師的教學滿意度的影響,需要用什麼樣的方式來跑統計?為什麼要這樣跑?
 
答:根據妳的研究,年級具有三個水準(高一、高二、高三)而教學滿意度您是採用李克特五點量表,因此妳的自變數是屬於類別變項,而依變數是屬於連續變項,因此妳可以採用單因子變異數分析(one-way ANOVA)來做。這個分析方法目的在於檢驗三個或三個以上獨立樣本觀察值之間的各組平均數彼此間是否相等。假如你的研究是性別對教學滿意度的話,則自變項只有男、女兩類,此時所要進行的就是兩組平均數的顯著考驗,這時候妳就需要用到t檢定。(隨後操作ANOVA給學生看),ANOVA table如果他的F值顯著,則我們就需要進一步的看事後比較,根據Kleinbaum at al.,所提出的多重比較方法中,對於事後比較方法,建議採用Tukey與Scheffe兩種方法。

統計TA 吳昇祐整理/ 回頁首

 

變異數分析與迴歸分析的差異

問:我的自變項是研究對象的個人背景變項,依變項是個人的幸福感。其中有一個背景變項是屬於四分類的類別變項,而依變項是連續變項,我想要瞭解自、依變項間的關係程度,請問根據我這樣的研究架構應該要把自變項換為虛擬變項來跑廻歸分析比較好?或者使用變異數分析的方法來跑?這兩種有什麼區別?

答:變異數分析是探討因子對依變數是否有影響的統計方法,但是變異數分析有些不足,那就是變異數僅能分析自變數與依變數有無關係而不能分析兩者之間的關係程度。廻歸分析是在探討連續變數對連續變項的影響。您需要透過相關理論建立依變項對自變項的函數模型,進而利用您所獲取的資料去評估模型中的參數並做預測,廻歸分析的意義是用來分析自變數與依變數間的數量關係,以瞭解當自變數為某一水準或數量時,依變數反應的數量或水準。
 
統計TA 吳昇祐整理/ 回頁首


典型相關與多元相關的基本概念

問:我的問卷包涵倆份量表,解釋變項總共有4個層面,預測變項有3個層面。像我這樣的資料型態,具有4個層面的自變項以及3個層面的依變項適合用典型相關來做分析嗎?有些人建議我可以跑典型相關,但典型相關與多元相關有什麼差別?在SPSS上要怎麼跑?要如何解讀報表呢?

答:您的資料適合用典型相關來做分析。如果您的資料有N個自變項,但是只有一個依變項。則探討這些自變項與依變項間的關係用多元相關來做分析會比較合適。但目前您的資料具有4個層面的自變項,同時具有3個層面的依變項,因此探討這些自變項與依變項之間的關係用典型相關最為合適。事實上,多元相關只是典型相關的一個特例,此因為它是最典型的,所以學者以典型相關來做命名。然而在SPSS底下跑典型相關需要輸入語法。

 
統計TA 吳昇祐整理/ 回頁首


預試問卷的分析方式

問:我已經回收60份的預試問卷,接下來我要該怎麼做預試問卷的分析?要如何驗證本份問卷的信、效度呢?

答:因為您是自編量表所以您需要做項目分析與試題分析來作為題項篩選的依據,進而建構出品質良好的問卷。項目分析主要是根據量表題項中的每一個題目為對象,逐題分析其可用程度。信度與效度是測驗的兩項重要特徵,這兩項特徵須視題項品質優劣而定,而題項品質可透過項目分析來提昇。項目可以大致上可以分為倆部份,決斷值比較與同質性檢驗,決斷值比較是t檢定的結果;而同質性檢驗則可分為倆各部份來做分析。第一部份,pearson積差相關分析,檢驗「題目與總分的相關」;第二部份,信度分析中勾選「刪除項目之量尺摘要」,可看出「校正題目與總分相關」,是再看除了該題之外與其他題項總分的相關。與「題項刪除後的α係數」:是在看刪除了該題項之後總量表的Cronbach’s Alpha值是否有降低,如果Alpha值提昇代表該題項與總量表的內部一致性不高,建議刪除該題項。至於您剛才說到的信度效度分析。信度是指多次測量結果的一致性;而效度則是測驗分數的正確性。效度又可以分為內容效度、校標關聯效度與建構效度三種。而探索式因素分析(EFA)就是為了使量表具有建構效度,所以做完項目分析之後我們需要進一步的做因素分析。經過EFA的結果我們在進一步的做各向度與總量表的信度分析,此時我們的預試就已到一個階段。

 
統計TA 吳昇祐整理/ 回頁首


使用Excel進行高階統計分析
問:如果沒有SPSS統計分析軟體時,可否使用Excel進行高階統計分析?

答: 可以的,Excel本身即具有強大的統計運算功能,尤其是安裝「資料分析工具箱」後,絕大部份的統計檢定幾乎都可以達成,甚至還能進行簡易的模擬研究。以下以Excel 2007版本為例,示範如何安裝Excel資料分析工具箱。

一、 步驟一:點選「增益集」,然後叫出「自訂快速存取工具列」。



二、  步驟二:選擇分析工具箱後點選「執行」。


三、  勾選對話視窗中的「分析工具箱」後按「確定」。

四、  安裝時需置入Office光碟片,然後點按「是」。

五、  成功安裝後即可使用資料分析工具箱功能。

統計TA 施俊名整理/ 回頁首


進行分析時,應如何決定統計方法?
問:進行分析時,應如何決定統計方法?

答:要採用何種統計方法要看所問問題以及所使用的自變數、依變數性質而定。大體來說,問題的性質可區分為描述性問題、相關與因果性問題以及差異性問題三大類。以下僅針對後兩者問題舉例說明如下:
層次
說明
問題類型相關性問題
問題描述「大學生每週花多少小時打工」與「每週花多少小時閱讀課外讀物」之關聯性為何?
問題的自變項及變項性質每週平均花多少小時從事打工?(屬連續變項)
問題的依變項及變項性質每週平均花多少小時從事閱讀課外讀物?(屬連續變項)
適用的統計方法皮爾森積差相關係數(僅能探討關聯程度)
問題類型相關性問題
問題描述使用大學生「每週平均上網總時數」來預測其「近視度數」?
問題的自變項及變項性質每週平均上網總時數(屬連續變項)
問題的依變項及變項性質近數度數(屬連續變項)
適用的統計方法直線迴歸分析(可探討因果關係及程度)
問題類型相關性問題
問題描述使用大學生「每週平均上網總時數」來預測其「社交程度強或弱」?
問題的自變項及變項性質每週平均上網總時數(屬連續變項)
問題的依變項及變項性質社交程度強或弱(屬類別變項)
適用的統計方法羅吉斯迴歸分析
問題類型差異性問題
問題描述不同「性別」(男、女兩類)的大學生,其「大學指定科目考試英文分數」有無顯著差別?
問題的自變項及變項性質不同性別的大學生(屬類別變項,二組)
問題的依變項及變項性質大學指定科目考試英文分數(屬連續變項)
適用的統計方法獨立樣本t考驗
問題類型差異性問題
問題描述大學生「期中考成績」與「期末考試成績」有無顯著差異?
問題的自變項及變項性質
問題的依變項及變項性質期中考與期末考成績(屬連續變項)
適用的統計方法相依樣本t考驗
問題類型差異性問題
問題描述不同「學院」(文學院、管學院、理學院以及醫學院四類)的大學生,其「大學指定科目考試英文分數」有無顯著差別?
問題的自變項及變項性質不同學院大學生(屬類別變項,三組以上)
問題的依變項及變項性質大學指定科目考試英文分數(屬連續變項)
適用的統計方法獨立樣本單因子變異數分析
問題類型差異性問題
問題描述「與父母親密與否」和「對人生為正面或負面看法」之人數比例有無顯著差別?
問題的自變項及變項性質與父母親密與否(屬類別變項)
問題的依變項及變項性質對人生為正面或負面看法(屬類別變項)
用的統計方法卡方考驗
統計TA 施俊名整理/ 回頁首


如果沒有SPSS統計軟體時,有甚麼辦法可以計算獨立樣本t考驗?

問:如果沒有SPSS統計軟體時,有甚麼辦法可以計算獨立樣本t考驗?

答:網路上有許多免費的統計計算網頁,只要您用心蒐尋,應該可以滿載而歸。其中,Usable Statistics就是相當方便的統計教學網頁,其網址為:http://www.usablestats.com/index.php。俟連結後點選2 Sample t-test,即可線上計算獨立樣本t考驗。
        為說明使用方式,以下以一範例說明:假設政府8個經濟研究單位與8位市場分析師分別預測明年的經濟成長率(%),所得結果如下:經濟研究單位(5.6, 5.8, 5.2, 5.0, 4.8, 5.3, 4.7, 5.1)、市場分析師(4.2, 3.9, 4.7, 3.6, 4.4, 4.0, 4.5, 3.7)。若經濟成長率為常態分配,試以 α=.05的顯著水準,檢定經濟研究單位所提供預測值是否顯著不同於市場分析師所提供的結果?
        首先,您必須將上述兩組資料以手動方式輸入至左邊對話視窗當中。其次,將資料傳送(Submit)後即可輸出結果。由於本例兩組變異數差異不大,可視為符合變異數同質性(Equal Variances)之假定,因此t檢定值為5.5379,在雙側考驗下,兩組平均數的差異達.05顯著水準,顯示經濟研究單位所提供預測值顯著不同於市場分析師所提供的結果。

至於其他統計方法尚可參考以下網頁學習:
1. 相關係數與迴歸線模擬程式 (http://www.stat.berkeley.edu/~stark/SticiGui/Text/ch4.htm) (http://www.stat.berkeley.edu/~stark/SticiGui/Text/ch5.htm
2. 常態Z值與p值變化模擬程式(http://www.stat.berkeley.edu/~stark/SticiGui/Text/ch15.htm
3. 信賴區間模擬程式 (http://www.stat.berkeley.edu/~stark/SticiGui/Text/ch18.htm
4. 卡方檢定模擬程式 (http://www.stat.berkeley.edu/~stark/SticiGui/Text/ch23.htm
5. Statistics Tools for Internet and Classroom Instruction with a Graphical User Interface (http://www.stat.berkeley.edu/~stark/SticiGui/index.htm)(有許多好用模擬程式) 
6. Exploratory software for confidence intervals (http://www.latrobe.edu.au/psy/esci/index.html)(有許多好用模擬程式)
統計TA 施俊名整理/ 回頁首


如何將Excel數據檔轉存為SPSS資料檔?

問:如何將Excel數據檔轉存為SPSS資料檔?

步驟一:點選「檔案」→「資料」。


步驟二:開啟Excel檔案,惟需留意檔案類型需先選擇Excel格式才可以看見。
步驟三:如果Excel的第一列存有變數名稱,則勾選「從資料第一列開始讀取變數名稱」;若第一列即是數據時,則應取消此預設選項。
統計TA 施俊名整理/ 回頁首


為何換了電腦後即無法開啟已存檔的SPSS輸出檔?

問:為何換了電腦後即無法開啟已存檔的SPSS輸出檔?

答:會造成此現象有可能是使用不同版本的SPSS所致。當使用SPSS 15.0以前版本進行分析時,所產生的結果檔副檔名為(*.spo),但若改以SPSS 16.0以後版本開啟時,就會發生無法開啟的問題,主要原因在於新的SPSS版本輸出檔的副檔名已修改為(*.spv)格式。要解決這個問題,需至SPSS台灣代理宏德資訊網站下載相對應的修正程式,網址為:(http://www.sinter.com.tw/spss_new/download_support/patch_plugin.htm)。
統計TA 施俊名整理/ 回頁首


如何計算效果量(Effect Size)?

問:如何計算效果量(Effect Size)?

答:近年來,在美國心理學會(APA)大力呼籲下,學術界已逐漸形成一個新的趨勢,亦即學術報告除交代檢定結果是否達顯著外,尚需呈現效果量(Effect Size)的大小,以判斷實驗結果實際顯著性(Practical significance)之程度。其中,尤以Cohen於1988年所提出的d係數,計算最為簡便、應用最廣。計算時只要輸入用以檢定時的平均數及標準差即可。以下提供一個簡易計算效果量的網站(http://www.uccs.edu/~faculty/lbecker/),提供同學們參考。假設您用以進行獨立樣本t考驗所使用的兩組平均數分別為115與105,標準差均為15時,則計算Cohen’s d係數將等於0.67。



根據Cohen的標準,若其值小於0.2表示實際顯著性為低,介於0.2至0.5表 示實際顯著性為低至中等,而0.5至0.8表示實際顯著性為中至高等,高於0.8表示具有相當大的實際顯著性。以本例來說,兩組平均數間差距僅屬中度效果量。

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為何無法順利安裝Amos 16版?

問:為何無法順利安裝Amos 16版?

答:在安裝Amos 16版時,常會看到以下畫面:


點選「OK」後,即會出現安裝精靈已經成功安裝。事實上,開啟程式集後會發現遍尋不著任何Amos相關程式。會造成此問題的主要原因在於Amos 16以後的版本需搭配Microsoft.Net Framework 2.0以上的版本,如果您的電腦長期未做過系統更新,很容易就會發生上述的現象。



解決方式為開啟Amos原版光碟目錄,然後安裝Microsoft. Net Framework 2.0後,再重新安裝Amos。若手邊沒有Microsoft.Net Framework 2.0這個程式,也可以逕自到微軟公司網站下載,網址如下:http://www.microsoft.com/downloads/details.aspx?displaylang=zh-tw&FamilyID=ab99342f-5d1a-413d-8319-81da479ab0d7


統計TA 施俊名整理/ 回頁首


應如何考驗量表的信度?
問:應如何考驗量表的信度?

答:茲以SPSS軟體為例,說明信度分析的步驟如下:

一. 從選單中點選【
分析】(Analyze),再點選【尺度】(Scale),最後點選【信度分析】(Reliability Analysis)。 
二. 將所有編造量表的個別題目(例如:生活滿意度lifsat 1~lifsat 5)拉入右邊項目中。 
三. 確定在模式(Model)欄位中,是選擇【
Alpha】。 
四. 按下【
統計量】(Statistics)的按鈕,在「敘述統計量」裡,勾選【項目】(Item)、【尺度】(Scale),以及【刪除項目後之量尺摘要】(Scale)。 
五. 最後點選【
繼續】(continue)及【確定】即可。






報表輸出結果
     
 



由上述結果顯示,生活滿意度5個題目整體信度值為.890,若刪除第五題後,則其餘四題的信度值將為.896,顯示第五題的刪除將有助於量表的信度提升,因此在題目數足夠的情況下,或可考慮將此題刪除。

統計TA 施俊名整理/ 回頁首


如何使用迴歸分析進行交互作用項的檢定?

問:如何使用迴歸分析進行交互作用項的檢定?

答: 進行交互作用項檢定除使用二因子變異數分析外,也可以使用迴歸分析的方法進行。以下圖為例,除分別探討兩個預測變數對依變數的預測效果外,還加入兩個預測變數交互作用項對依變數的預測效果。


        與一般迴歸分析不同的是,要跑交互作用項要先利用SPSS的「計算」(Compute)功能產生一個交互作用項的得分,然後再與其他預測變數一起投入進行迴歸分析。舉例來說,如果您想探討「年齡 性別」交互作用項對依變項(數學成就)的影響時,要先將年齡這一變數欄位原始連續數據乘上性別資料(以1與0編碼)後產生一個新的變項,此即稱為交互作用項。需要注意的是,構成交互作用項的變數通常一個是連續資料,而另一個是類別資料,以作為調節之用。因此,產生交互作用項資料前,就必須先將類別資料轉換成虛擬變數(Dummy variable)。以性別來說,編碼為1與0即為虛擬變數,但變數若超過兩類者,則產生的虛擬變數將不只一個,使得產生的交互作用項可能會有數個。
統計TA 施俊名整理/ 回頁首


進行SEM分析時通常需先檢定模式是否有違犯估計的問題。在實際判讀報表時有些研究者用Variances報表中的S.E.數值,有些人用非標準化中誤差變異數,此處所指的負的誤差變異數是指何者?

問:進行SEM分析時通常需先檢定模式是否有違犯估計的問題。其中,Hair, Anderson, Tatham與Black(1995)提出違犯估計的項目包括:(1)負的誤差變異數存在。(2)標準化迴歸係數超過或太接近1(以.95為門檻)。然而,在實際判讀報表時有些研究者用Variances報表中的S.E.數值,有些人用非標準化中誤差變異數,此處所指的負的誤差變異數是指何者?

答: 此處所指的是觀察指標誤差項變異數的估計值。以Amos非標準化解模式圖來說,誤差項所呈現的數值是指「變異數」。因為每個人在觀察指標上的得分(X)本來就不同,在扣除潛在變數所共同解釋的得分(T, True score)之後,剩下的誤差分數(E, Error score)自然也會不同。既然每個人的誤差分數都不同,就可以求得一個變異數,來表示此誤差分數的分散大小,這就是誤差項的變異數。由於誤差項的變異數只是抽樣後所得的結果,不代表母群的現況也是如此,因此,我們需要經過統計檢定,來探求此變異數估計值明顯不同於0,即不是隨機所產生的誤差。當用到檢定時,就必須要先求「標準誤」(S.E.)。以平均數差異檢定為例,我們會先去看兩樣本平均數(x1-x2)的差距是其標準誤(S.E.)的幾倍。若兩母群的u1與u2相等,理論上(u1-u2)會相當接近於0,那麼從母體抽樣所得的樣本平均數差距(x1-x2)也應該相當接近0才是,而將0除以S.E.當然也會等於0。但假設將(x1-x2)除以S.E.的結果明顯不等於0,而是大於1.96或-1.96時,此時我們就沒有理由相信母群的u1與u2是相等的,因為兩者如果相等,應該不會產生樣本平均數差距(x1-x2)如此大的結果。同理,誤差項變異數估計值也是抽樣所得的結果,真正要推論的母體誤差變異數不見得等於0,要經過檢定程序才能知道。其作法是將估計值除以標準誤(S.E.),所得結果類似t檢定,一般只要大於2我們就會宣稱該誤差項變異數顯著不等於0。所以有學者宣稱不能有「負的誤差變異數」所指的就是誤差項的變異數估計值(estimate),而不是指用來檢定是否為0的標準誤(S.E.)。
統計TA 施俊名整理/ 回頁首


何謂研究動機?

問:何謂研究動機?我的指導教授認為我論文的研究動機很像結論,應如何撰寫?

答: 所謂「研究動機」,主要針對所要探討的問題加以陳述,並提及此問題的重要性,也就是針對所訂定的研究問題做說明,說明其背景、出發動機,及為何要做這項論文題目。例如:是什樣的觸機或原因想要研究此議題?在你的論文中欲展現哪些內容,或是處理哪些問題、達成哪些目標?而較為常見的研究動機包含了欲探索問題的真相、想澄清過去研究的不足。
寫作TA 鐘文伶整理/ 回頁首


第一章緒論包含哪些章節?

問:請問第一章緒論包含哪些章節(文史哲類別學位論文)?

答:第一章大致包含了研究動機及目的、研究範圍、重要名詞解釋、研究方法步驟及論文架構。
寫作TA 鐘文伶整理/ 回頁首


為何要撰寫研究方法?

問:為何要撰寫研究方法?

答:不同的研究方法會影響其研究成果,針對問題選擇適當的研究方法,進行文獻資料的處理分析,並說明其步驟程序和研究架構。
寫作TA 鐘文伶整理/ 回頁首


如何撰寫文獻探討?

問:如何撰寫文獻探討,有哪些注意事項?

答:針對目前學術界己有的研究文獻做探討, 一般是先將基本或已有的文獻、理論做有系統的介紹,然後才探討有關的研究。文獻探討切忌流於資料的累積,較好的做法是引用與本研究有直接關係的文獻,不能為了湊篇幅,而堆積一些無用的資料。假如無法找到直接的文獻資料或理論依據,則須間接從相關研究來討論。
寫作TA 鐘文伶整理/ 回頁首


如何得知此論文題目有沒有研究過?或是有相關的學位論文?

問:如何得知此論文題目有沒有研究過?或是有相關的學位論文?

答: 撰寫論文前的準備工作是十分重要的,應先蒐集相關文獻,如學位論文、學術期刊.會議論文…等,可到國家圖書館的碩博士論文網搜尋,大陸方面的學位可到中國期刊網上,另外,以中文類門來說,《漢學通訊研究》會公佈各校學人(教授或研究生)正在撰寫之論文題目或研究主題。

寫作TA 鐘文伶整理/ 回頁首


從哪些地方檢索哪些相關資料?

問:除了紙本之外,還能從哪些地方檢索哪些相關資料?

答:同學除了可到國家圖書館的中華民國期刊網、碩博士論文網(部分論文有全文下載),檢索相關篇目或下載外,也使用學校圖書館的各項電子資料庫,及學校所購買的電子期刊,如:中國全文數據網,還有可到各大專校的圖書館網頁下載學位論文,如師範院校論文聯合系統、政大圖書館…等。
寫作TA 鐘文伶整理/ 回頁首


要如何投稿學報?從哪可以獲知這些徵稿訊息?

問:請問要如何投稿學報?從哪可以獲知這些徵稿訊息?

答:很多學校的網頁上都會放置各項徵稿訊息,除了有研討會的,亦有其他各校期刊學報的徵稿函。有時會放在教務處的網頁,或放置在首頁、教發中心的網頁上。另外,以文史哲類別來說,可訂閱電子版《漢學研究通訊》,裡面會有所記錄。
寫作TA 鐘文伶整理/ 回頁首


關於學術期刊投稿的徵稿格式及注意事項

問:關於學術期刊投稿的徵稿格式及注意事項

答:關於期刊論文的徵稿格式,國內各個期刊大多在稿約的部分,對於其格式及字數都有詳細規定。ㄧ般而言,以文史哲類別來說,大都以《漢學研究》的稿約為基準,亦有一些學報則以美國心理學學會(簡稱APA)制定的出版手冊為準,因此投稿前建議先參考ㄧ下各期刊的稿約說明。
寫作TA 鐘文伶整理/ 回頁首

何謂「關鍵字」?

問:何謂「關鍵字」?

答: 一般而言,論文的「關鍵字」常見的是以5組為單位,而以4-7組關鍵字為原則,「關鍵字」不僅方便他人搜尋、檢索論文資料,也是寫論文時有效的收集資料的方法之ㄧ,所以要善用「關鍵字」。
寫作TA 鐘文伶整理/ 回頁首

 

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SCI Science Citation Index

美國科學資訊研究所 Institute for Scientific Information, ISI

SCI是美國科學資訊研究所所發表之著名引文索引資料庫Web of Science(簡稱WOS)中的一個子庫,主要收錄重要的科學技術領域的國際期刊,ISI通過嚴格的選刊標準及評估來挑選刊源,且收錄文獻涵蓋全世界最重要、最有影響力的研究成果,SCI不僅是一文獻檢索工具,也成為對科學研究進行評價的一種指標。


SSCI Social Science Citation Index

美國科學資訊研究所 Institute for Scientific Information, ISI

SSCI是美國科學資訊研究所所發表之著名引文索引資料庫Web of Science(簡稱WOS)中的一個子庫,主要收錄重要的社會學領域的國際期刊,為研究社會科學類重要指標依據。

http://www.tzuchi.com.tw/file/DivIntro/nursing/content/91-4/9.htm

MEDLINE 醫學文獻資料庫

美國國家醫學圖書館 National Library of Medicine, NLM

收錄期刊、新聞、雜誌以及時事通訊的生物醫學和生命科學主題研究資訊,是從事醫學相關領域研究人員不可或缺的重要資料庫。提供信賴且可靠的醫療資訊。

Click on any of the covers below to explore the resources on this site for your book.

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Full Record Display



Hardiness and health: A prospective study.Kobasa, Suzanne C.; Maddi, Salvatore R.; Kahn, Stephen[Journal Article]Journal of Personality and Social Psychology,  Vol 42(1), Jan   1982, 168-177. doi: 10.1037/0022-3514.42.1.168.



Hypothesized that hardiness—commitment, control, and challenge—functions to decrease the effect of stressful life events to

計畫主持人申請各類案件作業須知
項目
參考資料
各類案件定義說明
計畫主持人申請案件
臨床試驗認證
(GCP認證)說明
計畫主持人教育訓練
1010324人體研究法教育訓練資料 檔案1 檔案2
審查費 各類案件審查收費標準
(請計畫主持人於送件審查時一併將此滿意度調查表寄出)
案件作業說明A類案件A1類案件A2類案件A3類案件B類案件
新案申請一般審查需報請衛生署核定 JIRB代審 國衛院代審一般審查不需報請衛生署核定簡易審查
參考資料連結
變更案申請
參考資料連結1.變更案注意事項 2.變更前後對照表
期中/結案報告申請
參考資料連結1.期中結案注意事項 2.報告收錄個案表 3.SAE受試者摘要報告清單 4.檢體安全追蹤報告
回覆資料文件說明
 主持人回覆說明(製作中)
案件審查流程圖
1.一般審查作業流程圖(A A3) 2.簡易審查作業流程圖
SAE/試驗偏差1.嚴重不良事件注意事項 2.試驗偏差記錄通報表 3.院內SAE通報說明表 4.院外SAE通報說明表
實地稽核1.稽核記錄表(自行列管案件)    2.稽核記錄表     3.試驗主持人配合查核注意事項
4.
實地稽核常見缺失    5.
衛生署稽核常見缺失
臨床試驗合約書
其他1.通過證明範本(英文版) 2.計畫撤案申請表 3.計畫暫停或終止摘要表 4.解除計畫暫停申請表
5.
文件調閲及影印申請登記表 6.教育訓練參加證明證書補發申請
常見問題Q&A IRB常見問題Q&A




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Research Publications

I have published a large number of research papers. This is a partial list of key papers, organized by topic area.

Conflict Management

K. W. Thomas, “Conflict and Conflict Management,” in M. D. Dunnette (Ed.), Handbook of Industrial and Organizational Psychology (pp. 889-935), Chicago: Rand-McNally, 1976.
R. H. Kilmann & K. W. Thomas, “Interpersonal Conflict-Handling Behavior as Reflections of Jungian Personality Dimensions,” Psychological Reports, 37, 1975, pp. 315-318.
T. R. Ruble & K. W. Thomas, “Support for a Two-Dimensional Model of Conflict Behavior,” Organizational Behavior and Human Performance, 16, 1976, 315-318.
R. H. Kilmann & K. W. Thomas, “Developing a Forced-Choice Measure of Conflict Behavior: The ‘MODE’ Instrument,” Educational and Psychological Measurement, 37, 1977, 309-325.
K. W. Thomas, Editor, special sub-issue on “Conflict and the Collaborative Ethic,” California Management Review, 21, 1978.
K. W. Thomas, “Conflict and Negotiation Processes in Organizations,” in M. D. Dunnette & L. M. Hough (Eds.), Handbook of Industrial & Organizational Psychology, Second Edition, Volume 3 (pp. 652-717), Palo Alto, CA: Consulting Psychologists Press, 1992.
K. W. Thomas, G. F. Thomas, & N. Schaubhut, “Conflict Styles of Men and Women at Six Organization Levels,” International Journal of Conflict Management, 19, 2008, pp. 148-166.

Intrinsic Motivation and Employee Engagement

K. W. Thomas & B. A. Velthouse, “Cognitive Elements of Empowerment: An ‘Interpretive’ Model of Intrinsic Task Motivation,” Academy of Management Review, 15, 1990, pp. 666-681.
K. W. Thomas & W. G. Tymon, Jr., “Does Empowerment Always Work: Understanding the Role of Intrinsic Motivation and Personal Interpretation,” Journal of Management Systems, 6, 1994, pp. 1-13.
K. W. Thomas, E. Jansen, & W. G. Tymon, Jr., “Navigating in the Realm of Theory: An Empowering View of Construct Development,” Research in Organizational Change and Development, 10, 1997, pp. 1-30.
K. W. Thomas & W. G. Tymon, Jr., “Bridging the Motivation Gap in Total Quality,” Quality Management Journal, 4, 1997, pp. 80-96.
K. W. Thomas, “Intrinsic Motivation at Work: Building Energy & Commitment,” San Francisco: Berrett-Koehler, 2000.
K. W. Thomas, “Unlocking the Mysteries of Intrinsic Motivation,” OD Practitioner, 32, 2000, pp. 27-30.
K. W. Thomas,“ Intrinsic Motivation at Work: What Really Drives Employee Engagement,” Second Edition, San Francisco: Berrett-Koehler, 2009 (co-published by ASTD, the American Society for Training and Development).

Producing Useful Research

K. W. Thomas & W. G. Tymon, Jr., “Necessary Properties of Relevant Research: Lessons from Recent Criticisms of the Organizational Sciences,” Academy of Management Review, 7, 1982, pp. 345-352.
K. W. Thomas & R. H. Kilmann, “Where Have the Organizational Sciences Gone? A Survey of the Academy of Management Membership,” in R. H. Kilmann, K. W. Thomas, D. P. Slevin, R. Nath, & S. L. Jerrell (Eds.), Producing Useful Knowledge for Organizations, New York: Praeger, 1983, pp. 69-81. (This book was also reprinted by Jossey-Bass, San Francisco, in 1994.)

Stress Management

K. W. Thomas & W. G. Tymon, Jr., “Interpretive Styles that Contribute to Job-Related Stress: Two Studies of Managerial and Professional Employees,” Anxiety, Stress, and Coping, 8, 1995, pp. 235-250.
K. W. Thomas & W. G. Tymon, Jr., “Stress Resiliency Profile: A Measure of Interpretive Styles that Contribute to Stress,” in C. P. Zalaquett & R. J. Wood (Eds.), Evaluating Stress: A Book of Resources, Lanham, MD: Scarecrow Press, 1997.

如何寫好一篇優質的碩博士論文


如何寫好一篇優質的碩博士論文

政治大學公共行政學系教授孫本初
一、如何寫好學術論文之「緒論」部分
(一)「緒論」之寫作所必須掌握的四個重點:
1.問題提出:
在進行研究計畫書之撰寫時,必須對「問題提出」部份特別予以重視,惟有
自己先搞清楚所欲研究的主題與相關問題究竟是什麼?然後才有可能談論其他問
題。
2.文獻評論:
針對自己所欲研究探討之主題與相關問題,在既存的研究文獻,先瞭解和蒐
集既有的研究成果為何?經過一定之處理步驟:概觀(歸類)、摘要、批判、建議,
然後找出其優缺點,同時針對其所採研究途徑和研究方法予以批判,進而提出作
者個人針對自己探討此一主題和相關問題時,應採取何種研究途徑與方法較為妥
適。
3.研究途徑、研究架構及研究方法:
此三者是具有密切相關的三種概念,必須分辨清楚,同時考量,可視為學位
論文的核心或心臟地帶,因而一篇學位論文的成敗,可以說是繫於作者個人對此
三者之。若處理得宜,則學位論文較有可看性;若未處理或處理不當,則學位論
文會被視為毫無章法。由此可見,吾人在處理學位論文時,對於研究途徑、研究
架構、研究方法等三者,必須予以特別重視。
4.論文重點說明:
在說明研究途徑、研究架構及研究方法之後,作者宜根據自己所提出的研究
架構作適當的佈局,特別是在說明相關之理論與發展史後,必須再針對自己所欲
探討之主題與相關問題加以說明。
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(二)關於「問題提出」
1.要扣緊研究主題,然後提出相關問題是什麼?有幾個?分別為何?
2.要有問題意識,並針對作者自己所欲探討之主題與相關問題,進行整體性、全方
位的思考。
3.相關重要結構說明如下:
(1)研究動機與問題界定──所謂問題之界定,指問題背景、問題內涵(欲
解決何種問題)、研究範圍等。
(2)研究目的、意義、重要性與價值。
(3)是否有「研究假設」?若該論文有「研究假設」,必須先搞清楚研究假
設之定義後,然後審慎處理之。
(4)論文寫作的六個主軸(5WIH)
1.What(事項):研究的主題包括哪些事項?
2.When(時間):研究的時間範圍約為哪段時間?
3.Where(空間):研究的地域範圍為何?
4.Who(人物):研究的對象包括哪些人物?
5.Why(理由):研究提出的原因為何?
6.How(經過、手段):研究當中所涉及的因果關係為何?
這六個主軸,最值得處理的為What、Why、How 的問題,頗值吾人循此三主
軸之一。
(三)關於「文獻評論」
1.文獻評論主要是在作者先搞清楚自己所欲探討之主題與相關問題後,針對自己所
欲探討之主題與相關問題,到底在中西方既存研究文獻中,已有那些研究成果,
作者必須先搞清楚,也讓他人能很快的作重點式了解,如同「站在巨人的肩膀上」
回顧過去前瞻未來,針對該主題與相關問題進行探討。
2.文獻探討之步驟主要有四:
(1)歸類:將類似的文獻歸於一類,此部分可根據自己的標準來進行歸類。
(2)摘要:以往文獻勢不可能全文摘錄,因此必須根據過去文獻的重點進行摘要。
通常重要的資訊包括研究的年代、研究的對象、研究的方法以及研究的結論等。
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(3)批判:在整理完過去文獻之後,必須對相關文獻進行檢討,了解過去文獻研究
所不足之處,作為未來研究的改進方向。
(4)建議:即前述所說明的未來改進方向,最好該建議改進方向就是自己研究所欲
加強之處。
3.相關理論之探討與說明
(1)說明與研究題目有關且與欲探索之研究問題頗具相關之理論為何種理論,可簡
列數個,並以一個段落說明即可。
(2)針對所欲探討之題目與欲研究問題最具相關性,且作者最感興趣的某一個理論
詳加討論。
4.文獻評論之最後段落,宜針對前人之研究成果所採用之研究途徑、方法作一檢
討,並說明其優缺點,進而針對作者所欲探討之主題與相關問題,作者自認宜先
採用何種研究途徑,再採取何種研究方法,以利突顯自己的研究方法,有別於他
人。
(四)關於「研究途徑、研究架構及研究方法」
1.研究途徑與研究方法
(1)研究途徑(approach),是指選擇問題與相關資料的標準,主要是指作者擬從何
種角度切入去探討該主題與相關問題。例如結構功能研究途徑、理性選擇途徑、
社會心理學途徑等。
(2)研究方法(method,是指蒐集與處理資料的程序與手段,主要是指作者針對自
己所欲探討之主題與相關問題,擬如何進行蒐集和分析資料。
(3)根據研究者介入研究對象程度的多寡,比較常見的研究方法可分為三類:
A.觀察法:最不干涉研究對象的一種方法,通常由研究者在一旁進行
研究對象的紀錄,許多的田野調查便是採取此一方式。
B.調查法:包括透過格式化的問卷調查或者透過開放式問卷進行的非結構性
調查。透過調查可由當事人的觀點來分析某一事件,惟缺點是受訪談者的
回答是否為事實。
C.實驗法:通常自然科學當中比較常用,社會科學當中比較少用,社會科學
當中則以心理學比較常進行實驗室內的實驗(如幼兒的學習發展態度等),
「撰寫碩博士論文與投稿學術期刊」論壇
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一般社會科學當中採取的都是準實驗法,而非真實驗法。
D.另外包括二手文獻的分析法,歷史文獻的檢閱等,亦均屬於研究方法的一
種。
(4)研究途徑和研究方法是二具密切相但不相同的東西,應分辨清楚,不可混同,
且前後順序有別,不可前後倒置,應該先決定採用何種研究途徑(approach),然
後再決定採用何種研究方法(method),絕對不可先談研究方法再談研究途徑,亦
不宜只談研究方法,不談研究途徑。
(5)研究途徑宜採一個,若有必要亦可採二種研究途徑,但不宜過多,以免徒增困
擾。但研究方法可採二種以上,以利透過多種研究究方法進行資料蒐和分析,增
強研究成果。學界或稱此為「交叉檢證」,以取得更多的事件相互對照,了解最後
的真相。
2.研究架構
(1)研究架構或稱分析架構,是作者針對擬研究主題進行整個思考、研究、分析的
架構,此一研究架構是作者解析該主題與相關問題的法寶,最具關鍵性與重要性。
(2)研究架構包括二個重點:
1、研究架構圖
研究架構圖與研究流程圖絕不相同,有些人常將研究流程圖誤為研究架構
圖,或將研究流程圖植入研究架構圖中,此種謬誤作者務必特別留意並避免。
2、研究架構圖之文字說明
針對所探討之研究架構之若干重要區塊,作一整體說明,並分別說明,約0.5
∼1 頁左右即可。
3、整個研究架包括研究架構圖與文字說明,共約2 頁。
4、創見與研究架構具密切關係,因而創新的想法必須在規劃研究架構時就植入,
並具體突顯出來,否則研究之結論難以產生「創見」。
(五)關於「論文重點說明」
1.緒論中的「論文重點說明」,即主要章節說明,它是根據所探討的主題、提出的
研究架構和論文大綱,作一整體思考而呈現出來的。
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2.主要章節說明只簡單扼要地說明各章節主要重點,大多用標號一、1、等表示出
所欲探討之問題與重點,有幾章就有幾個段落,段落分明,條理清楚,不可長篇
大論,且將各章節重點連結在一起,簡單扼要即可。
二、如何寫好學術論文之「本文」部分
(一)本論是論文中的核心部分,是針對「研究題目」和所要深入探討的「問題」而
開展出來的主要部份。基本上,應該有一個主軸,但是可分成幾個重點來說明與
討論。它是論文的主體,也是最主要、最關鍵的重要部分。
(二)通常,「本論」約可分為三至五章,一章約15,000 字,若三至五章,則約45,000
∼75,000 字。其主要重點說明如下:
1.有一章可談關於理論或發展史方面的問題,針對該研究題目,可能在該研究領域
中已有不少相關的理論,作者可稍為談論一下,隨即選定某一最具有密切相關,
且自己最有興趣、最有把握的理論,拿來解釋該研究題目。至於與該研究題目有
關的發展史,作者可採歷史研究途徑將它分成若干期。
2.緊接著,有2∼3 章可針對該研究題目,並將扣緊主軸的2∼3 個重點,分成2∼
3 章來討論。「本論」的各章節之處理,必須注意下列幾點:
(1)各章節的安排,有二個層次即可,即有「章」也有「節」,且在「章」之下分成
若干「節」。每「章」究竟有多少「節」較妥,不太一定,通常2∼3 節即可,若
有必要4∼5 節亦可,但最好要注意到勻稱,不宜有些章是2 節,有些章則是5 節,
相差太多,另外,如何將一章控制在15,000 字左右,或12,000∼20,000 字,似乎
較為允當。
(2)各章的佈局與研究架構密切相關。在論文的「緒論」中即有研究架構圖的構思,
該研究架構圖與作者在探討該研究題目時所採用的理論有一定的關聯,且該研究
架構圖可拆解成若干大區塊,進而各章的佈局,即係參考該研究架構圖的構思而
逐步開展出來。因此,各章的佈局,有其一定的邏輯存在。
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(3)各章節的結構,基本上與整個論文的結構類似,皆包括三部分:「緒論」、「本論」
及「結論」。同樣的道理,在撰寫各章時,應有「前言」、「本文」及「結語」,即
在每章的標題之後,宜有一段文字,一方面扣緊該章與該研究題目的關係,並說
明該章在整個論文的重要性;另一方面則是簡要地說明該「章」的主要重點有幾
個,然後才引出該章的幾個「節」,此段文句相當於該章的「前言」。緊接著,有
若干節的出現,此相當於該章的「本文」,到了該章最後一節結束後,應有結語,
以利將前面的若干節的結論與該章的主題扣在一起,進而說出其整章的結論,各
位需注意,對於前述各章內部的處理,雖然在操作時其中含有相當於「前言」、「本
文」、「結語」的性質,但是這些字眼,包括「前言」、「本文」、「結語」毋須寫出,
在結構當中作者自己意會即可。
三、如何寫好學術論文之「結論」部分
論文的最後一章為「結論」,通常包括:研究發現(創見)、研究貢獻、研究
限制、建議。
(一)研究發現
論文最主要、最關鍵部分就是「研究發現」,即作者針對該研究題目經過研究
後,必須說明它的研究成果與發現,因此,所謂「研究發現」,又可稱為「研究結
論」,或「研究結論與發現」,或「主要研究發現」。在撰寫時,宜盡量採條列式或
標題化,力求精簡扼要,以提高可讀性。
論文結構的第一部分「緒論」中的「研究目的」,必須與「結論」中的「研究
發現」一前一後相互呼應,通常在寫作實務上較好的做法,是將「緒論」中的「研
究目的」做兩階段的處理:
第一階段,即初擬研究計畫書時,就以條列式的方式先標明清楚有幾個預擬定的
「研究目的」。
第二階段,即完成撰寫「研究發現」後,再回過頭來修改原先預擬的「研究目的」,
這種做法叫做「倒寫法」,可以保證「研究目的」一定可達成。即「研
究發現」與「研究目的」是一致的。
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(二)研究貢獻
所謂「研究貢獻」,就是指作者在得出研究結論與發現後,它所可能產生的效
果。這一部分又可稱為「研究特色」或「研究特色與貢獻」。
作者在寫出個人針對某一研究題目的研究結論與發現之後,應可進一步說
明,在學術方面,例如在該專門的研究領域中,作者可能有何研究貢獻?它在研
究途徑、研究方法、概念、理論等方面,是否有所精進?有何突破?或者在實務
方面,作者所得出的研究結論與發現,是否可解決問題?
研究生在撰寫碩博士論文時,一般都不太懂得要特別寫出他的研究特色與貢
獻,但是在論文口試時,口試委員最喜歡問、最有可能問的問題之,就是自認為
重要的研究特色是什麼?有什麼貢獻?但在撰寫研究貢獻時,態度應謙虛、謹慎,
除非自己的確是具有「獨創性」的研究貢獻,否則措詞方面不宜太肯定地說:「此
為學術界的創舉」、「此主題從未有人研究過,本研究是開學術界之先河」⋯⋯等
類似的詞句。
(三)研究限制
所謂「研究限制」,就是指作者在研究過程中遭遇到什麼困難、阻礙和瓶頸,
以致論文具有一定的侷限性。常見的研究限制如:抽樣調查的樣本不足、樣本不
具代表性、資料不足、受訪者的回答態度、研究途徑、研究方法等。作者可依自
己論文的實際狀況予以增減。但是,與研究本身無一定關係的,例如:時間不夠、
課業忙碌、電腦中毒、⋯等,則不可做為研究限制。
(四)建議
在論文告一段落時,作者尚可就學術或實務方面提出一些建議。在學術方面
如:在後續研究方向有何建議?未來可嘗試再用何種研究途徑、研究方法來探討
該研究題目?又有那些理論可用來解析該研究題目?是否還有那些具有關聯性的
研究題目有待大家來共同探討?作者可依論文題目之性質,來思考在學術方面可
提出的一些建議。在實務方面,若論文題目之性質,與實務有關,例如:若與政
府的政策有關,則可提出某一政策或若干實務上的改善措施,供政府施政之參考。
若與組織的經營有關,則可提出若干經營策略,供組織管理者參考。

Influence of Interpretive Styles of Stress Resiliency on Registered Nurse Empowerment

Simoni, Patricia S. EdD, CS, RN; Larrabee, June H. PhD, RN; Birkhimer, Terri L. BSN, RN; Mott, Christine L. BSN, RN; Gladden, Stephanie D. BSN, RN

© 2004 Lippincott Williams & Wilkins, Inc.


日期

主題

閱讀

教師
9/14Introduction to StatisticsCh 1郭瑞祥
9/21Graphical and Tabular Descriptive StatisticsCh 2郭瑞祥
9/28Numerical Descriptive TechniquesCh 4郭瑞祥
10/5ProbabilityCh 6郭佳瑋
10/12          Random Variables and Discrete Probability DistributionsCh 7郭瑞祥
10/19Continuous Probability DistributionsCh 8郭瑞祥
10/26Advanced Concepts in Random Variables and DistributionsHandout (Ch.3)郭瑞祥
11/2Exam 1 郭瑞祥
11/9Advanced Concepts in ExpectationHandout (Ch.4)郭瑞祥
11/16Advanced Concepts in Probability DistributionsHandout (Ch.5)郭瑞祥
11/23Sampling DistributionsCh 9郭瑞祥
11/30Statistical Inference: EstimationCh 10郭佳瑋
12/7Exam 2 郭瑞祥
12/14Statistical Inference: Hypothesis TestingCh 11郭佳瑋
12/21Statistical Inference: Hypothesis TestingCh 11郭佳瑋
12/28Statistical Inference: Inference about a PopulationCh 12郭佳瑋
1/4Statistical Inference: Inference about a PopulationCh 12郭佳瑋
1/11Exam 3 郭佳瑋

 

統計學上 (2011/9)
統計學是一門研究如何對蒐集到的資料進行必要的分析,以得到具體的結論的方法論。本課程除
了會對統計的方法與原理會做一個深入淺出的介紹,同時也將要求學生用統計軟體如 Excel 與
SPSS,交日常作業,以培養學生理論與應用並重的能力。
授課教師:  郭瑞祥,管院二館 813 聯絡電話: 33661050    rsguo@ntu.edu.tw
郭佳瑋,管院二館 504 聯絡電話: 33661045     cwkuo@ntu.edu.tw
教學網站:http://guo.ba.ntu.edu.tw
上課時間:  星期三上午 9:10 --- 12:10   管理學院二號館 104
習題講演時間:星期五中午 12:30 ---2:00
課程評分: 平時作業: 30% 考試: 70%
教科書: Keller, Managerial Statistics,8th ed,South-Wester n,2008 (滄海)
參考書(Handout):
DeGroot and Schervish, Probability and Statistics, 3
rd
ed, Addison Wesley, 2002 (雙葉)
課程進度:
日期 主題 閱讀 教師
9/14 Introduction to Statistics Ch 1 郭瑞祥
9/21 Graphical and Tabular Descriptive Statistics Ch 2 郭瑞祥
9/28 Numerical Descriptive Techniques Ch 4 郭瑞祥
10/5 Probability Ch 6 郭佳瑋
10/12 Random Variables and Discrete Probability Distributions Ch 7 郭瑞祥
10/19 Continuous Probability Distributions Ch 8  郭瑞祥
10/26 Advanced Concepts in Random Variables and Distributions Handout (Ch.3) 郭瑞祥
11/2 Exam 1 郭瑞祥
11/9 Advanced Concepts in Expectation Handout (Ch.4) 郭瑞祥
11/16 Advanced Concepts in Probability Distributions Handout (Ch.5) 郭瑞祥
11/23 Sampling Distributions Ch 9 郭瑞祥
11/30 Statistical Inference: Estimation Ch 10 郭佳瑋
12/7 Exam 2 郭瑞祥
12/14 Statistical Inference: Hypothesis Testing Ch 11 郭佳瑋
12/21 Statistical Inference: Hypothesis Testing Ch 11 郭佳瑋
12/28 Statistical Inference: Inference about a Population Ch 12 郭佳瑋
1/4 Statistical Inference: Inference about a Population Ch 12 郭佳瑋
1/11 Exam 3 郭佳瑋



統計學(下) (2012/2)
統計學是一門研究如何對蒐集到的資料進行必要的分析,以得到具體的結論的方法論。本課程除
了會對統計的方法與原理會做一個深入淺出的介紹,同時也將要求學生用統計軟體如 Excel 與
SPSS,交日常作業,以培養學生理論與應用並重的能力。
授課教師:  郭瑞祥,管院二館 813 聯絡電話: 33661050    rsguo@ntu.edu.tw
郭佳瑋,管院二館 504 聯絡電話: 33661045     cwkuo@ntu.edu.tw
教學網站:http://guo.ba.ntu.edu.tw
上課時間:  星期三上午 9:10 --- 12:10
實習時間地點: 星期二 1:20pm---2:10pm (管院大、小電腦教室)
星期三 1:20pm---2:10pm (管院小電腦教室)
習題講演時間地點:星期五中午 12:30 ---2:00
課程評分: 平時作業: 30% 考試: 70%
教科書: Keller, Managerial Statistics,8th ed,South-Wester n,2008 (滄海)
課程進度:
日期 主題 閱讀 教授
2/22 Inference about Two Populations Ch 13 郭瑞祥
2/29 Inference about Two Populations Ch 13 郭瑞祥
3/7 Analysis of Variance (ANOVA) Ch 14.1, 3 郭瑞祥
3/14 Analysis of Variance (ANOVA) Ch 14.4, 5 郭瑞祥
3/21 Analysis of Variance (ANOVA) review Ch 14.2 郭瑞祥
3/28 Exam 1
4/11 Simple Linear Regression Ch 16 郭佳瑋
4/18 Simple Linear Regression Ch 16 郭佳瑋
4/25 Multiple Regression Ch 17 郭佳瑋
5/2 Multiple Regression Ch 17 郭佳瑋
5/9 Regression Analysis: model building Ch 18 郭佳瑋
5/16 Exam 2
5/23 Chi-square Test Ch 15 郭佳瑋
5/30 Time Series Analysis and Forecasting Ch 20 郭佳瑋
6/6 Time Series Analysis and Forecasting Ch 20 郭佳瑋
6/13 Nonparametric Methods Ch 19 郭佳瑋
6/20 Exam 3

高等統計學 (2007/2)
本課程為進階統計學,是一門研究統計學背後理論根據的數理統計學。課程著重於數學觀
念推導與物理意涵解釋,期使同學對過去在初等統計學所讀過公式的來龍去脈有更深層的
認識。本課程有較重的作業要求,電腦軟體的使用並非課程的重點。為確保上課品質,修
課同學必需先修過微積分與初等統計學。
任課老師:郭瑞祥    管院二館 813 室 (3366-1050)  rsguo@ntu.edu.tw
黃俊堯  管院二館 1107 室(3366-1066)  cyhuang@management.ntu.edu.tw
教學網站:http://guo.ba.ntu.edu.tw
上課時間:週五、2:20 - 5:20
上課地點:管院一號館 205 室
Office hours:週四、1pm-3pm
教科書:DeGroot and Schervish, Probability and Statistics, 3
rd
 ed, Addison Wesley, 2002 (雙葉).
評分:作業 30%   期中考 35%    期末考 35%
日期    主題                    閱讀      教授
3/2   Introduction to probability       ch.1.1-1.11   郭瑞祥
3/9   Conditional probability       ch.2.1-2.3, 2.5   黃俊堯
3/16   Random variables and distribution     ch.3.1-3.3   黃俊堯
3/23   Marginal and conditional distributions     ch.3.4-3.6   黃俊堯
3/30   Multivariate distributions and functions of RV  ch.3.7-3.9   黃俊堯
4/6   No class
4/13   Expectation and moment generating functions  ch.4.1-4.4   黃俊堯
4/20   Mean and covariance and conditional expectation  ch.4.5-4.8   郭瑞祥
4/27   Special discrete distributions      ch.5.1-5.5   郭瑞祥
5/4      Mid-term exam              
5/11   Special continuous distributions     ch.5.6-5.8   郭瑞祥
5/18   Special continuous distributions     ch.5.9-5.12   郭瑞祥
5/25   Posterior distribution       ch.6.1-6.3   郭瑞祥
6/1 (3:30pm) Bayes and maximum likelihood estimations   ch.6.4-6.6   郭瑞祥
6/8   Sampling distributions       ch.7.1-7.5   郭瑞祥
6/15   Unbiased estimators and F distribution    ch.7.7, 8.7   郭瑞祥
6/22     Final exam  





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個人與團隊適配與人際組織公民行為之研究-探討積極企圖與個人影響力之中介角色




http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume122007/No1Jan07/LookingBackwardtoInformtheFuture.aspx

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謝龍發(1987).工作特性、個人屬性與員工工作滿足之關連性研究.交通大學管理科學研究所碩士論文。
羅俊龍(1995).教師個人背景變項與工作價值觀、工作滿足、組織承諾關係之研究─宜蘭縣公立國民中學現任教師之實證研究.東吳大學企業管理研究所碩士論文。
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McCloskey, J. (1974). Influence of rewards and incentives on staff nurse turnover rate. Nursing Research, 23(3), 239-245.
Maslow, A. H. (1954). A theory of human motivation. NY: Harper and Row.
Parahoo, K., & Barr, O. (1994). Job satisfaction of community nurses working with people with a mental handicap. Journal of Advanced Nursing, 20(6), 1046-1055.
Riordan, J. (1991). Prestige: Key to job satisfaction for community health nurses. Public Health Nursing, 8(1), 59-64.
Ruffing, K. I., Smith, H. I., & Rogers, R. (1984). Factors to encourage nurse to remain in nursing. Nursing Forum, 21: 78-85.
Rokeach, M. (1973). The nature of human values. NY: Free Press.
Stewart, M. J., & Arklie, M. (1994). Work satisfaction, stressors and experiences by community health nurses. Canadian Journal of Public Health, 85(3), 180-184.
Simpson K. (1985). Job satisfaction or dissatisfaction reported by registered nurses. Nursung Administration Quarterly, 9: 64-73.
Sims, H. P., Szilagyi, A. D., & Keller, R. T. (1976). The measurement of job characteristics. Academy of Management Journal, 19(2), 195-212.
Smith, P. C., Kendall, L. M., & Hulin C. L. (1969). The measurement of satisfaction in work and retirement. Chicago: Rand McNally.
Seashore, S. E., & Taber, T. D. (1975). Job satisfaction and their correlates. American Behavior Scientist, 18(3), 333-368.
Super, D. E. (1970). Work values inventory: Manual. Chicago, IL: Riverside.
Turner, A. N., & Lawrance, P. R. (1965). Industrial job and the worker. Boston: Harvard Graduate School of Business Administration.
Vroom, V. H. (1962). Ego-involvement, job satisfaction and job performance. Personnel Psychology, 15, 159-177.
Wollack, S., Goodale, J. G., Wijting, J. P., & Smith, P. C. (1971). Development of the survey of work values. Journal of Applied Psychology, 55, 331-338.
篇名: 藥癮戒治病房護理人員的工作壓力與因應行為之探討
作者:石芬芬(Fen-Fen Shih);周照芳(Chaw-Fang Chou)
來源:中山醫學雜誌 (13卷2期)
關鍵字:藥癮戒治病房;工作壓力;因應行為;drug addictive ward;job stress;coping behaviors



Empowerment Research
Professor of Management and Organizations
Chair of Management and Organizations
Empowerment
Articles
Spreitzer, Gretchen.  (2007).  Taking Stock: A review of more than twenty years of research on empowerment at work.  In The Handbook of Organizational Behavior, C. Cooper and J. Barling eds.  Sage Publications.
Bartunek, J.M. and Spreitzer, Gretchen (2006).  The Interdisciplinary Career of a Popular Construct Used in Management: Empowerment in the Late 20th Century.  Journal of Management Inquiry, 15:3 255-273.
Spreitzer, G.M. (2006).  Empowerment.  In S. Rogelberg (ed.) Encyclopedia of Industrial and Organizational Psychology.  Thousand Oaks, CA:  Sage Publications, p. 202-206.
Spreitzer, Gretchen M., and Doneson, David  (2005).  Musings on the Past and Future of Employee Empowerment.  Forthcoming in the Handbook of Organizational Development, Tom Cummings ed., Thousand Oaks: Sage.
Spreitzer, Gretchen, and Mishra, Aneil.  (2002).  To stay or go:  Voluntary survivor turnover following an organizational downsizing.  Journal of Organizational Behavior, 23: 707-729.
Finegold, David, Mohrman, Susan, and Spreitzer, Gretchen.  (2002). Age effects on the predictors of technical workers’ commitment and willingness to turnover.  Journal of Organizational Behavior, 23: 655-674.
Shapiro, Debra .L., Furst, Stacie, Spreitzer, Gretchen, and Von Glinow, Mary Ann.  (2002).  Transnational teams in an Electronic Age.  Journal of Organizational Behavior, 23: 455-467.
Quinn, Robert E., Spreitzer, Gretchen, and Brown, Matthew. (2000).  Changing others through changing ourselves:  The transformation of human systems. Journal of Management Inquiry, 9(2): 147-164.
Spreitzer, Gretchen M., De Janesz, Suzanne, and Quinn, Robert E.  (1999).  Empowered to lead:  The role of psychological empowerment in leadership. Journal of Organizational Behavior, 20: 511-526.
Spreitzer, Gretchen M., Cohen, Susan G., and Ledford, Gerald.  (1999). Developing effective self-managing work teams in service organizations. Group and Organizational Management, 24(3): 340-366.
Spreitzer, Gretchen M., and Mishra, Aneil K.  (1999).  Giving up control without losing control:  Trust and its substitutes’ effects on managers’ involving employees in decision making.  Group and Organization Management, 24(2): 155-187.
Spreitzer, Gretchen M., Nobel, Deborah, Mishra, Aneil, and Cooke, William.  (1999).  Predicting process improvement team performance in an automotive firm:  Explicating the roles of trust and empowerment.  In E. Mannix, M. Neale & R. Wageman (eds.)  Research on Groups and Teams (vol. 2).  Greenwich, CT:  JAI Press, p. 71-92.
Spreitzer, Gretchen M., De Janesz, Suzanne, and Quinn, Robert E.  (1999).  Empowered to lead: The role of psychological empowerment in leadershipJournal of Organizational Behavior, 20: 511-526.
Spreitzer, Gretchen M., Cohen, Susan G., and Ledford, Gerald.  (1999). Developing effective self-managing work teams in service organizations. Group and Organizational Management, 24(3): 340-366.
Spreitzer, Gretchen M., and Mishra, Aneil K.  (1999).  Giving up control without losing control:  Trust and its substitutes’ effects on managers’ involving employees in decision making.  Group and Organization Management, 24(2): 155-187.
Quinn, Robert E., and Spreitzer, Gretchen M.  (1997).  The road to empowerment: Seven questions every leader should considerOrganizational Dynamics, Autumn, 26(2): 37-51.
Spreitzer, Gretchen M., Kizilos, Mark, and Nason, Stephen.  (1997).  A dimensional analysis of the relationship between psychological empowerment and effectiveness, satisfaction, and strain.  Journal of Management, 23(5): 679-704.
Spreitzer, Gretchen M.  (1996).  Social structural characteristics of psychological empowermentAcademy of Management Journal, 39(2): 483-504.
Spreitzer, Gretchen M., and Quinn, Robert E.  (1996). Empowering middle managers to be transformational leaders.  Journal of Applied Behavioral Science, 32(3): 237-261. Excerpted in a research briefing in Psychology Today, May-June, 1997: 16.
Cohen, Susan G., Ledford, Gerald E., Jr., and Spreitzer, Gretchen M.  (1996).  A predictive model of self-managing work team effectiveness. Human Relations, 49(5): 643-676.
Spreitzer, Gretchen M.  (1995).  Psychological empowerment in the workplace:  Dimensions, measurement, and validation Academy of Management Journal, 38(5): 1442-1465.
Spreitzer, Gretchen M.  (1995).  An empirical test of a comprehensive model of intrapersonal empowerment in the workplace. American Journal of Community Psychology, 23(5): 601-629.
Spreitzer, Gretchen M., Quinn, Robert E., and Fletcher, Jerry.  (1995).  Excavating the paths of meaning, renewal, and empowerment:  A typology of managerial high-performance myths. Journal of Management Inquiry, 4(1): 16-39.
Spreitzer, Gretchen M., & Quinn, Robert E.  2001.
A Company of Leaders: Five Disciplines for
Unleashing the Power in Your Workforce
.
San Francisco: Jossey-Bass.





The Relationship of Empowerment and Selected Personality Characteristics to Nursing Job Satisfaction


論文、升等、研究、投稿期刊(SCI、SSCI)是每個碩博士以及學術界的重要工作,希望透過這個研究方法部落格訊息的分享,讓更多對研究方法(量化分析工具--SPSS、統計分析、多變量分析、結構方程模型SEM--AMOS、HLM階層線型模型、AHP、ANP、甚至Eview and Panel analysis;質性研究--紮根理論


http://www.mendeley.com/library/

Gordon十一項功 能性健康型態評估技巧


心理學專有名詞中英對照表

ch.1
心理動力------psycho-dynamics 心理分析------psychoanalysis行為論-------behaviorism 心理生物觀---psycho-biological perspective認知---------cognition 臨床心理學家-clinical psychologist諮商--------counseling 人因工程-------human factor engineering組織--------organization 潛意識---------unconsciousness完形心理學---Gestalt psychology 感覺------------sensation知覺--------perception 實驗法--------experimental method獨變項-------independent variable 依變項--------dependent V.控制變項------control V. 生理------------physiology條件化---------conditioning 學習------------learning比較心理學---comparative psy. 發展-------------development社會心理學---social psy. 人格--------------personality心理計量學—psychometrics 受試()---------subject實驗者預期效應—experimenter expectancy effect雙盲法-----double—blind 實地實驗--------field experiment相關-----------correlation 調查-------------survey訪談-----------interview 個案研究-------case study觀察-----------observation 心理測驗-------psychological test

ch.5
紋理遞變度-----texture gradient 注意------------attention物體的組群---grouping of object 型態辨識—pattern recognition形象-背景----figure-ground 接近律--------proximity相似律--------similarity 閉合律-------closure連續律--------continuity 對稱律-------symmetry錯覺-----------illusion 幻覺----------delusion恆常性--------constancy 大小----------size形狀-----------shape 位置---------- location單眼線索-----monocular cue 線性透視----linear- perspective雙眼線索-----binocular cue 深度---------depth調節作用-----accommodation 重疊----superposition雙眼融合-----binocular fusion 輻輳作用-----convergence雙眼像差-----binocular disparity 向度 --------- dimension自動效應-----autokinetic effect 運動視差----- motion parallax誘發運動---- induced motion 閃光運動----- stroboscopic motion上下文﹑脈絡-context 人工智慧------artificial intelligence A.I.脈絡關係作用-context effect 模板匹配------template matching 整合分析法---analysis-by-synthesis 豐富性---------redundancy選擇性---------selective 無意識的推論-unconscious inferences運動後效---motion aftereffect 特徵偵測器—feature detector激發性---excitatory 抑制性----inhibitory幾何子---geons 由上而下處理—up-down process由下而上處理---bottom-up process 連結者模式---connectionist model聯結失識症---associative agnosia 臉孔辨識困難症---prosopagnosia

ch.6
意識
意識--consciousness 意識改變狀態---altered states of consciousness 無﹑潛意識----unconsciousness 前意識---------preconsciousness 內省法---introspection 邊緣注意---peripheral attention 午餐排隊(雞尾酒會)效應—lunch line(cocktail party) effect多重人格-----multiple personality 自動化歷程----automatic process解離----dissociate 解離認同失常----dissociative identity disorder快速眼動睡眠----REM dream 非快速眼動睡眠—NREM dream神志清醒的夢----lucid dreaming 失眠---insomnia顯性與隱性夢---manifest & latern content 心理活動性psychoactive 冥想------meditation 抗藥性 tolerance 戒斷 withdrawal感覺剝奪---sensory deprivation 物質濫用----substance abuse成癮--------physical addiction 物質依賴----sub. dependence戒斷癥狀----withdrawal symptom 興奮劑--stimulant幻覺(迷幻)劑----hallucinogen 鎮定劑---sedative
抑制劑--depressant 酒精中毒引起譫妄—delirium tremens 麻醉劑---narcotic 催眠-------hypnosis 催眠後暗示----posthypnotic suggestion 催眠後失憶 posthypnotic amnesia超心理學---parapsychology 超感知覺extrasensory perception ESP心電感應---telepathy 超感視---clairvoyance 預知---precognition心理動力—psycokinesis PK

ch.4.
感覺
受納器----------receptor 絕對閾---------absolute threshold差異閾----------difference threshold 恰辨差------- -JND韋伯律---------Weber’s law 心理物理-----psychophysical費雪納定律---Fechner’s law  頻率-----frequency振幅----------amplitude 音頻-------pitch 基音----------fundamental tone 倍音-----overtone 和諧音-------harmonic 音色------timbre白色噪音----white noise 鼓膜-----eardrum耳蝸----------cochlea 卵形窗—oval window圓形窗-------round window 前庭-----vestibular sacs半規管-------semicircular canals 角膜-------cornea水晶體-------lens 虹膜------------iris 瞳孔----------pupil 網膜---------retina睫狀肌-------ciliary muscle 調節作用---accommodation



ch.2.
生物架構
脊髓---------spinal cord 反射弧--------reflex arc腦幹---------brain stem 電腦軸性線斷層掃描-- CAT CT

PET---
正子放射斷層攝影 MRI-----磁共振顯影
延腦----medulla 橋腦-----pons 小腦----cerebellum網狀結構---reticular formation RAS----網狀活化系統
視丘----thalamus 下視丘----hypothalamus 大腦----cerebrum 腦(下)垂體(腺)—pituitary gland 腦半球---cerebral hemisphere 皮質---cortex 胼胝體----corpus callosum 邊緣系統------limbic system 海馬體----hippocampus 杏仁核--------amygdala 中央溝---central fissure 側溝-----------lateral fissure 腦葉------lobe 同卵雙生子----identical twins 異卵雙生子—fraternal twins



ch.7
制約與學習
古典制約--classical conditioning 操作制約---operant conditioning非制約刺激—(US )unconditioned stimulus非制約反應—(UR)unconditioned R.制約刺激---(CS) conditioned S. 制約反應----(CR)conditioned R.()-----acquisition 增強作用------reinforcement消除()------extinction (發性)然恢復----spontaneous recovery前行制約—forward conditioning 同時制約--simultaneous conditioning回溯制約---backward cond. 痕跡制約——trace conditioning延宕制約—delay conditioning 類化(梯度)---generalization (gradient)區辨------discrimination (次級)增強物-------(secondary) reinforcer嫌惡刺激---aversive stimulus 試誤學習---trial and error learning效果率-----law of effect ()性增強物—positive (negative) rei. 行為塑造—behavior shaping 循序漸進-----successive approximation自行塑造—autoshaping 部分(連續)增強—partial (continuous)R定比()時制—fixed ratio (interval) schedule FRFI變化比率(時距)時制—variable ratio (interval) schedule VRVI逃離反應---escape R. 迴避反應—avoidance response習得無助----learned helplessness 頓悟--------insight學習心向—learning set 隱內(潛在)學習---latent learning認知地圖---cognitive map 生理回饋------biofeedback敏感遞減法-systematic desensitization 普里邁克原則—Premack’s principle洪水法----flooding 觀察學習----observational learning動物行為學----ethology 敏感化—sensitization習慣化---habituation 聯結---association 認知學習----cognitional L. 觀察學習---observational L.

CH.7
記憶
登錄﹑編碼----encoding 保留﹑儲存-----retention提取------retrieval 回憶----(free )recall 全現心像﹑照相式記憶---eidetic imageryphotographic memory  . 舌尖現象(TOT—tip of tongue 再認---------recognition再學習--------relearning 節省分數----savings外顯與內隱記憶--explicit & implicit memory 記憶廣度---memory span組集---chunk 序列位置效應---serial position effect 起始效應---primacy effect 新近效應-----recency effect ()境依賴學習---state-dependent L. 無意義音節—nonsense syllable 順向干擾---proactive interference 逆向干擾---retroactive interference閃光燈記憶---flashbulb memory 動機性遺忘----motivated forgetting器質性失憶症—organic amnesia 阿茲海默症---Alzheimer”s disease近事(順向)失憶症—anterograde amnesia舊事(逆向)失憶—retrograde A.高沙可夫症候群—korsakoff”s syndrome 凝固理論—consolidation th.感覺記憶(SM—sensory memory 短期記憶(STM—short-term M.長期記憶(LTM—long-term memory 複誦---rehearsal預示(激發)----priming 童年失憶症---childhood amnesia視覺編碼(表徵)---visual code (representation) 聽覺編碼—acoustic code運作記憶---working memory 語意性知識—semantic knowledge記憶掃瞄程序—memory scanning procedure竭盡式掃瞄程序-exhaustive S.P.自我終止式掃瞄—self-terminated S. .程序性知識—procedural knowledge命題(陳述)性知識--propositionaldeclarativeknowledge情節(軼事)性知識—episodic K. 訊息處理深度—depth of processing精緻化處理—elaboration 登錄特殊性—coding specificity記憶術—mnemonic 位置記憶法—method of loci字鉤法—peg word (線)探索(測)(激發)—prime關鍵字---key word

ch.9
思考與語言
命題思考----propositional thought 心像思考---imaginal thought行動思考---motoric thought 概念---concept原型----prototype 屬性----property 特徵---feature範例策略--exemplar strategy 語言相對性(假說)—linguistic relativity th.音素---phoneme 詞素---morpheme

(
字詞的)外延與內涵意義—denotative & connotative meaning (句子的)表層與深層結構—surface & deep structure語意分析法---semantic differential 全句語言—holophrastic speech 過度延伸---over-extension 電報式語言—telegraphic speech 關鍵期----critical period 差異減縮法---difference reduction方法目的分析---means-ends analysis 倒推---working backward

ch.10
動機
動機---------motive 自由意志------free will決定論------determinism 本能-----------instinct種屬特有行為-----species specific 驅力----drive誘因------incentive 驅力減低說---drive reduction th.恆定狀態(作用)—homeostasis 原級與次級動機—primary & secondary M.功能獨立—functional autonomy 下視丘側部(LH—lateral hypothalamus脂肪細胞說----fat-cell theory. 下視丘腹中部(VMH—ventromedial H定點論---set point th. CCK───膽囊調節激素
第一性徵---primary sex characteristic  第二性徵---secondary sex characteristic自我效能期望—self-efficiency expectancy 內在(發)動機—intrinsic motive 外在(衍)動機—extrinsic motive    成就需求---N. achievement 需求層級—hierarchy of needs     自我實現---self actualization 衝突----conflict

ch.11
情緒
多項儀---polygraph 膚電反應----------GSR

(
認知)評估---(cognitive appraisal) 臉部回饋假說---facial feedback hypothesis

(
生理)激發----arousal 挫折-攻擊假說---frustration-aggression hy.替代學習----vicarious learning

ch.3
發展
發展------development 先天-----nature 後天-----nurture成熟-------maturation (視覺)偏好法-----preferential method習慣法-----habituation 視覺懸崖-----visual cliff剝奪或豐富(環境)---deprivation or enrichment of env. 基模----schema同化----assimilation 調適-----accommodation 平衡----equilibrium感覺動作期----sensorimotor stage 物體永久性----objective permanence運思前期----preoperational st. 保留概念----conservation道德現實主義---moral realism 具體運思期-----concrete operational形式運思期----formal operational st. 前俗例道德---pre-conventional moral俗例道德----conventional moral 超俗例道德----post-conventional moral氣質----temperament 依附---attachment 性別認定---gender identity性別配合----sex typing 性蕾期---phallic stage 戀親衝突—Oedipal conflict認同-----identification 社會學習----social learning 情結---complex性別恆定----gender constancy 青年期----adolescence 青春期-- -puberty第二性徵---secondary sex characteristics 認同危機---identity crisis定向統合---identity achievement 早閉型統合---foreclosure未定型統合---moratorium 迷失型統合---identity diffusion傳承---generativity


字彙 說明、解釋
radical behaviorism
激進行為主義
Skinner派的行為主義,它認為心理學的主旨應該是關心外顯的行為,不需要去顧及、去推論行為的內在的過程,例如希望、特質,或預期等等。
ratio scale
比例量表
這個量表是有真正零點的,所以這種量表可以提供比例的比較,例如這個聲音比另一個聲音大二倍。見categorycal stale, interval scale, ordinal scale。
ratio schedule
比率增強方式
增強方式的一種,增強物只有在做了多少反應後才能得到。在固定比率增強方式中,受試者必須要做到某一個數量的反應後才能得到增強物。在變動比率增強方式中,這個反應的數量不定。
rationalization
合理化
在心理分析的理論中,這個防衛機制是將一個不可接受的思想或衝動重新解釋為比較可以接受,比較不引起焦慮的方式,例如一個被拋棄的情人告訴自己說,他從來沒有真正地愛過她。
reaction formation
反向作用
在心理分析的理論中,這種防衛機制是將一個被禁止的衝動轉換成正好相反的方式,例如將對弟弟的恨以超乎尋常的友愛姿態出現。
reaction time
反應時間
從信號出現到觀察者對該信號所做的反應的這段時間叫反應時間。
recall
回憶
一種從記憶中找出一些項目的實驗作業。見reechoingtin。
regency effect
新近效果
在自由回憶中,靠近字序結尾的幾個項目回憶得比中間的項目好。見primacy effect,
receptive field
感受區
在視網膜上 視覺刺激所激發某個特定細胞的發射率的地域。
receptor cells
感受體細胞
一種特別的細胞,專門對各種物理刺激起反應並傳導這些反應。
reciprocal altruism
互惠的利他行為
見altruism。
reciprocity principle
禮尚往來的原則
許多社會互動所遵循的一個基本原則,一個人一定要回報所曾經受過的禮。
recoding
轉錄
將訊息原來儲存的形式加以改變。
recognition
再認
一種實驗作業,受試著必須要決定這個刺激是否曾經出現過。見recall。
reflex
反射
對一些刺激的一種非常簡單、典型的反應,如感到痛時,肢體的自然回縮。
rehearsal
複誦
見elaborative rehearsal及maintenance rehearsal。
reinforced trial
有增強的嘗試
在古典制約中,CS後面有跟隨著US的嘗試叫增強的嘗試。在工具制約中,一個工具的反應後面有跟隨著報酬、懲罰的停止或其他增強物的嘗試,叫有增強的嘗試。
reinforcement
增強
在古典制約中,US跟隨著CS出現的程序叫增強。在工具制約中,某一個追求的成果跟隨著工具的反應的出現而出現的程序叫增強。
releasing stimulus
釋放刺激
行為學家用來形容一個刺激,動物對這個刺激有一個天生設定的接受方式,看到這個刺激後就會引發出一個固定形態的行為反應出來。例如一個細長的、尖端有紅色的喙就會引發herring gull的幼鳥乞食的反應。見fixed-actionpatterns。
reliability
信度
去測量一個測驗的一致性,例如可以用測試一再測試的方法。
REM sleep
REM睡眠
見active sleep,
repetition priming
重複促發
一個字被確認、辨識、或回憶出的可能性因最近曾出現遇而增加,而此出現過並不需要意識上的自覺。
representational thought
表徵思考
在Piaget的理論中,思想是內化的,並包括以前的各種經驗的心理表徵。
representativeness heuristic
代表性策略
一種依一個物體或事件跟它所屬種類之典型有多相似,來估計它是否屬於那一種類的一種估計或然率的方法。它並不將它發生的基本可能性(基率,base rate)考慮進去。
repression
壓抑
在心理分析理論中,這個防衛機制是將會引起焦慮的思想、衝動,或記憶都推到意識之外去。
resistance
抗拒
在心理分析理論中,病人無法去做自由聯想及說出第一個進入他心中的字來的一個統稱。
response bias
反應偏差
在心理物理實驗中,對某種反應有所偏好而無視於實際刺激的情況。
response suppression
反應的壓抑
田制約的恐懼而對某個制約的反應加以抑制。
restrained-eating hypothesis
約束進食假設
這個假設是說肥胖症的人對外在提示過分敏感的原因是因為意識上一直約束、限制進食的反抑制效果。見externality hypothesis及setpoint hypothesis。
restructuring
重新建構
指對一個問題的重新組織,通常是在一個突然的,富有創造性的思考之後。
retention
保存
指記憶痕跡在經過一段期間之後所存留下來的多寡。
reticular formation
網狀組織
一個神經元的網路組織遍布在中腦中並分枝到上層的腦去,這個組織掌管著睡眠及激起。
retina
視網膜
一個含有視覺感受細胞的組織。
retinal image
視網膜影像
一個物體投射到視網膜上的影像。這個影像的大小與物體的大小成正比,與物體距離視網膜的遠近成反比。
retrieval
提取
在記憶中搜索並找到該項目的過程。如果提取不成,這並不表示這個記憶痕跡不在了,只是表示目前無法取得而已。
retrieval cue
提取提示
幫助提取記億痕跡的刺激。
retroactive inhibition
後向抑制
一種受後來所學習的材料的干擾,而影響到回憶成績的現象。見proactive inhibition。
retrograde amnesia
後向失憶症
一種因頭部受傷而引起的記憶缺失,病人失去受傷前事件的記憶。見anterograde amnesia。
ROC curve
ROC曲線
在察覺的實驗中,一個顯示答中與假警報關係的曲線。
rods
桿細胞
一種視覺感受細胞,專門對低強度的光起反應而產生無顏色的視覺感覺。
Rorschach inkblot test
Rorschach墨漬測驗
一個投射的方法,病人要看墨漬然後說出他看到的是什麼。
INDEX
A B C
D E F
G H I
J K L
M N O
P Q R
S T U
V W X
Y Z Home


論文名稱(中文)服務人員情緒勞動之前因後果探討
論文名稱(英文)Exploring the Antecedents and Consequences of Service Employees’ Emotional Labor
研究生(中文)林鈺容
研究生(英文)Yu-Jung Lin
學號R97724040
學位類別碩士
出版年2010
論文頁數50
學校名稱臺灣大學
學院名稱管理學院
系所名稱國際企業學研究所
指導教授林俊昇 ; 
學年度98
語文別中文
論文使用權限不同意授權瀏覽/列印電子全文服務。

中文摘要
第一線服務人員面對顧客時,除了提供商品或勞務外,往往也需要表現出符合社會期待的情緒表現,稱之為情緒勞動。服務人員的情緒勞動策略有兩種:(1)深層演出─調適內心感受以表達一致的情緒,(2)淺層演出─與內心感受相悖,僅表面上表達應有的情緒。本研究旨在探討影響服務人員於工作環境中選擇不同情緒勞動策略之個人因素,以及不同的情緒勞動策略對顧客面之影響。
本研究首先探討表達規則、員工情緒和內在動機三個變項與深層演出和淺層演出之間的關係,之後進一步檢驗深層演出和淺層演出對於員工友善和服務品質所造成的影響。透過201組商圈店鋪店員與顧客的問卷調查,進行假設之檢驗。
研究結果發現表達規則與深層演出和淺層演出均具有顯著的正向關係,員工情緒和內在動機則均與深層演出具有顯著的正向關係,與淺層演出則有顯著的負向關係。另一方面,深層演出對於員工友善和服務品質均有顯著正面影響,反之,淺層演出則對兩者皆有顯著的負面影響。此外,員工友善與服務品質間也具有顯著的正向關係。
英文摘要
The issue of service employees’ emotions is beginning to gain closer attention by service researchers. Emotional labor literature addresses the stress of managing emotions when the work role demands that certain expressions be shown to customers. In this research, we extend emotional labor theories, proposing and testing a model that includes emotional labor strategy as well as its antecedents and consequences. Data were collected from 201 service employee-customer pairs in Taiwan. Results showed that all the antecedents of emotional labor strategy, including display rules, employee positive emotions and intrinsic motivations, have positive influence on deep acting, which in turn enhances employee friendliness and service quality. On the contrary, employee positive emotions and intrinsic motivations are negatively related to surface acting, which lead to negative evaluation of employee friendliness and service quality. Implications, limitations and future research directions are then discussed.
論文目次
第一章 緒論 1
第一節 研究動機與目的 1
第二節 研究流程 3
第二章 文獻探討 4
第一節 情緒勞動 4
第二節 表達規則、員工情緒與內在動機 6
第三節 情緒勞動、員工友善與服務品質 9
第三章 研究方法 11
第一節 研究架構 11
第二節 研究假說 12
第三節 研究變數定義與衡量 13
第四節 研究設計與研究工具 15
第五節 資料分析方法 16
第四章 研究結果 17
第一節 樣本特性分析 17
第二節 衡量模型分析 22
第三節 線性結構關係模式 29
第五章 研究結論與建議 35
第一節 研究結論 35
第二節 研究貢獻 38
第三節 管理意涵 40
第四節 研究限制與後續研究建議 42
參考文獻 43
參考文獻
一、中文部分
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5. 張紹勳 (2001),「結構方程模式」,雙葉書廊。
二、英文部分
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Research Publications

I have published a large number of research papers. This is a partial list of key papers, organized by topic area.

Conflict Management

K. W. Thomas, “Conflict and Conflict Management,” in M. D. Dunnette (Ed.), Handbook of Industrial and Organizational Psychology (pp. 889-935), Chicago: Rand-McNally, 1976.
R. H. Kilmann & K. W. Thomas, “Interpersonal Conflict-Handling Behavior as Reflections of Jungian Personality Dimensions,” Psychological Reports, 37, 1975, pp. 315-318.
T. R. Ruble & K. W. Thomas, “Support for a Two-Dimensional Model of Conflict Behavior,” Organizational Behavior and Human Performance, 16, 1976, 315-318.
R. H. Kilmann & K. W. Thomas, “Developing a Forced-Choice Measure of Conflict Behavior: The ‘MODE’ Instrument,” Educational and Psychological Measurement, 37, 1977, 309-325.
K. W. Thomas, Editor, special sub-issue on “Conflict and the Collaborative Ethic,” California Management Review, 21, 1978.
K. W. Thomas, “Conflict and Negotiation Processes in Organizations,” in M. D. Dunnette & L. M. Hough (Eds.), Handbook of Industrial & Organizational Psychology, Second Edition, Volume 3 (pp. 652-717), Palo Alto, CA: Consulting Psychologists Press, 1992.
K. W. Thomas, G. F. Thomas, & N. Schaubhut, “Conflict Styles of Men and Women at Six Organization Levels,” International Journal of Conflict Management, 19, 2008, pp. 148-166.

Intrinsic Motivation and Employee Engagement

K. W. Thomas & B. A. Velthouse, “Cognitive Elements of Empowerment: An ‘Interpretive’ Model of Intrinsic Task Motivation,” Academy of Management Review, 15, 1990, pp. 666-681.
K. W. Thomas & W. G. Tymon, Jr., “Does Empowerment Always Work: Understanding the Role of Intrinsic Motivation and Personal Interpretation,” Journal of Management Systems, 6, 1994, pp. 1-13.
K. W. Thomas, E. Jansen, & W. G. Tymon, Jr., “Navigating in the Realm of Theory: An Empowering View of Construct Development,” Research in Organizational Change and Development, 10, 1997, pp. 1-30.
K. W. Thomas & W. G. Tymon, Jr., “Bridging the Motivation Gap in Total Quality,” Quality Management Journal, 4, 1997, pp. 80-96.
K. W. Thomas, “Intrinsic Motivation at Work: Building Energy & Commitment,” San Francisco: Berrett-Koehler, 2000.
K. W. Thomas, “Unlocking the Mysteries of Intrinsic Motivation,” OD Practitioner, 32, 2000, pp. 27-30.
K. W. Thomas,“ Intrinsic Motivation at Work: What Really Drives Employee Engagement,” Second Edition, San Francisco: Berrett-Koehler, 2009 (co-published by ASTD, the American Society for Training and Development).

Producing Useful Research

K. W. Thomas & W. G. Tymon, Jr., “Necessary Properties of Relevant Research: Lessons from Recent Criticisms of the Organizational Sciences,” Academy of Management Review, 7, 1982, pp. 345-352.
K. W. Thomas & R. H. Kilmann, “Where Have the Organizational Sciences Gone? A Survey of the Academy of Management Membership,” in R. H. Kilmann, K. W. Thomas, D. P. Slevin, R. Nath, & S. L. Jerrell (Eds.), Producing Useful Knowledge for Organizations, New York: Praeger, 1983, pp. 69-81. (This book was also reprinted by Jossey-Bass, San Francisco, in 1994.)

Stress Management

K. W. Thomas & W. G. Tymon, Jr., “Interpretive Styles that Contribute to Job-Related Stress: Two Studies of Managerial and Professional Employees,” Anxiety, Stress, and Coping, 8, 1995, pp. 235-250.
K. W. Thomas & W. G. Tymon, Jr., “Stress Resiliency Profile: A Measure of Interpretive Styles that Contribute to Stress,” in C. P. Zalaquett & R. J. Wood (Eds.), Evaluating Stress: A Book of Resources, Lanham, MD: Scarecrow Press, 1997.


小型醫院員工情緒勞務負荷與顧客導向行為關係之研究─以自我監控、內部行銷為干擾變項空
論文名稱(英)A Study of Emotional Labor loading and Customer-Oriented Behavior
-Self Monitoring and Internal Marketing as Moderators
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    摘要(中)本研究之目的在研討自我監控與內部行銷之差異對於情緒勞務工作者情緒勞務負荷與顧客導向行為間的干擾效果。主要以問卷調查方式進行,樣本主要來自高雄地區兩家醫院之工作人員,共計發出問俊490份,實際回收456份,有效問卷400份。問卷有效回收率為86.8%。
    研究結果發現如下:
    1、 情緒勞務負荷對顧客導向行為的關係具有顯著相關,其中執行情緒勞務負荷對病患為主顧客導向行為有正向影響結果;執行情緒勞務負荷對任務為主顧客導向行為有負向影響結果。
    2、 自我監控和情緒勞務負荷的交互作用對顧客導向行為具有顯著的影響;顯然自我監控為情緒勞務負荷與顧客導向行為的干擾變項。
    3、 內部行銷和情緒勞務負荷的交互作用對顧客導向行為不具有顯著的影響;顯然內部行銷並非情緒勞務負荷與顧客導向行為的干擾變項。
    摘要(英)The Purpose of this study is to explore the moderating effects of self monitoring and internal marketing on the relationships between the emotional labor loading and customer-oriented behavior.
    The sample of this study consisted 2 hospitals at koashing. The questionnaires were used to survey and there were 400 Valid samples.
    The results of this search indicate that:
    1.Emotional labor loading affects customer-oriented behavior significantly. Emotional labor loading has positive impact on patient -orientation , however has negative impact on mission-orientation.
    2. The interaction effects between the self monitoring and the emotional labor loading on patient-orientation is significantly, the hypothesis of moderating effect of self monitoring was supported.
    3.The interaction effects between the internal marketing and the emotional labor loading on customer-oriented behavior is not significantly, the hypothesis of moderating effect of internal marketing was not supported.
    關鍵字(中)





































  • 情緒勞務負荷































































































  • 自我監控































































































  • 顧客導向行為































































































  • 內部行銷































































































  • 中小型醫院


























































  • 關鍵字(英)





































  • Self Monitoring































































































  • Emotion labor loading































































































  • Customer-Oriented Behavior































































































  • Internal Marketing































































































  • small hospitals


























































  • 論文目次目    錄
                           頁次
    第一章 緒論……………………………………………………………………………1
        第一節 研究背景………………………………………………………………1
    第二節 研究動機…--……………………………………………………………2
    第三節 研究目的………………………………………………………………4
    第四節 研究流程………………………………………………………………4
    第五節 解釋名詞………………………………………………………………6
    第二章 文獻探討……………………………………………………………………8
    第一節 情緒勞務與顧客導向行為……………………………………………8
    第二節 自我監控的干擾效果………………………………………………… 16
    第三節 內部行銷的干擾效果………………………………………………… 19
    第三章 研究方法……………………………………………………………… 27
    第一節 研究架構與假設……………………………………………………… 27
    第二節 研究工具……………………………………………………………… 28
    第三節 修正後研究架構……………………………………………………… 37
    第四節 研究變項與操作性定義………………………………………………41
    第五節 研究設計…………………………………………………………… 40
    第六節 資料分析方法……………………………………………………… 41
      第七節 研究限制……………………………………………………………… 42
    第四章 實證結果分析與討論………………………………………………… 43
      第一節 樣本及各研究變項之描述性統計分析…………………………… 43
    第二節 個人屬性與各研究變項之關係…………………………………… 47
      第三節 各研究變項間相關性之分析……………………………………… 52
      第四節 各研究變項之影響性分析………………………………………… 53
      第五節 情緒勞物與顧客導向行為之干擾性分析………………………… 54
    第五章 結論與建議………………………………………………………………59
      第一節 結論……………………………………………………………………59
    第二節 建議……………………………………………………………………62
    參考文獻………………………………………………………………………… 64
    附錄…………………………………………………………………………………65
    表目錄
    表2-1-1 情緒勞務的定義…………………………………………………………10
    表2-3-1 內部行銷的定義…………………………………………………………21
    表2-3-2 文獻探討之整理…………………………………………………………26
    表3-2-1 本研究採用之量表………………………………………………………31
    表3-2-2 情緒勞務量表之信度係數………………………………………………32
    表3-2-3 自我監控量表之信度係數………………………………………………32
    表3-2-4 內部行銷量表之信度係數………………………………………………34
    表3-2-5 顧客導向行為量表之信度係……………………………………………36
    表4-1-1 樣本資料次數分配………………………………………………………45
    表4-1-2 各研究變項之描述性統計量表…………………………………………47
    表4-2-1 不同個人屬性在情緒勞務上之差異……………………………………48
    表4-2-2 不同個人屬性在病患為主之顧客導向行為上之差異…………………50
    表4-2-3 不同個人屬性在任務為主之顧客導向行為上之差異…………………51
    表4-2-4 機構在各變項上之差異分析……………………………………………52
    表4-3-1 情緒勞務負荷與顧客導向行為各構面相關分析摘要表………………36
    表4-4-1 情緒勞務負荷對顧客導向行為之複迴歸分析表………………………54
    表4-5-1 自我監控對情緒勞務負荷與顧客導向行為之層級迴歸分析…………57
    表4-5-1 自我監控對情緒勞務負荷與顧客導向行為之層級迴歸分析表………58
    表5-1-1 研究假設驗證結果彙整表………………………………………………59
    圖目錄
    圖1-4-1 研究流程……………………………………………………………………6
    圖2-1-1 工作中會影響情緒表達的因素…………………………………………12
    圖2-2-1 自我監控對情緒失調與工作滿足、組織承諾的干擾影響……………26
    圖3-1-1 研究架構…………………………………………………………………27
    圖3-2-1 修正後研究架構…………………………………………………………37
    圖4-5-1 自我監控與情緒勞務負荷的交互作用對顧客導向行為之影響………57
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    賦權empowerm​ent、工作疲潰 job burnout Herbert J . F reud en berger 1974

    mobility capability



    應用職能分析模式探討急診室護理人員的工作特性及獎酬制度



    Using Hierarchical Cluster Analysis to Investigate Nursing Staffs Job

    Characteristics and to Establish Incentive System


    護理人員、KSAO、群集分析法、德菲法;



    Nursing staff、KSAO、Clustering、Delphi method;

    In this study, use Catano scholars KSAO model to construction nursing staff job characteristics of the questionnaires, then use cluster analysis of the "average linkage method". All nursing staff in accordance with the characteristics of different to distribution their respective cluster. After use of Delphi method, for different clusters and different incentive system to inspire the work of nursing staff more output. End of questionnaire recovery, 54 the number of valid samples in accordance with the "average linkage method", will be divided into two clusters, the cluster I have 45 people and cluster 2 of 9 people. Then in accordance with the characteristics of these two clusters will be named. Cluster I is “deep qualifications, enough experience” and Cluster 2 is “young, highly educated”. According to Delphi method, four experts interviewed, according to these two different characteristics of the cluster, to develop a different incentive system. Incentive system of Cluster I “deep qualifications, enough experience” is job satisfaction, and Incentive system of Cluster 2 young, highly educated is Education and training.
    本研究利用了學者Catano所提出的KSAO模型去建構出護理人員的工作職能問卷後,再利用群集分析法(clustering method)中的「平均連鎖法」,依照各個護理人員不同的特質歸納出其所屬的集群,之後再利用德菲法,針對不同的集群而給予不同的獎酬制度,以激勵護理人員有更多的工作產出。  本研究利用了學者Catano所提出的KSAO模型去建構出護理人員的工作職能問卷後,再利用群集分析法(clustering method)中的「平均連鎖法」,依照各個護理人員不同的特質歸納出其所屬的集群,之後再利用德菲法,針對不同的集群而給予不同的獎酬制度,以激勵護理人員有更多的工作產出。  在回收完問卷之後,將54份有效的樣本數根據「平均連鎖法」,將其分為二個群集,而群集一有45人,群集二有9人。之後便依照這二個群集的特性,將其命名。群集一為『資歷深、經驗足』,而群集二為『年紀輕、學歷高』。  依據德菲法,訪談了4位專家,並依據這二個群集不同的特性,來制定不同的獎酬制度。群集一『資歷深、經驗足』的獎酬制度為工作滿足感,而群集二『年紀輕、學歷高』的獎酬制度則為教育訓練。





    http://ehis.ebscohost.com/eds/results?sid=f7ad6a7b-760b-42f2-b06f-fffc23256ca9%40sessionmgr114&vid=8&hid=121&bquery=(job+AND+involvement)&bdata=JnR5cGU9MCZzaXRlPWVkcy1saXZl

    http://www.lib.ntu.edu.tw/

    http://www.rdrb.utoronto.ca/browse.php?type=source&source=International+Journal+of+Nursing+Education+Scholarship

    Eysenck personality questionnaire . EPQ 艾克森人格問卷

    Maslach burnout inventory-general survey,MBI-GS 馬氏工作倦怠量表
    http://www.mendeley.com/research/maslach-burnout-inventory/

    http://www.mendeley.com/research-papers/?rec=validation-maslach-burnout-inventorygeneral-survey-internet-study-occupations-5

    http://www.sciencedirect.com/science/article/pii/019188699290073X


    http://www.tandfonline.com/doi/abs/10.1080/026783799296039

    http://en.pdfsb.com/maslach+burnout+inventory?p=3

    American Association of College and Universities (2011). Making Excellence Inclusive. http://www.aacu.org/compass/inclusive_excellence.cfm








    American Association of College of Nursing. (2010). Fact Sheet: Enhancing Diversity in the Nursing Workforce. http://www.aacn.nche.edu/media/pdf/diversityFS.pdf








    Title: Using Professional Specialty Competencies to Guide Course Development. By: Foss, Gwendolyn F., Janken, Janice K., Langford, David R., Journal of Nursing Education, 01484834, August 2004, Vol. 43, Issue 8.


    Database: OmniFile Full Text Select (H.W. Wilson).

    HTML Full TextUsing Professional Specialty Competencies to Guide Course Development

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    AUTHOR: Foss, Gwendolyn F.; Janken, Janice K.; Langford, David R.

    TITLE: Using Professional Specialty Competencies to Guide Course Development

    SOURCE: Journal of Nursing Education 43 no8 368-75 Ag 2004



    The magazine publisher is the copyright holder of this article and it is reproduced with permission. Further reproduction of this article in violation of the copyright is prohibited.



    Gwendolyn F. Foss, Janice K. Janken, David R. Langford and Margaret M. Patton





    ABSTRACT

    This article describes how an RN-to-BSN community health nursing (CHN) course was reconceptualized from a traditional model to a competency-based model. The traditional course assigned students to CHN preceptors and required a set number of clinical contact hours. As clinical preceptor placement opportunities diminished, students and faculty became increasingly dissatisfied with the course structure and requirements. Faculty endorsed the use of professional competencies to measure course learning outcomes and selected competencies identified by the Association of Community Health Nursing Educators. These competencies were clustered into units, with learning activities and grading criteria based on the critical knowledge, values, and clinical skills needed to demonstrate mastery of specific competencies. Course faculty, rather than agency preceptors, assessed student learning outcomes and mastery of competencies. The students demonstrated mastery of competencies and liked the degree of self-directed learning that built on their professional status as RNs.

    The unique challenges of educating RNs who pursue baccalaureate degrees are well known. Most RN-to-BSN students are employed and work rotating shifts. Such students have been successful in the work environment where they gain useful clinical knowledge and, thus, have little patience with coursework that seems redundant with what they already know. Faculty at the University of North Carolina at Charlotte, School of Nursing found it increasingly challenging to find traditional, pedagogically sound ways for RN-to-BSN students to use their prior professional knowledge as building blocks for new learning, without wasting time on superfluous assignments.

    Competency-based learning is a method of education that allows for flexibility, reduction of duplicity, and building on previous knowledge (Knowles, 1975, 1980). Burz and Marshall (1997) used the term "performance-based education" to refer to the process of teaching students to be accountable for their learning and to apply it in measurable and observable ways. Tanner (2001) defined competency-based nursing education as that which emphasizes individualized teaching-learning processes and flexible ways of achieving knowledge and performance outcomes.

    To clarify the concept of competency-based learning, the National Postsecondary Education Cooperative (NPEC) (2002) convened a group of experts in competency-based, postsecondary education to synthesize knowledge and develop a guide for college educators interested in implementing competency-based learning. This group defined competency as the blend of skills, abilities, and knowledge needed to perform a specific task. In addition, it conceptualized competency-based learning as a four-level pyramid. At the base are those characteristics and traits innate to individuals that help explain differences in learning styles and learning achievements. At the next level are the skills, abilities, and knowledge that are learned, whether through formal education or work and life experiences. Competencies are the third level and result from being able to merge knowledge, skills, and abilities into useful tasks. At the peak of the pyramid is assessment of the competency through demonstration. Thus, competency-based education is aimed at defining, teaching, and assessing competencies.

    Some critics of competency-based education are concerned that it is overly reductionistic and results in teaching to the task, rather than developing critical thinking (Tanner, 2001). However, advocates identify its focus on outcome behaviors that can be clearly articulated to students and future employers, its flexibility in shaping learning experiences, and its ability to match skill development in education with those needed in the work force as strengths (Evers, Rush, & Berdrow, 1998; Halstead, Rains, Boland, & May, 1996; Knowles, 1980; NPEC, 2002) Alice Voorhees (2001) noted that professional programs enjoy a natural connection with competency-based education because of the clear relationship between student performance and work force expectations.

    Competency-based learning is not new to nursing. In fact, del Bueno was an early proponent (del Bueno, 1978; del Bueno, Barker, & Christmyer, 1981). However, recent developments in higher education, the workplace in general, and health care more specifically have made the adoption of competency-based education more appealing. Richard Voorhees (2001) observed that a revolution is occurring in which the labor market progressively, holds postsecondary institutions more accountable for demonstrating that students have learned the competencies needed in the workplace. O'Rourke (2003) based a theoretical model on the use of professional nursing competencies to show how employees successfully assume practitioner, scientist, and leadership roles in the work environment. Terkla (2001) asserted that demonstration of student learning outcomes will increasingly become linked with accreditation.

    More specific to nursing, the highly regarded Pew Health Professions Commission identified competencies required to health care professionals in the 21st century (O'Neil & Pew Health Professionals Commission, 1998) and, subsequently, offered additional guidance to encourage educators to conceptualize teaching in these terms (Long, 2003). Some educators have used professional competencies as a basis for clinical teaching. Kaiser and Rudolph (2003) used the American Nurses Association's community/public health nursing standards to develop a clinical performance tool, and Patterson, Crooks, and Lunyk-Child (2002) described how they revised their BScN program to follow the steps of self-directed or competency-based learning.

    This article describes how a community health nursing (CHN) course in an RN-to-BSN program was reconceptualized from a traditional model to a competency-based model, but the process is applicable to other clinical courses. The goals were to ensure faculty were preparing students for the unique needs of the CHN work force and to create a course with more flexibility and less redundancy for RN-to-BSN students.





    EVOLUTION FROM A TRADITIONAL TO A COMPETENCY-BASED MODEL





    IMPETUS FOR CHANGE

    Prior to becoming competency based, the CHN course for RN-to-BSN students was very traditional. Its philosophical basis conformed to the pervasive expectation that RN-to-BSN students need the same CHN course content, supervised clinical experiences, and clinical hour requirements as prelicensure students (Davidhizar & Vance, 1999; Marcus, Swint, Valadez, Ward, & Williams, 1986). The original course followed the standard practice of most RN-to-BSN programs that required preceptor-guided clinical experiences in traditional settings, such as health departments, home health agencies, occupational health, and health promotion centers for a set number of hours (Bittner & Anderson, 1998; Kalischuk & Thorpe, 2002; Rosenlieb, 1993).

    From the students' perspective, the time constraints imposed by the CHN course were viewed negatively. Most students worked full time, which made scheduling an educational clinical day into a Monday-through-Friday framework difficult. The students often voiced dissatisfaction with their clinical placements with preceptors, viewing them as redundant and irrelevant to their personal educational and career goals.

    The traditional approach to education became progressively less satisfactory for the faculty as well, although for different reasons. The question of whether or not students were learning essential content became bothersome. Students maintained journals and logs to provide evidence they were attaining course objectives. However, the typical pattern was that students listed activities they had completed and the time spent on each. Faculty realized that students probably were recording what they were doing but not what they were learning.

    A second faculty concern was the increasing difficulty of identifying a sufficient number of traditional CHN clinical sites for both the RN-to-BSN and prelicensure students. Funding for area public health programs declined every year. In an attempt to provide needed services, the local county government contracted with a hospital system to provide services that traditionally had been provided by health departments. The hospital system restructured the health department and closed or merged many community-based clinics with other hospital services. Community health nurses who had worked as preceptors for the university were no longer assigned to traditional CHN roles. At the same time, local home health agencies experienced decreased Medicare funding and increased their productivity expectations of nurses. Facing declining resources, agencies became reluctant to provide support for preceptors. As a consequence of this widespread restructuring and shrinking numbers of community health facilities, finding suitable clinical placements for RN-to-BSN students became increasingly difficult.

    A final issue concerned the growing administrative responsibilities placed on course faculty. Each time the CHN course was offered, faculty had to locate appropriate preceptors, generate individual contracts for each preceptor and student, and orient preceptors to their responsibilities. In addition, when new clinical sites were used, the university required an institutional contract. Faculty began to feel they were spending more time on administrative tasks than on teaching. Given these concerns, CHN faculty decided to explore alternative ways of providing clinical learning experiences for RN-to-BSN students.





    QUEST FOR A NEW MODEL

    The process of change began with informal discussions among faculty about educational philosophies. Ideas and assumptions about the purpose of the CHN clinical experiences and the relative roles of learners, teachers, and preceptors were discussed at length. Faculty compared the purposes of clinical experiences for prelicensure and RN-to-BSN students. They discussed theories of adult learning (Knowles, 1980) and ways to apply theories that support performance-based education in a clinical course. The advantages and disadvantages of substituting competency-based clinical experiences for preceptor-guided experiences were debated. A central question was how to ensure the clinical experiences fostered appropriate learning and how this learning could be measured. During the conversations, faculty identified assumptions about RN-to-BSN education that they shared and that were also consistent with competency-based learning theories (Table 1).

    Throughout the discussions, the advantages and disadvantages of competency-based learning became clearer. The most attractive advantage was the flexibility it provided students to learn and apply CHN concepts. Since the focus would be on outcome, rather than process, the students could practice at times convenient for them and develop their skills in settings other than traditional community health agencies. Nonetheless, a lingering concern was that students may not have enough hours or clinical experiences in CHN.

    Conveniently, these discussions occurred at the same the Association of Community Health Nursing Educators (ACHNE) was revising and updating a document that identified core competencies for community and public health nursing practice (ACHNE, 2000). Looking at the proposed competencies made it easier to visualize how the clinical component of a CHN course could be transformed to competency-based learning.





    IDENTIFYING AND SELECTING COMPETENCIES

    When faculty begins the design of competency-based education, the initial hurdle is to articulate and reach consensus on the competencies required for success in the work force (Jones, 2001). Fortunately, within nursing, numerous groups of professional experts have been convened to identify requisite competencies (Quad Council Public Health Nursing Organizations, 2003; Tanner, 2001; U.S. Department of Health and Human Services, Public Health Service, 1997). Jones (2001) encouraged using competencies identified by professional groups in curriculum development because they reflect the best thinking in the field and demonstrate clear links between education and success in the work force. O'Rourke (2003) built on these links to demonstrate workplace role development.

    The competencies identified by the ACHNE (2000) were part of a document designed to describe the essential elements of entry-level CHN practice that can and should be expected as outcomes of baccalaureate education. The document identifies five professional values core to CHN: Health promotion, prevention of illness and injury, partnership, respect for the environment and respect for diversity. In addition, it names 12 areas of core knowledge, each accompanied by specific competencies that could be demonstrated. For example, the core knowledge area of epidemiology and biostatistics is tied to the following competencies:

    * Interpret basic epidemiological measures and aggregate-level data.

    * Link the natural history of disease model, levels of prevention, and the epidemiological triangle with appropriate interventions.

    * Interpret probability, proportion, and measures of risk.

    * Interpret and apply population-based research to practice.

    The faculty judged the ACHNE (2000) document to be compatible with its emerging reconceptualization of the CHN course. The document not only identified competencies but connected them with knowledge requirements. In addition, the document was developed in a manner consistent with the best practices of competency-based education. According to the NPEC (2002), a principle of competency development is to include in the deliberations key stakeholders, such as policymakers and employers. The ACHNE used documents from the American Nurses Association, Council of Community Health Nurses (1986), the Quad Council of Public Health Nursing Organizations (1999), the American Association of Colleges of Nursing (1998), and the Pew Health Professions Commission (O'Neil & Pew Health Professions Commission, 1998) to identify essentials of generalist baccalaureate nursing education and entry-level CHN practice. Furthermore, nurses from education and practice from different regions of the United States provided critique and input to the final document (Kaiser, Carter, O'Hare, & Callister, 2002).

    After extensive discussion of how the ACHNE (2000) competencies would facilitate transformation to self-directed learning by Rn-to-BSN students, the CHN faculty agreed to adopt the ACHNE document as a framework, and redesign the course to make the clinical component competency based. The didactic component would be directed at critical knowledge and values students need to develop the competencies. Faculty would no longer control all clinical learning experiences, but instead would facilitate and guide the RN-to-BSN students in the application of CHN values and knowledge to practice.





    CONNECTING COMPETENCIES TO LEARNING PROCESSES AND ASSESSMENT

    The next step for the faculty in transforming the course was to connect the ACHNE competencies with learning processes and determine how to measure competency attainment. However, before proceeding, it was essential to seek support from the RN-to-BSN program director and other faculty colleagues who taught other courses in the program. As anticipated, these individuals voiced questions and concerns similar to those already discussed and debated by the CHN faculty. Four points seemed particularly persuasive to colleagues and administrators:

    * The clinical experiences clearly centered on development of knowledge and values that undergird professional practice and evidence-based, standards-related practice.

    * Proposed learning experiences would be based on sound adult learning principles.

    * Learning experiences would acknowledge the past experiences and education of RN-to-BSN students, rather than assuming they have the same learning needs to prelicensure students.

    * Faculty time normally spent locating and orienting preceptors and generating contracts could be redirected to teaching and scholarly pursuits.

    After support from these colleagues was obtained, CHN faculty began course redesign. The challenge became connecting the ACHNE competencies, course teaching and learning strategies, and competency assessment criteria into a unified whole. To accomplish this, the entire list of ACHNE competencies was reviewed. Some competencies were omitted from this CHN course because they were part of other courses in the program. For example, all RN-to-BSN students took courses specifically aimed at learning skills associated with nursing informatics and technology, and nursing management. Consequently, ACHNE competencies related to core knowledge and value development associated with "information and healthcare technology" and "coordinator and manager" were assigned to those courses.

    Jones (2001) advised faculty who are linking competencies with learning experiences to consider where in the curriculum students will learn important skills such as writing, teamwork, public speaking, and critical thinking. At this university, and students are required to take a writing-intensive course in their major. The CHN course meets this graduation criterion for undergraduate students enrolled in nursing. Thus, the writing-intensive requirement needed to be considered when the course was reconfigured into competency units.

    To organize faculty thinking, grids were constructed to cluster ACHNE competencies and align them with teaching-learning strategies and a method for measuring whether the competencies had been attained. This endeavor resulted in seven learning units. Six units included clinical competency-based assignments. The first unit introduces the foundations of community/public health nursing and, thus, is not specifically linked with any competencies. Table 2 depicts the six clinical learning units aligned with the competencies addressed in the revised CHN course.

    The critical components of each unit included:

    * Explanation and analysis of the specific knowledge and CHN values that inform the clinical activity.

    * Articulation and explanation of the specific skill-building clinical activities that must be completed to meet the competency.

    * Description of the specific items that validate the students' mastery of the skills and knowledge for each competency.

    Table 3 shows how selected competencies for the community-as-client unit were attained and validated by faculty. Faculty conceptualized environmental health knowledge as an essential component of any community assessment, so it was included here.

    As faculty developed the competency units, embedded ideas of traditional clinical learning experiences gave way to conceptualizations of population-based practice and learning that could be accomplished with populations in any setting. Faculty agreed that students could meet some of the competencies in their employment setting or other community agencies. They assumed students would have knowledge of and access to resources in the community in which they could develop such skills. Faculty expected to regularly consult with students to ensure selected experiences would be appropriate.





    IMPLEMENTATION

    The revised competency-based course was initially offered to a summer cohort of RN-to-BSN students in their last semester of the program. Thus cohort had no previous experience with competency-based learning. The assignments were presented in writing to the students and were discussed verbally with the entire class. The instructor focused on how the specific competency assignments recognized their status as licensed RNs, thus giving them a measure of freedom in fulfilling the requirements of the ACHNE competencies. Due dates for completion of the required assignments were left open to provide maximum flexibility and independence for the students throughout the 10-week summer session.





    STUDENT REACTIONS

    Although the students were already licensed RNs, they initially embraced the traditional role of students as passive recipients of information. The students requested that all assignments and course requirements be so clearly defined that there was no latitude for interpretation that would or could lead to an assignment not being completed to the instructor's specifications and receiving a lower grade. Zuzelo (2001) identified similar characteristics of RN-to-BSN students and postulated that these attitudes are possibly coping mechanisms used to help them manage their anxieties about completing school and juggling work, family, and school roles.

    Many of the students experienced difficulty locating clinical experiences in their communities. This was especially true for students who had no work or volunteer experiences with any community agencies. Students who had participated in community activities in their work setting were more successful in identifying community health resources. Identifying appropriate experiences in the work setting was easier for the family and transcultural nursing competencies.





    FACULTY RESPONSE

    Based on the experiences of the first class of students who implemented has competency-based approach to CHN, most faculty assumptions were validated. Validated assumptions included:

    * Clinical learning in CHN was not equated with a predetermined number of clinical hours.

    * The population-focused nature of the discipline did foster flexibility in learning.

    * The degree to which students mastered clinical competencies, with corresponding values and knowledge, could be assessed.

    * Students liked the self-directed nature of learning, which recognized their status as licensed RNs.

    Although surprising, the finding that RN-to-BSN students were less confident and competent to locate community health experiences was consistent with the literature (Nickel et al., 1995).

    When the course was offered a second time, the Quad Council of Public Health Nursing Organizations (1999) and the ACHNE competencies were discussed to a greater degree. Acceptable types of clinical experiences that would demonstrate specific competencies were discussed, and students were referred to appropriate community resources as needed. Structure was added to the course by clearly stating due dates for each competency activity. Students verbalized more comfort with this increased structure and located appropriate clinical learning experiences with few problems.

    The university's decision to offer a completely online option or the entire RN-to-BSN program, including the CHN course, coincided with the revision of the course after its initial offering. The same group of CHN faculty met regularly to modify the competency units into an interactive online format. The revised course was designed so similar versions could be offered in both classroom and online formats.





    EVALUATION

    Faculty found that the assignments provided ample evidence of the degree to which students mastered the required competencies. The Assessment of Competencies section in Table 3 includes most of the required reports for the community-as-client unit. These assignments demonstrate how students provided evidence that they had mastered the skills of a community assessment and used core knowledge and values to discuss and explain their activities. Assignment of grades, based on the completeness and quality of papers and reports of clinical activities, was no less or more demanding than in a traditional course.

    Student responses to the revised course have been enthusiastic. They particularly like the degree of self-directed learning that builds on their professional status as RNs. The synthesis of core knowledge and values with required skill development was identified as a strength. Several students stated that their perspectives of patients or families had broadened dramatically. They now understand how a patient in the hospital is part of a community and a population. Other students stated that participating in the required learning activities for the course resulted in awareness of the independent nature of nursing and how community health nurses possess the knowledge and skills to improve the health of specific communities and populations. Such comments contrast sharply with previous student comments that a CHN course was a "waste of time."





    DISCUSSION

    When transforming a CHN course from a traditional to a competency-based model, several issues need to be addressed by faculty. A major concern of CHN courses is to develop population-focused knowledge, values, and skills. At-risk populations exist in all practice environments. The challenge for CHN educators is to facilitate a transformation of thinking in RN-to-BSN students so they can reconceptualize patients from merely individuals in need of nursing care, to individuals who are members of groups, influenced by the environment, who need population-level interventions. While preceptors can offer assurances that students receive population-focused clinical experiences (Bittner & Anderson, 1998; Davidhizar & Vance, 1999), it is more difficult for them to ensure quality experiences if they are overwhelmed with agency responsibilities. By using a self-directed learning approach that measures outcomes of knowledge, values, and skills for specific competencies, students are able to learn and apply population-focused nursing care in a manner that strengthens their critical thinking abilities.

    A related issue is the appropriateness of clinical experiences for specific competencies. Student responses to the first course offering made it clear they needed more specific guidelines for clinical experiences than faculty expected. When criteria for selecting the clinical experiences were clearly stated, students identified opportunities in agencies or at work that they had not previously considered to be "nursing" roles. For example, many students already volunteered in schools or with organizations such as scouting or boys and girls clubs. When they provided health education or health screening for targeted populations, the students suddenly realized what "population-focused nursing" actually meant. Faculty need to be prepared to coach and guide students in locating and using community resources to develop population-focused nursing skills.

    An educational concern is recognition of student progress or failure, without direct validation from a preceptor. When the clusters of competencies that formed each unit were constructed so students had to synthesize requisite core knowledge, values, and skills to demonstrate mastery of the competency, the reports were sufficiently detailed so instructors could readily identify whether the students had both completed the required activities and engaged in the critical thinking process of synthesizing and analyzing the core knowledge and values supporting mastery of the clinical skill and, thus, the competency. Variations in the quality of student work were found, and the grades reflected those variations. Student reports included information such as agency addresses and names of contact individuals, which could be verified by the instructor if questions arose about actual completion of activities.





    SUMMARY

    The nursing work force expects new graduates to demonstrate the competencies of the profession (NPEC, 2002; O'Neil & Pew Health Professions Commission, 1998; Quad Council of Public Health Nursing, 2003; A. Voorhees, 2001). RN-to-BSN students can and do learn essential knowledge and skills in a variety of settings and are able to demonstrate competency in clinical nursing. Competency-based learning allows them to build on their previous learning in a self-directed manner that fosters evidence-based thinking. The transformational power of such a course is summarized by one student who stated at the end of the revised course: "My thinking about nursing has changed from waiting to be told what to do, to thinking about what needs to done and then doing it."

    ADDED MATERIAL

    Gwendolyn F. Foss, DNSc; Janice K. Janken, PhD; David R. Landford, DNSc; and Margaret M. Patton, MSN, MSEd

    Dr. Foss, Dr. Janken, and Dr. Langford are Associate Professors, and Ms. Patton is Lecturer, Department of Family and Community Nursing, School of Nursing, College of Health and Human Services, University of North Carolina at Charlotte, Charlotte, North Carolina.

    Address correspondence to Gwendolyn F. Foss, DNSc, Associate Professor, Department of Family and Community Nursing, School of Nursing, College of Health and Human Services, University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC 28223-0001; e-mail: gffoss@email.uncc.edu.

    TABLE 2 Organization of Community Health Nursing Course by the Association of Community Health Nursing Educators (ACHNE) Competencies (2000)





    Learning Module Applicable ACHNE Competencies



    Community * Interpret basic epidemiological measures, such as morbidity and mortality and incidence and



    prevalence rates.



    Assessment and * Link the natural history of health problems with levels of prevention and appropriate



    interventions.



    Intervention * Interpret and apply population-based research to practice.



    * Demonstrate skill in the use of methods for assessing health risks of individuals, families, and



    communities.



    * Plan and implement multilevel approaches for health promotion and disease prevention.



    * Conduct a community, workplace, and home environmental assessment.



    * Identify and access environmental health information sources.



    * Link environmental exposure to illness/disease.



    * Make referrals to appropriate environmental health resources in the community.



    * Assess the health needs and assets of communities and populations.



    * Use knowledge of disease transmission, health policy, and primary health care in planning for



    population



    health interventions.



    Elected Body Report * Work as an advocate for community health.



    and Letter to Member of * Influence health-related legislation at the local, state, and national levels.



    Policy-Making Body * Interpret the effects of the economic and political environments and population growth on global



    health.



    * Use ethical problem-solving strategies to address ethical problems.



    Transcultural * Assess client definitions of health and culture.



    Communication * Demonstrate skill in the use of methods for assessing health risks of individuals, families, and



    communities.



    * Deliver nursing and health care within the context of the global environment.



    * Complete a cultural assessment at the individual, family, and community levels.



    * Use the results of a cultural assessment to plan and implement culturally sensitive interventions.



    Family Nursing * Demonstrate skill in the use of methods for assessing health risks of individuals, families, and



    communities.



    * Assess and monitor the health status of individuals and families.



    * Integrate knowledge of appropriate developmental and other theories into health planning and



    interventions.



    * Plan and implement appropriate interventions.



    Health Screening * Demonstrate skill in the use of methods for assessing health risks of individuals, families, and



    communities.



    * Develop an assessment plan in collaboration with community partners.



    * Assist in the data collection process.



    * Interpret basic community data.



    * Use community assessment data in the development of appropriate interventions.



    * Participate with other community activists in planning, implementing, and evaluating health



    interventions.



    * Document appropriately in ethically challenging situations.



    * Interpret probability, proportion, and measures of risk.



    Health Education * Initiate community partnerships for goal setting and development of interventions.



    * Inform and educate the public about health issues.



    * Adhere to professional standards of community health practice.



    * Identify appropriate participants in a community project.REFERENCES

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    TABLE 1 FACULTY ASSUMPTIONS ABOUT RN-TO-BSN EDUCATION THAT ARE CONSISTENT WITH COMPETENCY-BASED EDUCATION

    * RN-to-BSN students are adult learners and, as such, are self-directed.

    * Clinical expectations based on broad, population-focused practice are flexible and foster participatory self-directed learning.

    * RN-to-BSN students have completed programs in nursing and have been exposed to have values and knowledge base of nursing.

    * Community health nursing learning experiences must be grounded in the values and core knowledge of the discipline.

    * Clinical learning is not a function of a predesignated number of hours in a clinical agency.

    * The community health nursing course needs to recognize and build on RN-to_BSN students' expertise in their areas of practice.

    * RN-to-BSN students know their communities and can use that knowledge to identify potential population-focused clinical experiences.

    * Students in the program will welcome recognition of their status as RNs.





    TABLE 3 SAMPLE OF ASSOCIATION OF COMMUNITY HEALTH NURSING EDUCATORS (ACHNE) COMPETENCIES (2000), WITH PARTIAL DESCRIPTION OF CONTENT, SKILLS, AND ASSESSMENT FOR THE COMMUNITY-AS-CLIENT UNIT





    ACHNE (2000) COMPETENCIES

    * Interpret basic epidemiological measures, such as morbidity and mortality and incidence and prevalence rates.

    * Link the natural history of health problems with levels of prevention and appropriate interventions.

    * Interpret and apply population-based research to practice.

    * Demonstrate skill in the use of methods for assessing health risks of individuals, families, and communities.

    * Plan and implement multilevel approaches for health promotion and disease prevention.

    * Conduct a community, workplace, and home environmental assessment.

    * Identify and access environmental health information sources.

    * Link environmental exposure to illness/disease.

    * Make referrals to appropriate environmental health resources in the community.

    * Assess the health needs and assets of communities and populations.

    * Use knowledge of disease transmission, health policy, and primary health care in planning for population health interventions.





    THEORETICAL CONTENT: COMMUNITY-AS-CLIENT UNIT

    * Theoretical approach to community and population care.

    * Epidemiology.

    * Natural history of disease.

    * Levels of prevention.

    * Healthy cities.

    * Community and home environment assessment.

    * Environmental influences on health.

    * Community-level data sources and data collection strategies.

    * Government policy and regulation.





    CLINICAL ACTIVITIES

    Conduct community assessment:

    * Choose geographical community.

    * Conduct windshield assessment.

    * Perform analyses of secondary data relevant to community's health, available from sources such as the U.S. Census Bureau, the Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Reports, chambers of commerce, health departments, and newspapers.

    * Find out how the community rates environmentally by going to http://www.scorecard.org/.





    ASSESSMENT OF COMPETENCY

    Submit a paper that will be evaluated on the following:

    * A community assessment is provided addressing the eight subsystems of the Community-as-Partner Model. (20 points)

    * Sources of data for the assessment are identified and referenced. (5 points)

    * Windshield survey results are attached as an appendix. (10 points)

    * Assessment data are summarized in a description of the community's strengths and weaknesses. (10 points)

    * The community is used as the unit of analysis; the priority nursing diagnosis if identified; and the response (problem), what the problem is related to (cause), and how the problem is manifested (cues from the assessment data) are stated. (10 points)

    * A logical intervention is recommended for the nursing diagnosis, along with a statement of the desired outcome or goal for the intervention, and a statement on how the effectiveness of the intervention will be evaluated. (10 points)

    * A minimum of six scholarly references from the literature on the topic of the priority nursing diagnosis and proposed intervention are included in the reference list and cited in the text of the paper. (10 points)

    * The paper conforms to the Publication Manual of the American Psychological Association format, with appropriate grammar and style used. (10 points)









    --------------------------------------------------------------------------------



    Source: Journal of Nursing Education, August 2004, Vol. 43 Issue 8, p368, 8p

    Item: 507924357

    .


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    工作倦怠量表MBI-GS


    2005年12月3日

    工作倦怠方面最權威、最常用的量表——MBI-GS(Maslach Burnout Inventory-General Survey)。2002年,李超平獲得該問卷開發者Michael Leiter教授的授權,在國內修訂MBI-GS。結果表明:該量表在國內具有較好的信度和效度。



    該量表包括三部分:情緒衰竭(Emotional Exhaustion)、玩世不恭(Cynicism)和成就感低落(Reduced Personal Accomplishment)。情緒衰竭分量表包括5道題,玩世不恭分量表包括5道題,成就感低落分量表包括6道題,整個問卷共16道題。

    該量表採用利克特7分等級量表,0代表“從不”,6代表“非常頻繁”。

    整個量表的修訂過程如下:

    1、先由4名專家獨立將問卷翻譯成中文,再通過討論確定中文稿。然後,請6名來自不同企業不同文化程度的企業員工實際填寫了問卷,在問卷填寫完之後對他(她)進行了訪談,並根據訪談結果對部分文字表述進行了修改,形成了MBI-GS中文版初稿。之後,邀請兩名學英文專業的專家通過討論將中文的問卷回譯成英文。最後,將回譯的英文稿寄給了MBI-GS的主要開發者之一Michael Leiter,讓其對回譯的問卷和原來的問捲進行了比較,並根據Michael的意見對翻譯的問捲進行了部分調整,確定了最後的中文問卷。

    2、由於工作倦怠量表在國內是第一次使用,所以我們先在3家企業對工作倦怠量表進行了預試。預試發放問卷340份,收回問卷303卷份,有效問卷294份。

    3、對MBI-GS的16個項目進行了探索性因素分析,採用主成分法抽取因數,正交轉軸,發現“玩世不恭”有一個專案的交叉負荷較高。刪除該項目之後,重新進行了因素分析,得到了非常理想的結果。調整後的MBI-GS(刪除了其中的第13道題)與原來的MBI-GS結構完全一致,表明MBI-GS在中國具有較好的構想效度。

    4、情緒衰竭,玩世不恭和成就感低落三個維度的內部一致性係數分別為:0.88,0.83及0.82。

    5、此後,我們在很多研究中進一步對MBI-GS的構想效度和信度進行了檢驗,都得到了比較理想的結果。

    6、國內部分學者在他們的研究中採用了MBI-GS,同時對MBI-GS的信度與效度進行了檢驗,也都得到了比較理想的結果。

    7、所有這些研究結果都表明,我們修改訂後的工作倦怠量表MBI-GS在國內具有較好的信度和效度。

    出處(可下載全文)

    1、李超平、時勘,分配公平與程式公平對工作倦怠的影響,心理學報,2003年第5期,677-684

    由於版權原因,我們無法在網上公開該問卷。如果大家希望在研究中採用該問卷,請與中國人民大學公共管理學院組織與人力資源研究所李超平聯繫,email: lichaoping#mparuc.edu.cn(發送郵件時,請將#改為@)。


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    分配公平與程序公平對工作倦怠的影響


    李超平,時勘

    中國科學院心理研究所社會經濟與心理行為研究中心,北京 100101






    Lester, 1990D. Lester


    Maslow's hierarchy of needs and personality

    Personality and Individual Differences, 11 (1990), pp. 1187–1188



    Article
    PDF (196 K)
    View Record in Scopus
    Cited By in Scopus (5)




    ID 1614683


    Subject/Title 疲憊的概念分析

    Alternative Title Concept Analysis of Fatigue

    Author 李碧娥(Bih-O Lee);林秋菊(Chiu-Chu Lin)

    Journal Title 長庚護理

    Parallel Title Chang Gung Nursing

    Vol./Publishing Date Vol.13 No.4 (2002/12)

    Page(s) 339-344

    Language Chinese

    Abstract 疲憊是一個主觀且不愉快的感覺,臨床上護理人員因而不易發現個案有疲憊的現象,有時甚至將之與其他概念相混淆。本文主要目的乃籍由概念分析的方法,以澄清與分析「疲憊」之概念。採Walker與Avant(1995)的概念分析步驟進行,希望藉此概念分析步驟,使護理人員對疲憊有更深一層的認識,並可做爲日後發展理論架構及當作研究的基礎。

    Fatigue is a subjective and unpleasant feeling that is often unrecognized by clinical nurses, and sometimes easily confused with other concepts. The purpose of this report was to conduct a concept analysis to clarify and define fatigue and its components. The analysis was based on the steps and techniques proposed by Walker and Avant (1995). Results will help nurses to better understand and assess fatigue in their patients, and provide a basis for theory development and research.



    Keyword(s) 疲憊,概念分析;fatigue,concept analysis

    CEPS Category Subject Catagory>Medical & Life Science>Public Health



    臨床護理輔導員制度對新進護理人員輔導成效之探討


    Effectiveness of a clinical preceptor program for new staff nurses

    中文摘要

    傳統新進護理人員訓練被認為是造成新進護理人員流動、現實休克及人員不滿的

    重要原因,本研究擬推行系統化的臨床護理輔導員制度以改善應屆畢業新進護理

    人員的適應問題。研究目的主要探討接受臨床護理輔導員制度之新進護理人員在

    護理能力、專業社會化及工作滿意度方面與接受傳統訓練者有何不同,以及護理

    人員及臨床護理輔導員之基本屬性對新進護理人員在護理能力、專業社會化及工

    作滿意度之影響。

    本研究以類實驗研究法進行,以隨機方法將十個性質相近內外科病房分為實驗組

    及對照組。於實驗組病房中依標準選定2 至3 位臨床護理輔導員並加以輔導員課

    程訓練。依單位需要及新進人員工作志願分派新進護理人員。實驗組單位新進護

    理人員接受臨床護理輔導員為期三個月之臨床輔導,對照組單位之新進護理人員

    則接受傳統新進護理人員訓練。參與研究之護理人員及護理長分別於初到職、到

    職1.5 個月及到職三個月時評價護理能力,護理人員同時施測專業社會化,至到

    職第三個月時加測工作滿意度。收案期間為88 年6 月至12 月止,共收案實驗組

    10 位,對照組15 位。

    結果發現接受臨床護理輔導員制度輔導的護理人員在護理能力總得分、人際關係

    /溝通及專業發展方面在訓練期間持續顯著增加,對照組之護理能力只有在初到

    職時顯著高於到職1.5 個月時。在專業社會化及工作滿意度方面兩組間並無顯著

    差異。臨床護理輔導員之工作年資與實驗組之病患照護及計劃/評值能力有顯著

    之正相關。接受專科畢業臨床護理輔導員輔導者之教學/協調能力顯著高於其他

    人。

    接受輔導之護理人員、臨床護理輔導員及實驗組單位護理長,均認為此制度對新

    進護理人員之助益很大,應可在臨床實務中繼續推行,以助新進護理人員之適

    應,但應在臨床護理輔導員的選擇及訓練上再加強,使輔導效果更具成效。

    英文摘要

    The traditional orientation program may induce the turnover, reality shock and

    dissatisfaction of new nurses. This study was conducted to determine the effect of

    systematic preceptor program on improving the adaptation of new staff nurses. The

    purpose of this study was to differentiate nursing competency, professional

    socialization and job satisfaction between the new staff nurses who received the

    preceptor program and traditional orientation program. Another purpose was to

    explore the influence of the demographic variables of new staff nurses and preceptors

    on the nursing competency, professional socialization and job satisfaction of new staff

    nurses.

    The Qsuai-experimental design was used in this study. Ten medical-surgical wards

    were randomized into experimental group and control group. Two or three preceptors

    per ward were recruited to attend the preceptor training course in the experimental

    group. The new nurses were assigned into experimental or control group according to

    the requirement of each ward and the willingness of new nurses. The nurses in

    experimental group were trained by the preceptors for three months, while the nurses

    in the control group received the traditional orientation program. All the nurses and

    the head nurses of ten wards filled the nursing competency scale in three stages. The

    nurses also filled the professional socialization scale at the same time and finished the

    job satisfaction scale at 3 months after they got the job. The study period was from

    June to December, 1999. There were 10 samples in experimental group and 15

    samples in control group.

    Results of this study were as followed:

    1.The nurses received the preceptor training program whose total nursing competency

    score, interpersonal relationship/communication subscale score and professional

    development subscale score were increased continuously after working for 3 months.

    The nursing competency of control group nurses only increased during the first 1.5

    months.

    2.There were no difference on professional socialization and job satisfaction between

    experimental and control group.

    3.Scores of the patient care and planning/evaluation competency was positively

    related to the working years of preceptor in experimental group.

    4.Scores of teaching/collaboration competency of new nurses who were trained by

    preceptor who was graduated with junior college diploma was significant higher than

    others.

    All of the training nurses, preceptors and the head nurses of experimental group felt

    that the preceptor program was very helpful to new staff nurses. It is suitable to apply

    on clinical practice and to help the adaptation of new nurse. But the selection and

    training of preceptors should be enforced to make more efficient.
    勞權 護理教育失落的拼圖…

    【聯合報╱梁秀眉/護理指導老師(彰縣溪州)】 2012.02.12 02:10 am


    我是一個由學校指派到醫院,指導護專生實習的老師。看到聯合報報導「『工作不像讀書…』 護士燒炭自盡」的新聞,讓我十分痛心。

    該護士因在醫院「不適應」,自殘後離職,其後被安排在急診室擔任護佐助理員,工作半年後自殺。所謂的「不適應」,絕不能說是她個人的問題,我認為這是普遍的現象,在護理學界稱之為「現實休克」。

    根據護理師公會調查指出,新進護理人員三個月內的離職率為三成二,一年離職率高達五成八,南部地區到職三個月的離職率,更高達七成。很清楚反映了,當前護士所處的艱難勞動條件,不應僅視為個案。

    現在的醫院要求新手護士,上班一周就要上線,獨立照顧所有病人,一個護士照顧十幾床是常態。

    記得民國八十二年,我當臨床護士時,一個護士只照顧六至七個病人,試用期三個月,第一周只練習照顧一個病人,逐漸增加照顧人數。這讓新護士有合理的緩衝期,循序漸進的適應工作。

    有人把離職率高,歸因於她們是「草莓族」的描述,我認為是不當的。實際上,有些醫院的護理勞動條件,已逐漸惡化到慘不忍睹的狀況。部分醫院小夜班,一個護士要照顧廿七個病人,事情做不完延遲下班,連續超時工作,又沒有加班費。長期操勞、爆肝的生活,怎麼會不過勞,又怎麼會有好的照護醫療品質。

    看到這則新聞,身為護理教育工作者,感覺既慚愧又傷心。

    慚愧的是,專業其實是有兩隻腳,增加自己的專業知能是一隻腳;但另一隻,其實是我們要捍衛自己的勞動權益。否則,再高的學歷與護理能力,並不見得能讓我們得到應有的勞動條件保障。

    然而,勞動權益意識的啟蒙,卻是當前護理教育失落的一塊大拼圖。我們的學生就這麼死了,護理教育與勞動環境出了什麼問題?身為老師,我們怎麼能夠不慚愧心痛呢!

    傷心的是,看著遺書上還念念不忘負債壓力,寫著「對不起父母親,希望死後保險能償還貸款」,這是多麼沉痛的指控啊。眼看著就學貸款債務,與血汗醫院共構日益嚴重,多麼希望新內閣與社會大眾,能以此為鑑,改善護理勞動環境,不要再讓類似的慘事發生了!



    【2012/02/12 聯合報】



    行政院衛生署建議本土化護理人員留任策略模式
    受委託單位:中華民國護理師護士公會全國聯合會
    受委託時間:97516971225
          
    一、新進人員訓練與輔導構面  
    留任策略
    具體措施
    (一)建立新進人員訓練制度,使新人有所依據
    1.建立新進人員訓練制度。
    2.擬定新進人員訓練計畫。
    1)加強專業知識與技能之訓練。
    2)加強與醫療團隊溝通技巧。

    (二)採臨床輔導員制度,促進新進人員適應

    1.訂定臨床輔導員獎勵制度,例如輔導期間給予輔導津貼、列入升遷加分考量、輔導期間減少照顧病人數等。
    2.採一對一方式,新進人員排班與輔導員相同。
    3.規劃臨床輔導機制:一般安排三個月,臨床輔導一個月後,依新進人員適應狀況,逐步增加照顧病人數,但臨床輔導員仍繼續從旁輔導至能獨立照護病人為止。

    (三)護理主管定期與新進人員面談

    1.面談前準備:需先評估新進護理人員之工作表現,並利用查檢方式(checklists)了解新進人員對適應期的感覺、過渡期度過的過程。詢問、收集有關醫院吸引他們的地方在哪裡。
    2.面談內容:工作表現、目標達成情形、視需要讓新進護理人員瞭解醫院福利或相關政策,激勵表現佳的行為,以提升其留任意願。
    3.定期面談:原則上新進人員到職三個月內面談至少4次,面談時間可為:第一次面談安排在工作滿7日後,第二次安排在工作滿3-4週時。到職2-3個月內,每月至少1次。

    (四)辦理輔導員訓練,加強輔導員輔導能力
    1.界定輔導員角色:輔導員應為新進人員之照護者,扮演一位值得親近、信賴、具經驗之諮商者或指導者,是新進人員生涯中的鼓勵、教導、支持和指引者,使用範例與模式的教導者,成為共鳴者,提供誠實的回應者,以協助新進人員在專業中建立自信。
    2.界定輔導員遴選條件:應樂於指導、態度友善、有耐心、專科以上、至少年資滿一年、優良臨床能力與組織能力、溝通技巧、團隊關係好
    3.辦理或參與院際間之臨床輔導員訓練:訓練以2-3天為原則,課程包括機構及護理部宗旨理念及照護模式、醫院中護理人員專業成長與發展、輔導員的角色功能與特質、溝通技巧與同理心運用、如何設定教學目標、成人學習原則(教與學)、轉換跑道-從理想到現實-談現實休克、危機處理、如何幫助新進護理人員、輔導員的壓力調適、如何給予新進護理人員支持、新進護理人員學習之評價、如何終止帶領關係等。醫院舉辦臨床輔導員訓練時,開放給其他醫院參與,也建議地方公會定期辦理臨床輔導員訓練(共同課程)每年約1-2次。

    二、工作安排構面
    留任策略
    具體措施
    (一)各部門人員協調合作
    1.建立各職系分工合作機制,護理業務範圍明確化。
    1)由藥劑部科室提供特殊藥物調配,包括PCT試劑、化療藥品、全靜脈營養輸液等。
    2)營養師參與對營養不良高危險群及治療飲食病人之飲食指導。
    3)相關復健治療師共同參與病人復健之評估以及配合實施病人之床邊復健。
    4)由相關部門(工務、醫工)負責醫療儀器、各項設備與設施之定期保養與維護。
    5)由專門部門負責醫院環境管理。
    6)由專責單位或人員處理病人或家屬意見、抱怨及申訴案件。
    2.減少干擾或中斷護理人員之工作流程。
    (二)簡化工作內容
    1.醫院作業盡量採資訊化,以減少護理人員之文書工作負擔。
    2.建立標準化照護資訊,供護理人員查詢。
    (三)提供相關作業工具和手冊


    1.提供工作過程中所需的相關工具,例如添購或汰換電腦、護士工作車、發藥推車、集針器等。
    2.提供護理手冊。


    三、人力配置構面
    留任策略
    具體措施
    (一)安排護理人員至合適的單位
    依護理人員的個別性、性向、能力,分派至合適的單位。
    (二)合理之護理人力配置
    1.護理人力配置符合醫院評鑑標準,並視醫院業務提供合理之人力。
    2.合理之工作時數。
    3.臨時護理人員比率以不超過15%為原則。

    (三)依單位特性調整護理模式
    1.護理高階主管定時檢視醫院之護理照護系統:評估哪一種護理模式--主護護理模式還是採成組護理或個案管理模式會較佳?對護理人員的挫折會較少?對病患之照護品質會較好?
    2.視需要採混合照護模式(skill mix),建議在護理人員編制外增聘照顧服務員,協助護理人員執行非專業性工作。
    (四)採彈性排班
    1.排班方式:
    1)盡量採固定班別制,同一週期內盡量減少班別變動。
    2)每週至少休息一日。
    3)建立多元班別制,採護理人員自我排班。
    4)排班原則盡量考慮人員在職進修或家庭需求。
    2.需考慮病人數及病人疾病嚴重度,機動調整護理人員數。
    (五)建立請調制度
    1.建立護理人員請調機制。
    2.公開缺額單位,供人員申請請調。
    3.依護理人員興趣、能力,提供請調機會。

                           
    四、護理執業環境構面
    留任策略
    具體措施
    (一)提供安全執業環境
    1.提供光線充足,無噪音的安全環境。
    2.資材供應充足。
    3.工作場所有24小時保全監測設備、巡邏、警民連線或其他安全設施、標準防護設備、洗手設備、宿舍安全設施、值班人員休息場所、針扎防範措施與設備。
    4.醫院對工作場所之各項安全設施定期檢查,並維持正常運作。

    (二)塑造良好組織氛圍
    1.建立醫護“相互尊重”之組織文化。
    2.改善單位氣氛,提昇團體凝聚力,例如定期聚會或舉辦活動聯繫感情。
    3.營造良好的醫護關係:教導與醫護團隊溝通技巧。

                             
    五、人員關懷構面
    留任策略
    具體措施
    (一)建立員工輔導機制
    1.由護理部或人力資源部門設置專人,參與協助單位進行留任措施。
    2.建立員工申訴管道。
    3.當護理人員發生某些問題時,如排班、家庭、經濟、財務問題或發生錯誤等,協助其解決。
    4.提供關懷陪伴護理人員渡過各種困境之資源。

    (二)舉辦各類關懷活動
    1.成立成長/支持團體
    1)成立新進人員、臨床輔導員、護理長等不同之成長/支持團體,可由受過訓練之護理主管或具相關專業背景(例如精神科護理背景、社工背景)之相關人員帶領團體。
    2)每月一次,每次至少一小時,至少安排三場次,且盡量安排在不同時段進行。
    3)團隊成立前應先設立共同目標及成長方向。
    4)定期舉辦聯誼、聚餐、運動會等提昇團體凝聚力。
    2.安排離職/調職人員面談
    1)由護理部或人力資源部門指派專人進行離職/轉調人員面談。
    2)會談內容:了解護理人員對醫院的各種看法;如福利、臨床照護、單位主管、在職教育方案以及對醫院最喜歡與最不喜歡之處。
    3)會談後處理:彙整護理人員意見,與護理主管討論並改善問題。
    3.定期舉辦座談會
    1)新進人員座談:由督導主持,每月舉辦一次。
    2)一般人員座談:由副主任或主任主持,每半年舉辦一次。
    3)對護理人員之建議或問題,需列入改善與追蹤。
                           
    六、領導構面      
    留任策略
    具體措施
    (一)強化基層主管領導統御能力
    1.協助護理長瞭解其領導風格。
    2.辦理領導統御研習會。
    3.建立各種管理經驗分享管道。
    4.強化處理員工問題能力,以公平、公正處理護理人員申訴問題。

    (二)建立監測制度
    1.每季計算各單位護理人員離職率,並與去年同期比較,最後進行原因分析,並提出改善措施。
    2.由人力資源部門進行員工工作滿意度調查:
    1)調查時間:每年至少調查一次。
    2)調查內容:包括工作、薪資、升遷、工作伙伴、直屬上司、排班等構面之重要程度與滿意程度,進行SWOT分析。
    3)對護理人員認為重要性高、滿意度低的項目,優先進行改善。


    七、薪資、福利構面
    留任策略
    具體措施
    (一)合理的薪資制度
    1.提供的薪資與所在區域同級醫療院所相當。
    2.提高相關津貼,例如夜班、包班、重症或特殊單位等津貼。
    3.超時工作應給予補休或加班費。
    4.提供績效獎金、紅利。
    5.護理人員進階制度與薪資連結,通過進階者加薪。
    6.人力招募不足,在人力補足前,應發給缺額獎金。

    (二)提供相關福利措施
    1.提供安親班與嬰幼兒照護等相關資訊。
    2.提供用餐空間及休息空間。
    3.提供相關福利措施。
    4.提供旅遊及社團費用補助。





    八、專業成長與發展構面    
    留任策略
    具體措施
    (一)提供第二專長訓練機會
    1.建立交叉訓練制度。
    2.依單位特性及護理人員經驗,擬訂交叉訓練計畫。
    3.交叉訓練時間至少一週以上,由臨床輔導員指導並作成效評值。。

    (二)提供繼續教育與在職進修機會
    1.提供繼續教育公假及費用補助。
    2.提供在職訓練或進修機會。
    3.提供線上繼續教育課程。
    4.建立院際間繼續教育網絡。

    (三)提昇臨床照護能力
    1.護理長定期巡視病房,並給予指導及協助解決問題。
    2.對於照護困難之個案,給予教導與協助問題解決。
    3.舉辦個案討論會。
    (四)建立考核、晉升制度
    1.建立考核、晉升機制。
    2.依考核結果,進行即時獎勵或輔導,並對表現特優者予以晉升較高職位。


    護理雜誌 51卷3期 中華民國93年6月 頁次24-33
    篇名:精神科護理人員人格堅毅性、因應策略與職業疲潰相關性之探討
    作者:謝佳容、謝馨儀、陳碧霞、蕭伶、李選

    職業疲潰(burnout)(亦稱職業倦怠或職業耗竭),
    1974年梅國心理分析學者Freudenberger首次引用此名詞,
    描述專業人員在工作上由工作情境所引起的耗竭現象,
    其認為疲潰是生理、情緒、心智的耗竭狀態,
    它包括消極的自我概念、工作態度、以及喪失對服務對象的感情和關懷。


    文章內裡面對『職業疲潰』的名詞解釋為:
    指個體因為長期工作壓力無法有效因應所產生之情緒耗竭、
    乏人性化及低成就感等負向症狀。
    (1)情緒耗竭:指助人專業的工作者因工作而存在情緒過渡擴張及耗損的感受。
    (2)乏人性化:指助人專業者對他所服務對象的冷漠、無人性反應。
    (3)個人成就感:指助人專業者在工作中勝任愉快及工作圓滿的感受。

    『疲潰』的期刊:
    李選(1989),護理人員壓力感、疲潰與自我主見度之探討。護理雜誌,36(1):85-98。


    有關於『疲潰』的論文:
    1 緊急救護技術員工作壓力、社會支持與專業承諾關係之研究-以臺北市專責救護隊為例
    林威/臺北醫學大學/醫學院/醫學人文研究所/ 2009/碩士


    2 醫療異常事件發生在護理人員之人格韌性、工作壓力、離職意願及護理工作環境知覺上的差異
    陳亞玲/高雄醫學大學/護理學院/護理學研究所/2008/碩士


    3 加護病房護理人員對職業危害的擔心程度與因應策略之探討
    吳安綺/慈濟大學/醫學院/護理研究所/2008/碩士


    4 精神科護理人員照顧邊緣性人格特質病患的護理困難及壓力感受
    吳惠雯/高雄醫學大學/護理學院/護理學研究所/2007/碩士


    5 精神衛生護理人員參與精神病患強制處置的經驗探討
    黃碧玲/中國醫藥大學/健康照護學院/護理學系碩士班/2007/碩士


    6 高科技產業員工壓力來源、員工協助方案認知、自我效能與倦怠感關係
    莊惠婷/長榮大學/管理學院/經營管理研究所/2006/碩士


    7 內外科病房新進護理人員工作壓力與離職傾向之相關性研究
    陸雅美/長榮大學/健康科學學院/醫學研究所/2006/碩士


    8 醫學中心護理人員之勞動條件對其工作壓力、工作負荷及疲勞影響之研究
    王昭儀/臺灣大學/公共衛生學院/衛生政策與管理研究所/2006/碩士


    9 安寧療護醫療團隊工作壓力與壓力調適之研究
    李榕峻/慈濟大學/人文社會學院/社會工作研究所/2006/碩士


    10 護理人員工作壓力與自覺身心健康狀況之相關性研究
    李葆瑋/慈濟大學/醫學院/護理研究所/2006/碩士


    有關於『現實休克』的期刊:
    劉雪娥(1986),現實休克的處理。護理雜誌;33:109-113。



    有關於『現實休克』的論文:
    1 護理科系應屆畢業生從事護理工作之意願及其相關因素
    賴妤甄/中國醫藥大學/公共衛生學院/醫務管理學研究所/2008/碩士


    2 臨床護理輔導員制度對新進護理人員輔導成效之探討
    陳小蓮/臺北醫學大學/護理學院/護理學研究所/2000/碩士


    3 應屆畢業新進護理人員對工作環境的知覺與因應策略
    余斯光/高雄醫學大學/護理學院/護理學研究所/1999/碩士

    11 精神科護理人員因應策略與自覺職業危害之探討
    王懿琨/中山醫學大學/醫學院/醫學研究所/2005/碩士

    12 精神科護理人員人格堅毅性與自覺職業危害相關性研究
    周青波/中山醫學大學/醫學院/護理研究所/2005/碩士

    13 SARS期間感控護理人員之焦慮、特定困擾及不確定感對工作壓力之影響
    陳孟娟/臺北醫學大學/護理學院/護理學研究所/2005/碩士

    14 牙醫助理的工作壓力、工作滿意度與職業倦怠相關因素之探討-以高高屏澎為例
    陳鈞卿/高雄醫學大學/口腔醫學院/口腔衛生科學研究所碩士在職專班/2005/碩士



    進入護理職場可能遇到的挫折
    • 現實休克:工作負荷遠超過預期
    • 學校所學與臨床實務差距大
    • 缺乏時間管理及組織能力
    • 臨床應變及處理能力不足
    • 不知如何處理複雜的人際關係
    • 環境複雜、工作壓力大→失去自信與專業熱忱→離職

    護理人員壓力來源
    • 工作負荷量人際關係
    • 工作之重要性
    •  醫院之政策規章
    • 負責任之狀況
    • 分配工作之性質
    • 環境安全
    • 體力需要

    護理新人的特質
    • 年輕有衝勁
    • 具備基本知識卻尚未融會貫通
    • 經驗有限
    • 勇氣十足
    • 工作態度不穩定

    護理主管協助護理新鮮人適應策略
    • 了解護理新鮮人的特性,協助角色轉換
    • 臨床護理主管至學校與應屆畢業生直接溝通
    • 辦理新進護理人員到職訓練
    • 安排有愛心及耐心的資深護理人員輔導新進人員
    • 主動關懷協助解決困難,適時給予鼓勵與支持
    • 新進人員座談會
    • 守護天使

    臨床新鮮人的調適與準備
    • 加強護理專業知識與能力
    • 重新思考對護理工作的興趣與熱誠
    • 儘早了解護理職場現況,降低理想與現實的距離
    • 調整心情,準備面臨挑戰,接受任勞任怨
    • 勉勵自己,相信自己能做得到,把辛苦當作學習
    • 尋求資源,練習減輕壓力的方法,與壓力共存

    學習的歷程
    ~ Novice to Expert ~
    • Novice 初學
    • Advanced beginner 進階學習
    • Competent 勝任
    • Proficient 精通
    • Expert 專家
    (Benner, 1984)

    • 自我成長
    –文獻搜尋書寫讀書報告
    – 感染管制數位學習
    –安全衛生教育數位學習
    • 人文素養
    – 新進人員角色、壓力處理與調適
    – 醫護溝通(含正確醫學名稱縮寫)、護病溝通
    – 員工權益:勞基法、兩性平等法、性騷擾等

    專業技能
    (4-12個月)
    – 常見疾病、檢查與治療之護理、一般疼痛評估
    – 常用藥物之作用、副作用、藥物及病患用藥安全
    – 常用護理技術
    – 常見臨床問題之處理:自動出院患者手續之辦理、
    不假外出、申訴抱怨處理等
    – 個案護理問題分析與處理(Ⅰ):護理過程之應用。
    – 品質管理(Ⅰ):護理品質概念、標準制定與監測、
    新制醫院評鑑
    – 感染管制訓練(依CDC規定)
    – 病患安全促進與案例分析
    – 自殺防範與處置

    人文素養
    –法律倫理與護理:醫療法、護理人員法介紹及護理病人之倫理困境
    –基本素養:生涯規劃、壓力調適與管理、傾聽技巧、關懷照護
    –安寧療護概:安寧緩和條例介紹及安寧護理概念

    • 自我成長
    –文獻查證、讀書報告
    • 實務操作
    –在護理長、小組長或臨床指導師指導下依病人病情獨立照顧8至12人(依病人病情嚴重程度進行調整)

    專業技能
    (13-24個月)
    – 常見疾病、檢查與治療之護理、一般疼痛評估
    – 常用藥物之作用、副作用、藥物及病患用藥安全
    – 常用護理技術
    – 常見臨床問題之處理:自動出院患者手續之辦理、不假外出、申訴抱怨處理等
    – 個案護理問題分析與處理(Ⅰ):護理過程之應用。
    – 品質管理(Ⅰ):護理品質概念、標準制定與監測、

    新制醫院評鑑
    – 感染管制訓練(依CDC規定)
    – 病患安全促進與案例分析
    – 自殺防範與處置

    人文素養
    –護理法律與倫理:倫理議題(自主權、告知同意、隱私權、保密)、醫療糾紛等案例討論。
    – 基本素養:護理指導策略與應用、認識專科護理師之角色
    – 壓力調適方法與實務應用

    • 自我成長
    –教與學
    – 問題分析與處理(Ⅱ):案例分析
    • 實務操作
    – 在護理長、小組長或臨床指導師指導下依病人病情獨立照顧8至12人(依病人病情嚴重程度進行調整)

    臨床專業能力進階制度
    �� 提供護理專業知能成長
    �� 滿足個別專業需求
    �� 發展理想人才建構
    �� 穩定臨床護理人力
    �� 留任專業護理人才
    Learning by doing


    護理雜誌 51卷3期 中華民國93年6月 頁次24-33
    篇名:精神科護理人員人格堅毅性、因應策略與職業疲潰相關性之探討
    作者:謝佳容、謝馨儀、陳碧霞、蕭伶、李選
    職業疲潰(burnout)(亦稱職業倦怠或職業耗竭),
    1974年梅國心理分析學者Freudenberger首次引用此名詞,
    描述專業人員在工作上由工作情境所引起的耗竭現象,
    其認為疲潰是生理、情緒、心智的耗竭狀態,
    它包括消極的自我概念、工作態度、以及喪失對服務對象的感情和關懷。
    文章內裡面對『職業疲潰』的名詞解釋為:
    指個體因為長期工作壓力無法有效因應所產生之情緒耗竭、
    乏人性化及低成就感等負向症狀。
    (1)情緒耗竭:指助人專業的工作者因工作而存在情緒過渡擴張及耗損的感受。
    (2)乏人性化:指助人專業者對他所服務對象的冷漠、無人性反應。
    (3)個人成就感:指助人專業者在工作中勝任愉快及工作圓滿的感受。 『疲潰』的期刊:
    李選(1989),護理人員壓力感、疲潰與自我主見度之探討。護理雜誌,36(1):85-98。

    有關於『疲潰』的論文:
    1 緊急救護技術員工作壓力、社會支持與專業承諾關係之研究-以臺北市專責救護隊為例
    林威/臺北醫學大學/醫學院/醫學人文研究所/ 2009/碩士
    2 醫療異常事件發生在護理人員之人格韌性、工作壓力、離職意願及護理工作環境知覺上的差異
    陳亞玲/高雄醫學大學/護理學院/護理學研究所/2008/碩士
    3 加護病房護理人員對職業危害的擔心程度與因應策略之探討
    吳安綺/慈濟大學/醫學院/護理研究所/2008/碩士
    4 精神科護理人員照顧邊緣性人格特質病患的護理困難及壓力感受
    吳惠雯/高雄醫學大學/護理學院/護理學研究所/2007/碩士
    5 精神衛生護理人員參與精神病患強制處置的經驗探討
    黃碧玲/中國醫藥大學/健康照護學院/護理學系碩士班/2007/碩士
    6 高科技產業員工壓力來源、員工協助方案認知、自我效能與倦怠感關係
    莊惠婷/長榮大學/管理學院/經營管理研究所/2006/碩士
    7 內外科病房新進護理人員工作壓力與離職傾向之相關性研究
    陸雅美/長榮大學/健康科學學院/醫學研究所/2006/碩士
    8 醫學中心護理人員之勞動條件對其工作壓力、工作負荷及疲勞影響之研究
    王昭儀/臺灣大學/公共衛生學院/衛生政策與管理研究所/2006/碩士
    9 安寧療護醫療團隊工作壓力與壓力調適之研究
    李榕峻/慈濟大學/人文社會學院/社會工作研究所/2006/碩士
    10 護理人員工作壓力與自覺身心健康狀況之相關性研究
    李葆瑋/慈濟大學/醫學院/護理研究所/2006/碩士
    有關於『現實休克』的期刊:
    劉雪娥(1986),現實休克的處理。護理雜誌;33:109-113。

    有關於『現實休克』的論文:
    1 護理科系應屆畢業生從事護理工作之意願及其相關因素
    賴妤甄/中國醫藥大學/公共衛生學院/醫務管理學研究所/2008/碩士
    2 臨床護理輔導員制度對新進護理人員輔導成效之探討
    陳小蓮/臺北醫學大學/護理學院/護理學研究所/2000/碩士
    3 應屆畢業新進護理人員對工作環境的知覺與因應策略
    余斯光/高雄醫學大學/護理學院/護理學研究所/1999/碩士
    11 精神科護理人員因應策略與自覺職業危害之探討
    王懿琨/中山醫學大學/醫學院/醫學研究所/2005/碩士

    12 精神科護理人員人格堅毅性與自覺職業危害相關性研究
    周青波/中山醫學大學/醫學院/護理研究所/2005/碩士

    13 SARS期間感控護理人員之焦慮、特定困擾及不確定感對工作壓力之影響
    陳孟娟/臺北醫學大學/護理學院/護理學研究所/2005/碩士

    14 牙醫助理的工作壓力、工作滿意度與職業倦怠相關因素之探討-以高高屏澎為例
    陳鈞卿/高雄醫學大學/口腔醫學院/口腔衛生科學研究所碩士在職專班/2005/碩士


    中文部分
    [1]于乃玲、胡瑞桃、周碧琴、賴瑞月(1999)。某醫院護理人員工作滿意度與留任意願相關性之探討。長庚護理,10(3),28–38。
    [2]尹祚芊、楊克平、劉麗芳(2001)。臺灣地區醫院護理人員留任措施計劃成效之評價。護理研究,9(3),247–256。
    [3]尹裕君、安妮(1991) 。護理人員離職原因與工作滿意度相關性之探討,台北:榮總護理,第八卷第四期,1991年12月,頁428–436。
    [4]王國川(1988)。臺北市國民中學健康教育教師工作滿意度之研究。國立臺灣師範大學衛生教育研究所未出版之碩士論文。
    [5]王瑞霞、林惠娟、郭明娟、石芬芬(1989)。某醫學中心臨床護理人員工作滿足感、人格類型與壓力症狀關係之探討。護理雜誌,36(4),47–55。
    [6]王麗淳(1998)。角色壓力影響情緒耗竭之過程探討,國立中正大學企業管理研究所未出版之碩士論文。
    [7]白玉珠(1994)。在職進修學士學位護理人員工作滿意度及其相關因素之研究。國防醫學院護理研究所碩士論文。
    [8]石樸(1991)。企業界員工工作滿足、工作投入與離職意願之研究,國立政治大學社會學研究所未出版之碩士論文。
    [9]朴英培、黃俊英、郭崑謨(1990)。工作價值觀、領導型態、工作滿足與組織承諾關係之研究─以韓國電子業為例,管理評論,9(1),53–87。
    [10]余安邦(1980),企業組織中員工離職行為之研究,國立臺灣大學心理研究所未出版之碩士論文。
    [11]宋清華(1991) 女性員工離職意願之研究--以高雄金融業為例。國立中山大學企業管理研究所未出版之碩士論文。
    [12]李吉祥(1997)。我國政府主計部門會計人員工作滿足感之研究,國立中興大學企業研究所未出版之碩士論文。
    [13]李育哲(1996)。變遷中之中大型電子企業員工工作期望與滿意度調查分析。德明學報,11,17–23。
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    [52]Smith, P. C.,  Kendall, L.M. & Hulin, C.L.(1969)  The Measurement of Statisfaction in Work and Retirement. Chicago: Rand and McNally.
    [53]Smucker, M.K. (2001).  Job satisfaction and referent selection in the sport industry.  Unpublished doctoral dissertations, University of The Florida State.
    [54]Tonges, M.C., Rothstein, H., & Carter, H.K. (1998).  Sources of satisfaction in hospital nursing practice:a guide to effective job design. Journal of Nursing Administration, 28(5), 47-61.
    [55]Veiga, J. F. (1983). Mobility influences during managerial career stages. Academy of Management Journa , 26, 64-85.
    [56]Vroom, V.H. (1964).  Work and Motivation, New York: Wiley.
    [57]Wai,C.T. Teresa&Robinson,C.D.(1998), Reducing staff turnover: A case study of dialysis facilities, Health Care Management Review,Vol.23,No.4,21-42.
    [58]Wilson, N., & Peel, M. J.(1991), The impact on absenteeism and quits of profit-sharing and other forms of employee participation, Industrial and Labor Relations Review, Vol. 44, 454-468.

    Keywords:China;intention to leave;job satisfaction;nurses;nursing;Shanghai;workforceJump to…Top of pageAbstractIntroductionBackground and literature reviewMethodsResultsDiscussionLimitationsConclusionRelevance to clinical practiceAcknowledgementsContributionsConflict of interestReferences AbstractAim.  To explore nurses’ views and experiences regarding job satisfaction and their intention to leave in Shanghai.Background.  The widespread nursing shortage and nurses’ high turnover rate has become a global issue. Job satisfaction is the most consistent predictor of nurses’ intention to leave and has been reported as explaining most of the variance on their intention to leave.Design.  A cross-sectional survey.Methods.  A convenience sample of nurses was recruited from 19 large general hospitals in Shanghai and the research assistants distributed 2850 questionnaires to nurses. The response rate of this study was 78·95%, and 2250 nurses completed the questionnaire.Results.  Regarding the overall job satisfaction, 50·2% nurses were dissatisfied and 40·4% nurses reported that they had intention to leave the current employment. Respondents’ characteristics had an impact on job satisfaction and their intention to leave. The results showed that age, marital status, work experience, overall job satisfaction, job satisfaction: extrinsic rewards, interaction, praise/recognition and control/responsibility were significant factors contributing to nurses’ intention to leave.Conclusions.  The finding may be a cause of concern for hospital management and highlights the importance of the two concepts (job satisfaction and intention to leave) in Shanghai. Innovative and adaptable managerial interventions need to be taken to improve nurses’ job satisfaction and to strengthen their intention to stay.Relevance to clinical practice.  Our findings outline some issues contributing to these problems and provide nurse administrators with information regarding specific influences on nurses’ job satisfaction and intention to leave in Shanghai and innovative and adaptable managerial interventions that are needed. Our findings may also provide direction for nurse managers and healthcare management to implement strategies to improve nurses’ job satisfaction and their intention to stay.Jump to…Top of pageAbstractIntroductionBackground and literature reviewMethodsResultsDiscussionLimitationsConclusionRelevance to clinical practiceAcknowledgementsContributionsConflict of interestReferences IntroductionThe widespread nursing shortage and nurses’ high turnover rate has become a global issue (Kingma 2001). Job satisfaction is the most consistent predictor of nurses’ intention to leave and has been reported as explaining most of the variance on intention to leave (Hsiao & Lu 1996, Borda & Norman 1997, Thorpe & Loo 2003, Sourdif 2004, Morrell 2005). There is an abundance of international research on nurses’ job satisfaction and intention to leave, however, in China, few studies has focused on nurses’ job satisfaction. As the nursing workforce in Mainland China also faces similar challenges in recruitment and retention, there is an urgent need for rigorous research regarding variables of Chinese nurses’ job satisfaction and intention to leave.Jump to…Top of pageAbstractIntroductionBackground and literature reviewMethodsResultsDiscussionLimitationsConclusionRelevance to clinical practiceAcknowledgementsContributionsConflict of interestReferences Background and literature reviewNurses’ job satisfactionJob satisfaction is defined as all the feelings that an individual has about his/her job (Spector 1997). Job satisfaction has been identified as a key factor to nurses’ intention to leave and turnover (Cavanagh 1992, Cowin 2002, Strachota et al. 2003), but job satisfaction is a complex fact affected by many components. Researchers have attempted to identify the various components of job satisfaction, measure the relative importance of each component and examine what effects these components have on workers’ productivity (Lu et al. 2005). Components of job satisfaction involve any aspect of the job and those frequently assessed including nursing care delivery models and organisational climate (Adams & Bond 2000), working environment (Adamson et al. 1995, Shaver & Lacey 2003, Moon et al. 2008), remuneration (Price 2002, Wang 2009), praise and recognition (Nolan et al. 1995, Lundh 1999), personal growth and promotion (Tzeng 2002, Khowaja 2005), leadership styles (Fang 2001, Fletcher 2001, Wang 2009), stress (Ma 2003), autonomy (O’Rouke et al. 2000, Upenieks 2000, Finn 2001, Larrabee et al. 2003) and relations with patients and co-workers. Job satisfaction was also positively affected by personal factors such as age (Moon et al. 2008), marital status (Cimete 2003), economic level (Cimete 2003), educational level (Cimete 2003, Moon et al. 2008), work experience (Moon et al. 2008) and so on.Nurses’ intention to leaveIntention to leave is defined as nurses’ anticipation of vacating the job in the foreseeable future (Price 1981). Throughout the literature, job satisfaction has been reported as the primary predictor of intention to leave and has been reported as explaining most of the variance on intention to leave (Borda & Norman 1997, Aikenet al. 2002, Ingersoll et al. 2002, Larrabee et al. 2003, Sourdif 2004, Morrell 2005). Many studies have reported positive relationships between job satisfaction and intention to leave (Chan & Morrison 2000, Shields & Ward 2001). Shields and Ward found that nurses who reported overall dissatisfaction with their jobs had a 65% higher probability of intending to leave than satisfied nurses (Shields & Ward 2001). Some studies have also reported positive relationships between nurses’ intention to leave and specific components of job satisfaction, including satisfaction with pay and benefits (Morrell 2005), support (Sourdif 2004), autonomy and responsibility (Larrabee et al. 2003), scheduling (Roberts et al. 2004), professional opportunities (Joshua-Amadi 2002), and good relationships with patients/co-workers (Adams & Bond 2000, Chan & Morrison 2000). Other associated factors include the following: age (Borda & Norman 1997), marital status (Shader et al.2001), work experience (Shader et al. 2001) and education (Roberts et al. 2004). Some studies have reported that nurses were more likely to stay in their jobs when they were older, worked in specialised clinical areas and had more years of work experience (Chan & Morrison 2000, Shader et al. 2001, Hu et al. 2004), and nurses who were single and not had children at home were more likely to stay (Shader et al. 2001).Nursing in Mainland ChinaWith continuing economic reform, China has made some major policy changes in health care. The health care system is in a restructuring phase of moving to autonomous management with a market-driven economy (Ho 1995, Hsiao 1995). Additionally, nursing model reforms have had an impact on the delivery of health care. The patient-centred holistic nursing care model has gradually replaced the traditional disease-centred nursing care model (Ministry of Health, China 2003). To ensure that the nurses provide safe and effective practice for the community, a regulatory mechanism was established in the Mainland China. The Registration Ordinance for nurses, published in 1993, established a licensing examination and registration system. The Nurses’ Regulation, published in Mainland China in 2008, provided the conditions of application for registration to practice nursing.At present, there are five levels of nursing education in Mainland China: diploma program delivered by health schools, associate degree program mainly provided by colleges of nursing, bachelor degrees, master’s degree and PhD through university-based education. There are four professional levels of registered nurse (RN): junior RN, senior RN, associate professor nurse and professor nurse according to the Health Technicians Title and Promotion Regulations, published in 1979. ‘Nurse in charge’ was added in 1981 to perfect the professional title systems of nursing staff.Shanghai, located on the east coast of Asia, is one of the largest cities in mainland China. There are 518 public and private medical agencies in Shanghai, including 37 large hospitals and tertiary hospitals (19 general hospitals and 18 special hospitals), 161 district hospitals and secondary hospitals and 320 community healthcare centres and primary hospitals (Cao et al. 2009). With a population of more than 18 million, there are only 38,700 nursing staff in Shanghai. According to 2007 Nursing Human Resources Survey, the number of RNs was 2·15:1000 of the population. Du et al. reported that 58·59% nurses had the intention to leave current employment in Shanghai (Du et al. 2007). The current nursing shortage and nurses’ high turnover in Shanghai highlight the importance of understanding nurses’ views and experiences regarding job satisfaction and intention to leave so that health care organisations can implement effective interventions to improve the retention of their nursing workforce.Jump to…Top of pageAbstractIntroductionBackground and literature reviewMethodsResultsDiscussionLimitationsConclusionRelevance to clinical practiceAcknowledgementsContributionsConflict of interestReferences MethodsAim and objectiveThe study aimed to explore nurses’ views and experiences regarding job satisfaction and intention to leave in Shanghai. The following objectives were set:•  To explore variables of nurses’ job satisfaction in Shanghai.•  To investigate factors associated with nurses’ intention to leave.Research design and sampleA cross-sectional survey design using questionnaires was selected to fulfil the research objectives. A convenience sample of nurses was recruited from 19 large general hospitals in Shanghai. The research assistants distributed 2850 questionnaires to nurses. The response rate of this study was 78·95%, and 2250 nurses completed the questionnaire.InstrumentsThe following instruments were used:Mueller-McCloskey Satisfaction Scale (MMSS, Mueller & McCloskey 1990): This tool consists of seven subscales with 31 items: satisfaction with extrinsic rewards (three items), scheduling (seven items), family/work balance (two items), coworkers (four items), interaction (five items), praise/recognition (six items) and control/responsibility (four items). The MMSS uses a five-point Likert scale with the following ratings: 1 = very dissatisfied, 2 = moderately dissatisfied, 3 = neither satisfied nor dissatisfied, 4 = moderately satisfied and 5 = very satisfied. Reliability and validity for the scales used in this study have been established by Huber et al.(2000). The original MMSS had a Cronbach α that ranged from 0·52–0·84 for each subscale. Correlations among subscales ranged from 0·53–0·75 for similar dimensions, indicating criterion-related validity. In this study, the Cronbach a of the nurses’ job satisfaction subscale ranged from 0·34–0·846.Demographic characteristics were collected regarding personal profile and age, marital status, educational level, professional level and years of experience in nursing. In addition, a question was asked to each nurse, ‘Do you intend to leave the current employment?’, to which they replied using one of two choices, ‘Yes’ or ‘No’.Instrument translationTo avoid the problems inherent in translation, this study used a combination of Brislin (1970) model for translating and back-translating instruments and committee approach. One bilingual expert translated the instruments from English to Chinese and a second bilingual expert back-translated blindly. A panel of four experts in the area of health care workforce management measured the face validity of the translated questionnaire. The instrument has been piloted in 58 nurses in a large general hospital in Shanghai. All of them said they understood all the items.Ethical considerations and negotiation of accessEthical approval was gained from the Second Military Medical University’s Research Ethics Committee. The main ethical issues were respondents’ right to self-determination, anonymity and confidentiality. Prior to data collection, approvals were obtained from hospital administrators and nurses. All nurses were sent a letter that invites them to participate in the study. The letter included a brief description of the purpose of the study, the questionnaire and the demographic form. Completed questionnaires were recruited in sealed envelopes via a collection box places in ward offices. All returned questionnaires were handled by the research team only. Participation was voluntary, and the names of the respondents were not recorded on the questionnaire, thus rendering the data anonymous.Analysis of dataData were entered and processed using the Statistical Package for the Social Sciences (spss) software, the English version 11·0. This study used descriptive statistics, chi-square and multiple logistic regression modelling (forward stepwise Conditional method) to analyse the data.Jump to…Top of pageAbstractIntroductionBackground and literature reviewMethodsResultsDiscussionLimitationsConclusionRelevance to clinical practiceAcknowledgementsContributionsConflict of interestReferences ResultsRespondents’ characteristics and job satisfactionThe respondents’ characteristics of the study nurses are shown in Table 1. All respondents were female. For job satisfaction, nurses scoring more than three in each component were classified as the ‘satisfied’ group. The rest were ‘dissatisfied’. Regarding overall job satisfaction, 50·2% respondents were dissatisfied. Most respondents were satisfied with their coworkers (n = 2185, 97·1%), interaction (n = 1760, 78·2%), praise/recognition (n = 1590, 70·7%) and control/responsibility (n = 1640, 72·9%). On the
    ...

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    左永安顧問
    15:58 (15 分鐘前)

    寄給 蓉、 mongjay2002


    現實休克(Reality Shock)

    還在唸書的時候
    學校所教的技術是最標準、最嚴格的
    棉枝一旦打開包裝便是非無菌
    優碘和酒精必須用倒出的方式來沾染棉枝
    手不能越過消毒過的VIAL
    IV加藥要計算精確的滴速跟滴注時間

    技術一練再練常在學校留很晚
    縱使每次技術考都搞得人仰馬翻
    卻還是覺得有標準技術很好
    一切按照標準流程來
    包準不會出錯

    第一次出去基護實習的時候
    只照顧一位病人
    給藥、量V/S、寫護理紀錄、交班
    然後回家看書比較該診斷臨床跟學理的差別
    其他學姊照顧的8~12個病人
    幫忙作的是最簡單的功能性護理
    量V/S、驗血糖、倒尿total I/O
    每完成一件事就覺得很有成就感
    病人和家屬會跟我說謝謝
    當時覺得好快樂好有成就感
    想著說不定自己很適合唸護理
    當學姊對於病人的哀嚎視而不見時
    會在心裡反駁不該這樣對待他、不該不耐煩
    換做我們是病人,我們一樣會感到痛苦
    想著以後工作也要像現在這樣充滿熱忱
    不管病人怎麼樣
    都要有愛心、有耐心的去安撫

    專科四年級
    照顧一、二位病人
    做的事情和基護實習差不多
    不過開始要寫個案報告、學習怎麼收集及統整資料
    然後也是回家查資料、看書
    努力的看卻還是有很多不懂的地方
    護理長說:你們這批怎麼這麼爛,以後根本不會想用你們!
    當時覺得很受傷
    想著自己有許多不足的地方需要再補強
    同時發現臨床的護理技術不像學校教的那麼標準
    體會到學姊照顧8~12個病人很辛苦
    想著自己以後不論如何累、如何忙
    都只能要求自己速度加快
    技術仍要標準、對病人仍要有耐心
    這是全年實習開始不久的事情

    升上五年級還在實習中
    到了兒科開始對不配合的病人感到不耐煩
    到了衛生所發現自己不擅與人溝通
    到了精神科發現自己無法獲得病人的信賴
    到了產科發現光哺乳就有一堆問題在課本上找不到解答
    漸漸失去自信
    也已經沒有成就感可言
    這時開始質疑:我真的能夠勝任嗎?

    到了二技
    和專科實習非常不一樣
    照顧一、二位病人
    total care
    並且開始要學會批判性思考、個別性護理
    觀察整個病程的變化、各種檢驗結果
    為什麼作這個治療、好不好、對不對?
    有什麼是護理獨立功能可以作的?
    針對這個病人可以再多做些什麼幫助他?
    然後回家查更多的資料、看更多的書
    每天想morning meeting到底該說什麼苦惱得噩夢連連
    護理長和學姊永遠可以揪出我們沒看到的一面
    不管再怎麼想、怎麼收集資料
    永遠都不夠好、不夠完善、不夠周全
    雖然了解到這個工作與經驗有絕對的關係
    卻也有說不出的挫敗感
    我想:或許我根本不適合當護理人員

    如今畢業了
    到了職場
    照顧3個病人(ICU)
    發現事情很多
    Q2H量V/S、寫紀錄、吃飯喝水小便大便都要記錄
    抽不完的血、滴不順又on不上的IV
    接不完的病人、轉不完的床、寫不完的paper work
    放假有上不完的課、修不完的時數
    棉枝伸進瓶子裡沾了優碘和酒精後
    又放回袋子裡備用
    IV加藥調個大概的滴速
    問題一堆的家屬我幫你叫醫生來
    病人敲床想寫字不予理會
    我知道你很痛苦
    但是我也很痛苦
    因為──事情做不完
    做不完就不能交班
    不能交班就會拖累下一班
    拖累下一班以後大家就會不想接你的班
    「厚,煩ㄟ,又要跟他交班!」
    現在被說閒話的是別人
    以後被人說閒話的就是你

    曾經
    我對護理充滿憧憬及熱忱
    但那已經是很久以前的事了

    現在
    依然不確定自己能否勝任
    但我還在努力著




    左永安顧問 於 2012年2月12日下午3:44 寫道:

    進入護理職場可能遇到的挫折
    • 現實休克:工作負荷遠超過預期
    • 學校所學與臨床實務差距大
    • 缺乏時間管理及組織能力
    • 臨床應變及處理能力不足
    • 不知如何處理複雜的人際關係
    • 環境複雜、工作壓力大→失去自信與專業熱忱→離職 護理人員壓力來源
    • 工作負荷量人際關係
    • 工作之重要性
    •  醫院之政策規章
    • 負責任之狀況
    • 分配工作之性質
    • 環境安全
    • 體力需要 護理新人的特質
    • 年輕有衝勁
    • 具備基本知識卻尚未融會貫通
    • 經驗有限
    • 勇氣十足
    • 工作態度不穩定
    護理主管協助護理新鮮人適應策略
    • 了解護理新鮮人的特性,協助角色轉換
    • 臨床護理主管至學校與應屆畢業生直接溝通
    • 辦理新進護理人員到職訓練
    • 安排有愛心及耐心的資深護理人員輔導新進人員
    • 主動關懷協助解決困難,適時給予鼓勵與支持
    • 新進人員座談會
    • 守護天使 臨床新鮮人的調適與準備
    • 加強護理專業知識與能力
    • 重新思考對護理工作的興趣與熱誠
    • 儘早了解護理職場現況,降低理想與現實的距離
    • 調整心情,準備面臨挑戰,接受任勞任怨
    • 勉勵自己,相信自己能做得到,把辛苦當作學習
    • 尋求資源,練習減輕壓力的方法,與壓力共存 學習的歷程
    ~ Novice to Expert ~
    • Novice 初學
    • Advanced beginner 進階學習
    • Competent 勝任
    • Proficient 精通
    • Expert 專家
    (Benner, 1984) • 自我成長
    –文獻搜尋書寫讀書報告
    – 感染管制數位學習
    –安全衛生教育數位學習
    • 人文素養
    – 新進人員角色、壓力處理與調適
    – 醫護溝通(含正確醫學名稱縮寫)、護病溝通
    – 員工權益:勞基法、兩性平等法、性騷擾等 專業技能
    (4-12個月)
    – 常見疾病、檢查與治療之護理、一般疼痛評估
    – 常用藥物之作用、副作用、藥物及病患用藥安全
    – 常用護理技術
    – 常見臨床問題之處理:自動出院患者手續之辦理、
    不假外出、申訴抱怨處理等
    – 個案護理問題分析與處理(Ⅰ):護理過程之應用。
    – 品質管理(Ⅰ):護理品質概念、標準制定與監測、
    新制醫院評鑑
    – 感染管制訓練(依CDC規定)
    – 病患安全促進與案例分析
    – 自殺防範與處置 人文素養
    –法律倫理與護理:醫療法、護理人員法介紹及護理病人之倫理困境
    –基本素養:生涯規劃、壓力調適與管理、傾聽技巧、關懷照護
    –安寧療護概:安寧緩和條例介紹及安寧護理概念 • 自我成長
    –文獻查證、讀書報告
    • 實務操作
    –在護理長、小組長或臨床指導師指導下依病人病情獨立照顧8至12人(依病人病情嚴重程度進行調整) 專業技能
    (13-24個月)
    – 常見疾病、檢查與治療之護理、一般疼痛評估
    – 常用藥物之作用、副作用、藥物及病患用藥安全
    – 常用護理技術
    – 常見臨床問題之處理:自動出院患者手續之辦理、不假外出、申訴抱怨處理等
    – 個案護理問題分析與處理(Ⅰ):護理過程之應用。
    – 品質管理(Ⅰ):護理品質概念、標準制定與監測、
    新制醫院評鑑
    – 感染管制訓練(依CDC規定)
    – 病患安全促進與案例分析
    – 自殺防範與處置 人文素養
    –護理法律與倫理:倫理議題(自主權、告知同意、隱私權、保密)、醫療糾紛等案例討論。
    – 基本素養:護理指導策略與應用、認識專科護理師之角色
    – 壓力調適方法與實務應用 • 自我成長
    –教與學
    – 問題分析與處理(Ⅱ):案例分析
    • 實務操作
    – 在護理長、小組長或臨床指導師指導下依病人病情獨立照顧8至12人(依病人病情嚴重程度進行調整) 臨床專業能力進階制度
    �� 提供護理專業知能成長
    �� 滿足個別專業需求
    �� 發展理想人才建構
    �� 穩定臨床護理人力
    �� 留任專業護理人才
    Learning by doing
     左永安顧問 於 2012年2月12日下午3:26 寫道:

    護理雜誌 51卷3期 中華民國93年6月 頁次24-33
    篇名:精神科護理人員人格堅毅性、因應策略與職業疲潰相關性之探討
    作者:謝佳容、謝馨儀、陳碧霞、蕭伶、李選
    職業疲潰(burnout)(亦稱職業倦怠或職業耗竭),
    1974年梅國心理分析學者Freudenberger首次引用此名詞,
    描述專業人員在工作上由工作情境所引起的耗竭現象,
    其認為疲潰是生理、情緒、心智的耗竭狀態,
    它包括消極的自我概念、工作態度、以及喪失對服務對象的感情和關懷。
    文章內裡面對『職業疲潰』的名詞解釋為:
    指個體因為長期工作壓力無法有效因應所產生之情緒耗竭、
    乏人性化及低成就感等負向症狀。
    (1)情緒耗竭:指助人專業的工作者因工作而存在情緒過渡擴張及耗損的感受。
    (2)乏人性化:指助人專業者對他所服務對象的冷漠、無人性反應。
    (3)個人成就感:指助人專業者在工作中勝任愉快及工作圓滿的感受。 『疲潰』的期刊:
    李選(1989),護理人員壓力感、疲潰與自我主見度之探討。護理雜誌,36(1):85-98。

    有關於『疲潰』的論文:
    1 緊急救護技術員工作壓力、社會支持與專業承諾關係之研究-以臺北市專責救護隊為例
    林威/臺北醫學大學/醫學院/醫學人文研究所/ 2009/碩士
    2 醫療異常事件發生在護理人員之人格韌性、工作壓力、離職意願及護理工作環境知覺上的差異
    陳亞玲/高雄醫學大學/護理學院/護理學研究所/2008/碩士
    3 加護病房護理人員對職業危害的擔心程度與因應策略之探討
    吳安綺/慈濟大學/醫學院/護理研究所/2008/碩士
    4 精神科護理人員照顧邊緣性人格特質病患的護理困難及壓力感受
    吳惠雯/高雄醫學大學/護理學院/護理學研究所/2007/碩士
    5 精神衛生護理人員參與精神病患強制處置的經驗探討
    黃碧玲/中國醫藥大學/健康照護學院/護理學系碩士班/2007/碩士
    6 高科技產業員工壓力來源、員工協助方案認知、自我效能與倦怠感關係
    莊惠婷/長榮大學/管理學院/經營管理研究所/2006/碩士
    7 內外科病房新進護理人員工作壓力與離職傾向之相關性研究
    陸雅美/長榮大學/健康科學學院/醫學研究所/2006/碩士
    8 醫學中心護理人員之勞動條件對其工作壓力、工作負荷及疲勞影響之研究
    王昭儀/臺灣大學/公共衛生學院/衛生政策與管理研究所/2006/碩士
    9 安寧療護醫療團隊工作壓力與壓力調適之研究
    李榕峻/慈濟大學/人文社會學院/社會工作研究所/2006/碩士
    10 護理人員工作壓力與自覺身心健康狀況之相關性研究
    李葆瑋/慈濟大學/醫學院/護理研究所/2006/碩士
    有關於『現實休克』的期刊:
    劉雪娥(1986),現實休克的處理。護理雜誌;33:109-113。

    有關於『現實休克』的論文:
    1 護理科系應屆畢業生從事護理工作之意願及其相關因素
    賴妤甄/中國醫藥大學/公共衛生學院/醫務管理學研究所/2008/碩士
    2 臨床護理輔導員制度對新進護理人員輔導成效之探討
    陳小蓮/臺北醫學大學/護理學院/護理學研究所/2000/碩士
    3 應屆畢業新進護理人員對工作環境的知覺與因應策略
    余斯光/高雄醫學大學/護理學院/護理學研究所/1999/碩士
    11 精神科護理人員因應策略與自覺職業危害之探討
    王懿琨/中山醫學大學/醫學院/醫學研究所/2005/碩士

    12 精神科護理人員人格堅毅性與自覺職業危害相關性研究
    周青波/中山醫學大學/醫學院/護理研究所/2005/碩士

    13 SARS期間感控護理人員之焦慮、特定困擾及不確定感對工作壓力之影響
    陳孟娟/臺北醫學大學/護理學院/護理學研究所/2005/碩士

    14 牙醫助理的工作壓力、工作滿意度與職業倦怠相關因素之探討-以高高屏澎為例
    陳鈞卿/高雄醫學大學/口腔醫學院/口腔衛生科學研究所碩士在職專班/2005/碩士

    左永安顧問 於 2012年2月11日下午4:38 寫道: 


    左永安顧問 於 2012年2月10日下午8:57 寫道:


    左永安顧問 於 2012年2月10日下午8:27 寫道:
    Keywords:China;intention to leave;job satisfaction;nurses;nursing;Shanghai;workforceJump to…Top of pageAbstractIntroductionBackground and literature reviewMethodsResultsDiscussionLimitationsConclusionRelevance to clinical practiceAcknowledgementsContributionsConflict of interestReferences AbstractAim.  To explore nurses’ views and experiences regarding job satisfaction and their intention to leave in Shanghai.Background.  The widespread nursing shortage and nurses’ high turnover rate has become a global issue. Job satisfaction is the most consistent predictor of nurses’ intention to leave and has been reported as explaining most of the variance on their intention to leave.Design.  A cross-sectional survey.Methods.  A convenience sample of nurses was recruited from 19 large general hospitals in Shanghai and the research assistants distributed 2850 questionnaires to nurses. The response rate of this study was 78·95%, and 2250 nurses completed the questionnaire.Results.  Regarding the overall job satisfaction, 50·2% nurses were dissatisfied and 40·4% nurses reported that they had intention to leave the current employment. Respondents’ characteristics had an impact on job satisfaction and their intention to leave. The results showed that age, marital status, work experience, overall job satisfaction, job satisfaction: extrinsic rewards, interaction, praise/recognition and control/responsibility were significant factors contributing to nurses’ intention to leave.Conclusions.  The finding may be a cause of concern for hospital management and highlights the importance of the two concepts (job satisfaction and intention to leave) in Shanghai. Innovative and adaptable managerial interventions need to be taken to improve nurses’ job satisfaction and to strengthen their intention to stay.Relevance to clinical practice.  Our findings outline some issues contributing to these problems and provide nurse administrators with information regarding specific influences on nurses’ job satisfaction and intention to leave in Shanghai and innovative and adaptable managerial interventions that are needed. Our findings may also provide direction for nurse managers and healthcare management to implement strategies to improve nurses’ job satisfaction and their intention to stay.Jump to…Top of pageAbstractIntroductionBackground and literature reviewMethodsResultsDiscussionLimitationsConclusionRelevance to clinical practiceAcknowledgementsContributionsConflict of interestReferences IntroductionThe widespread nursing shortage and nurses’ high turnover rate has become a global issue (Kingma 2001). Job satisfaction is the most consistent predictor of nurses’ intention to leave and has been reported as explaining most of the variance on intention to leave (Hsiao & Lu 1996, Borda & Norman 1997, Thorpe & Loo 2003, Sourdif 2004, Morrell 2005). There is an abundance of international research on nurses’ job satisfaction and intention to leave, however, in China, few studies has focused on nurses’ job satisfaction. As the nursing workforce in Mainland China also faces similar challenges in recruitment and retention, there is an urgent need for rigorous research regarding variables of Chinese nurses’ job satisfaction and intention to leave.Jump to…Top of pageAbstractIntroductionBackground and literature reviewMethodsResultsDiscussionLimitationsConclusionRelevance to clinical practiceAcknowledgementsContributionsConflict of interestReferences Background and literature reviewNurses’ job satisfactionJob satisfaction is defined as all the feelings that an individual has about his/her job (Spector 1997). Job satisfaction has been identified as a key factor to nurses’ intention to leave and turnover (Cavanagh 1992, Cowin 2002, Strachota et al. 2003), but job satisfaction is a complex fact affected by many components. Researchers have attempted to identify the various components of job satisfaction, measure the relative importance of each component and examine what effects these components have on workers’ productivity (Lu et al. 2005). Components of job satisfaction involve any aspect of the job and those frequently assessed including nursing care delivery models and organisational climate (Adams & Bond 2000), working environment (Adamson et al. 1995, Shaver & Lacey 2003, Moon et al. 2008), remuneration (Price 2002, Wang 2009), praise and recognition (Nolan et al. 1995, Lundh 1999), personal growth and promotion (Tzeng 2002, Khowaja 2005), leadership styles (Fang 2001, Fletcher 2001, Wang 2009), stress (Ma 2003), autonomy (O’Rouke et al. 2000, Upenieks 2000, Finn 2001, Larrabee et al. 2003) and relations with patients and co-workers. Job satisfaction was also positively affected by personal factors such as age (Moon et al. 2008), marital status (Cimete 2003), economic level (Cimete 2003), educational level (Cimete 2003, Moon et al. 2008), work experience (Moon et al. 2008) and so on.Nurses’ intention to leaveIntention to leave is defined as nurses’ anticipation of vacating the job in the foreseeable future (Price 1981). Throughout the literature, job satisfaction has been reported as the primary predictor of intention to leave and has been reported as explaining most of the variance on intention to leave (Borda & Norman 1997, Aikenet al. 2002, Ingersoll et al. 2002, Larrabee et al. 2003, Sourdif 2004, Morrell 2005). Many studies have reported positive relationships between job satisfaction and intention to leave (Chan & Morrison 2000, Shields & Ward 2001). Shields and Ward found that nurses who reported overall dissatisfaction with their jobs had a 65% higher probability of intending to leave than satisfied nurses (Shields & Ward 2001). Some studies have also reported positive relationships between nurses’ intention to leave and specific components of job satisfaction, including satisfaction with pay and benefits (Morrell 2005), support (Sourdif 2004), autonomy and responsibility (Larrabee et al. 2003), scheduling (Roberts et al. 2004), professional opportunities (Joshua-Amadi 2002), and good relationships with patients/co-workers (Adams & Bond 2000, Chan & Morrison 2000). Other associated factors include the following: age (Borda & Norman 1997), marital status (Shader et al.2001), work experience (Shader et al. 2001) and education (Roberts et al. 2004). Some studies have reported that nurses were more likely to stay in their jobs when they were older, worked in specialised clinical areas and had more years of work experience (Chan & Morrison 2000, Shader et al. 2001, Hu et al. 2004), and nurses who were single and not had children at home were more likely to stay (Shader et al. 2001).Nursing in Mainland ChinaWith continuing economic reform, China has made some major policy changes in health care. The health care system is in a restructuring phase of moving to autonomous management with a market-driven economy (Ho 1995, Hsiao 1995). Additionally, nursing model reforms have had an impact on the delivery of health care. The patient-centred holistic nursing care model has gradually replaced the traditional disease-centred nursing care model (Ministry of Health, China 2003). To ensure that the nurses provide safe and effective practice for the community, a regulatory mechanism was established in the Mainland China. The Registration Ordinance for nurses, published in 1993, established a licensing examination and registration system. The Nurses’ Regulation, published in Mainland China in 2008, provided the conditions of application for registration to practice nursing.At present, there are five levels of nursing education in Mainland China: diploma program delivered by health schools, associate degree program mainly provided by colleges of nursing, bachelor degrees, master’s degree and PhD through university-based education. There are four professional levels of registered nurse (RN): junior RN, senior RN, associate professor nurse and professor nurse according to the Health Technicians Title and Promotion Regulations, published in 1979. ‘Nurse in charge’ was added in 1981 to perfect the professional title systems of nursing staff.Shanghai, located on the east coast of Asia, is one of the largest cities in mainland China. There are 518 public and private medical agencies in Shanghai, including 37 large hospitals and tertiary hospitals (19 general hospitals and 18 special hospitals), 161 district hospitals and secondary hospitals and 320 community healthcare centres and primary hospitals (Cao et al. 2009). With a population of more than 18 million, there are only 38,700 nursing staff in Shanghai. According to 2007 Nursing Human Resources Survey, the number of RNs was 2·15:1000 of the population. Du et al. reported that 58·59% nurses had the intention to leave current employment in Shanghai (Du et al. 2007). The current nursing shortage and nurses’ high turnover in Shanghai highlight the importance of understanding nurses’ views and experiences regarding job satisfaction and intention to leave so that health care organisations can implement effective interventions to improve the retention of their nursing workforce.Jump to…Top of pageAbstractIntroductionBackground and literature reviewMethodsResultsDiscussionLimitationsConclusionRelevance to clinical practiceAcknowledgementsContributionsConflict of interestReferences MethodsAim and objectiveThe study aimed to explore nurses’ views and experiences regarding job satisfaction and intention to leave in Shanghai. The following objectives were set:•  To explore variables of nurses’ job satisfaction in Shanghai.•  To investigate factors associated with nurses’ intention to leave.Research design and sampleA cross-sectional survey design using questionnaires was selected to fulfil the research objectives. A convenience sample of nurses was recruited from 19 large general hospitals in Shanghai. The research assistants distributed 2850 questionnaires to nurses. The response rate of this study was 78·95%, and 2250 nurses completed the questionnaire.InstrumentsThe following instruments were used:Mueller-McCloskey Satisfaction Scale (MMSS, Mueller & McCloskey 1990): This tool consists of seven subscales with 31 items: satisfaction with extrinsic rewards (three items), scheduling (seven items), family/work balance (two items), coworkers (four items), interaction (five items), praise/recognition (six items) and control/responsibility (four items). The MMSS uses a five-point Likert scale with the following ratings: 1 = very dissatisfied, 2 = moderately dissatisfied, 3 = neither satisfied nor dissatisfied, 4 = moderately satisfied and 5 = very satisfied. Reliability and validity for the scales used in this study have been established by Huber et al.(2000). The original MMSS had a Cronbach α that ranged from 0·52–0·84 for each subscale. Correlations among subscales ranged from 0·53–0·75 for similar dimensions, indicating criterion-related validity. In this study, the Cronbach a of the nurses’ job satisfaction subscale ranged from 0·34–0·846.Demographic characteristics were collected regarding personal profile and age, marital status, educational level, professional level and years of experience in nursing. In addition, a question was asked to each nurse, ‘Do you intend to leave the current employment?’, to which they replied using one of two choices, ‘Yes’ or ‘No’.Instrument translationTo avoid the problems inherent in translation, this study used a combination of Brislin (1970) model for translating and back-translating instruments and committee approach. One bilingual expert translated the instruments from English to Chinese and a second bilingual expert back-translated blindly. A panel of four experts in the area of health care workforce management measured the face validity of the translated questionnaire. The instrument has been piloted in 58 nurses in a large general hospital in Shanghai. All of them said they understood all the items.Ethical considerations and negotiation of accessEthical approval was gained from the Second Military Medical University’s Research Ethics Committee. The main ethical issues were respondents’ right to self-determination, anonymity and confidentiality. Prior to data collection, approvals were obtained from hospital administrators and nurses. All nurses were sent a letter that invites them to participate in the study. The letter included a brief description of the purpose of the study, the questionnaire and the demographic form. Completed questionnaires were recruited in sealed envelopes via a collection box places in ward offices. All returned questionnaires were handled by the research team only. Participation was voluntary, and the names of the respondents were not recorded on the questionnaire, thus rendering the data anonymous.Analysis of dataData were entered and processed using the Statistical Package for the Social Sciences (spss) software, the English version 11·0. This study used descriptive statistics, chi-square and multiple logistic regression modelling (forward stepwise Conditional method) to analyse the data.
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    左永安顧問
    16:13 (0 分鐘前)

    寄給 蓉、 mongjay2002



    一般調適症候群

    ㄧ、警告反應期
      (alarm reaction)
    二、抵抗期
      (stage of resistance)
    三、疲憊期
      (stage of exhaustion)

    人類行為表現(Jaffe,1985)

    1.巔峰狀況
    2.精神平衡
    3.緊張費勁
    4.耗竭
    5.崩潰
    疲潰症狀生理反應
    1.疲勞
    2.經常感冒
    3.心跳快
    4.失眠
    5.精疲力竭
    6.頭痛、胸痛
    7.腸胃不適

    疲潰症狀心理反應
    1.冷漠
    2.易怒
    3.情緒不穩
    4.焦慮
    5.記憶力減退
    6.退縮
    7.注意力不集中

    疲潰症狀行為反應

    1.降低做事效率
    2.食慾不振
    3.易發生意外
    4.疏離人際
    5.批評他人或環境

    調適壓力的方法
    1.清楚自己的壓力來源
    2.了解自己對壓力的反應
    3.暸藉自己的壓力調適機制

    調適壓力的方法
    1.認知上
    2.行為上
    3.生理上
    4.社會因應







    左永安顧問 於 2012年2月12日下午3:58 寫道:

    現實休克(Reality Shock)
    還在唸書的時候
    學校所教的技術是最標準、最嚴格的
    棉枝一旦打開包裝便是非無菌
    優碘和酒精必須用倒出的方式來沾染棉枝
    手不能越過消毒過的VIAL
    IV加藥要計算精確的滴速跟滴注時間

    技術一練再練常在學校留很晚
    縱使每次技術考都搞得人仰馬翻
    卻還是覺得有標準技術很好
    一切按照標準流程來
    包準不會出錯

    第一次出去基護實習的時候
    只照顧一位病人
    給藥、量V/S、寫護理紀錄、交班
    然後回家看書比較該診斷臨床跟學理的差別
    其他學姊照顧的8~12個病人
    幫忙作的是最簡單的功能性護理
    量V/S、驗血糖、倒尿total I/O
    每完成一件事就覺得很有成就感
    病人和家屬會跟我說謝謝
    當時覺得好快樂好有成就感
    想著說不定自己很適合唸護理
    當學姊對於病人的哀嚎視而不見時
    會在心裡反駁不該這樣對待他、不該不耐煩
    換做我們是病人,我們一樣會感到痛苦
    想著以後工作也要像現在這樣充滿熱忱
    不管病人怎麼樣
    都要有愛心、有耐心的去安撫

    專科四年級
    照顧一、二位病人
    做的事情和基護實習差不多
    不過開始要寫個案報告、學習怎麼收集及統整資料
    然後也是回家查資料、看書
    努力的看卻還是有很多不懂的地方
    護理長說:你們這批怎麼這麼爛,以後根本不會想用你們!
    當時覺得很受傷
    想著自己有許多不足的地方需要再補強
    同時發現臨床的護理技術不像學校教的那麼標準
    體會到學姊照顧8~12個病人很辛苦
    想著自己以後不論如何累、如何忙
    都只能要求自己速度加快
    技術仍要標準、對病人仍要有耐心
    這是全年實習開始不久的事情

    升上五年級還在實習中
    到了兒科開始對不配合的病人感到不耐煩
    到了衛生所發現自己不擅與人溝通
    到了精神科發現自己無法獲得病人的信賴
    到了產科發現光哺乳就有一堆問題在課本上找不到解答
    漸漸失去自信
    也已經沒有成就感可言
    這時開始質疑:我真的能夠勝任嗎?

    到了二技
    和專科實習非常不一樣
    照顧一、二位病人
    total care
    並且開始要學會批判性思考、個別性護理
    觀察整個病程的變化、各種檢驗結果
    為什麼作這個治療、好不好、對不對?
    有什麼是護理獨立功能可以作的?
    針對這個病人可以再多做些什麼幫助他?
    然後回家查更多的資料、看更多的書
    每天想morning meeting到底該說什麼苦惱得噩夢連連
    護理長和學姊永遠可以揪出我們沒看到的一面
    不管再怎麼想、怎麼收集資料
    永遠都不夠好、不夠完善、不夠周全
    雖然了解到這個工作與經驗有絕對的關係
    卻也有說不出的挫敗感
    我想:或許我根本不適合當護理人員

    如今畢業了
    到了職場
    照顧3個病人(ICU)
    發現事情很多
    Q2H量V/S、寫紀錄、吃飯喝水小便大便都要記錄
    抽不完的血、滴不順又on不上的IV
    接不完的病人、轉不完的床、寫不完的paper work
    放假有上不完的課、修不完的時數
    棉枝伸進瓶子裡沾了優碘和酒精後
    又放回袋子裡備用
    IV加藥調個大概的滴速
    問題一堆的家屬我幫你叫醫生來
    病人敲床想寫字不予理會
    我知道你很痛苦
    但是我也很痛苦
    因為──事情做不完
    做不完就不能交班
    不能交班就會拖累下一班
    拖累下一班以後大家就會不想接你的班
    「厚,煩ㄟ,又要跟他交班!」
    現在被說閒話的是別人
    以後被人說閒話的就是你

    曾經
    我對護理充滿憧憬及熱忱
    但那已經是很久以前的事了

    現在
    依然不確定自己能否勝任
    但我還在努力著



    左永安顧問 於 2012年2月12日下午3:44 寫道:
    進入護理職場可能遇到的挫折
    • 現實休克:工作負荷遠超過預期
    • 學校所學與臨床實務差距大
    • 缺乏時間管理及組織能力
    • 臨床應變及處理能力不足
    • 不知如何處理複雜的人際關係
    • 環境複雜、工作壓力大→失去自信與專業熱忱→離職 護理人員壓力來源
    • 工作負荷量人際關係
    • 工作之重要性
    •  醫院之政策規章
    • 負責任之狀況
    • 分配工作之性質
    • 環境安全
    • 體力需要 護理新人的特質
    • 年輕有衝勁
    • 具備基本知識卻尚未融會貫通
    • 經驗有限
    • 勇氣十足
    • 工作態度不穩定
    護理主管協助護理新鮮人適應策略
    • 了解護理新鮮人的特性,協助角色轉換
    • 臨床護理主管至學校與應屆畢業生直接溝通
    • 辦理新進護理人員到職訓練
    • 安排有愛心及耐心的資深護理人員輔導新進人員
    • 主動關懷協助解決困難,適時給予鼓勵與支持
    • 新進人員座談會
    • 守護天使 臨床新鮮人的調適與準備
    • 加強護理專業知識與能力
    • 重新思考對護理工作的興趣與熱誠
    • 儘早了解護理職場現況,降低理想與現實的距離
    • 調整心情,準備面臨挑戰,接受任勞任怨
    • 勉勵自己,相信自己能做得到,把辛苦當作學習
    • 尋求資源,練習減輕壓力的方法,與壓力共存 學習的歷程
    ~ Novice to Expert ~
    • Novice 初學
    • Advanced beginner 進階學習
    • Competent 勝任
    • Proficient 精通
    • Expert 專家
    (Benner, 1984) • 自我成長
    –文獻搜尋書寫讀書報告
    – 感染管制數位學習
    –安全衛生教育數位學習
    • 人文素養
    – 新進人員角色、壓力處理與調適
    – 醫護溝通(含正確醫學名稱縮寫)、護病溝通
    – 員工權益:勞基法、兩性平等法、性騷擾等 專業技能
    (4-12個月)
    – 常見疾病、檢查與治療之護理、一般疼痛評估
    – 常用藥物之作用、副作用、藥物及病患用藥安全
    – 常用護理技術
    – 常見臨床問題之處理:自動出院患者手續之辦理、
    不假外出、申訴抱怨處理等
    – 個案護理問題分析與處理(Ⅰ):護理過程之應用。
    – 品質管理(Ⅰ):護理品質概念、標準制定與監測、
    新制醫院評鑑
    – 感染管制訓練(依CDC規定)
    – 病患安全促進與案例分析
    – 自殺防範與處置 人文素養
    –法律倫理與護理:醫療法、護理人員法介紹及護理病人之倫理困境
    –基本素養:生涯規劃、壓力調適與管理、傾聽技巧、關懷照護
    –安寧療護概:安寧緩和條例介紹及安寧護理概念 • 自我成長
    –文獻查證、讀書報告
    • 實務操作
    –在護理長、小組長或臨床指導師指導下依病人病情獨立照顧8至12人(依病人病情嚴重程度進行調整) 專業技能
    (13-24個月)
    – 常見疾病、檢查與治療之護理、一般疼痛評估
    – 常用藥物之作用、副作用、藥物及病患用藥安全
    – 常用護理技術
    – 常見臨床問題之處理:自動出院患者手續之辦理、不假外出、申訴抱怨處理等
    – 個案護理問題分析與處理(Ⅰ):護理過程之應用。
    – 品質管理(Ⅰ):護理品質概念、標準制定與監測、
    新制醫院評鑑
    – 感染管制訓練(依CDC規定)
    – 病患安全促進與案例分析
    – 自殺防範與處置 人文素養
    –護理法律與倫理:倫理議題(自主權、告知同意、隱私權、保密)、醫療糾紛等案例討論。
    – 基本素養:護理指導策略與應用、認識專科護理師之角色
    – 壓力調適方法與實務應用 • 自我成長
    –教與學
    – 問題分析與處理(Ⅱ):案例分析
    • 實務操作
    – 在護理長、小組長或臨床指導師指導下依病人病情獨立照顧8至12人(依病人病情嚴重程度進行調整) 臨床專業能力進階制度
    �� 提供護理專業知能成長
    �� 滿足個別專業需求
    �� 發展理想人才建構
    �� 穩定臨床護理人力
    �� 留任專業護理人才
    Learning by doing
     左永安顧問 於 2012年2月12日下午3:26 寫道:

    護理雜誌 51卷3期 中華民國93年6月 頁次24-33
    篇名:精神科護理人員人格堅毅性、因應策略與職業疲潰相關性之探討
    作者:謝佳容、謝馨儀、陳碧霞、蕭伶、李選
    職業疲潰(burnout)(亦稱職業倦怠或職業耗竭),
    1974年梅國心理分析學者Freudenberger首次引用此名詞,
    描述專業人員在工作上由工作情境所引起的耗竭現象,
    其認為疲潰是生理、情緒、心智的耗竭狀態,
    它包括消極的自我概念、工作態度、以及喪失對服務對象的感情和關懷。
    文章內裡面對『職業疲潰』的名詞解釋為:
    指個體因為長期工作壓力無法有效因應所產生之情緒耗竭、
    乏人性化及低成就感等負向症狀。
    (1)情緒耗竭:指助人專業的工作者因工作而存在情緒過渡擴張及耗損的感受。
    (2)乏人性化:指助人專業者對他所服務對象的冷漠、無人性反應。
    (3)個人成就感:指助人專業者在工作中勝任愉快及工作圓滿的感受。 『疲潰』的期刊:
    李選(1989),護理人員壓力感、疲潰與自我主見度之探討。護理雜誌,36(1):85-98。

    有關於『疲潰』的論文:
    1 緊急救護技術員工作壓力、社會支持與專業承諾關係之研究-以臺北市專責救護隊為例
    林威/臺北醫學大學/醫學院/醫學人文研究所/ 2009/碩士
    2 醫療異常事件發生在護理人員之人格韌性、工作壓力、離職意願及護理工作環境知覺上的差異
    陳亞玲/高雄醫學大學/護理學院/護理學研究所/2008/碩士
    3 加護病房護理人員對職業危害的擔心程度與因應策略之探討
    吳安綺/慈濟大學/醫學院/護理研究所/2008/碩士
    4 精神科護理人員照顧邊緣性人格特質病患的護理困難及壓力感受
    吳惠雯/高雄醫學大學/護理學院/護理學研究所/2007/碩士
    5 精神衛生護理人員參與精神病患強制處置的經驗探討
    黃碧玲/中國醫藥大學/健康照護學院/護理學系碩士班/2007/碩士
    6 高科技產業員工壓力來源、員工協助方案認知、自我效能與倦怠感關係
    莊惠婷/長榮大學/管理學院/經營管理研究所/2006/碩士
    7 內外科病房新進護理人員工作壓力與離職傾向之相關性研究
    陸雅美/長榮大學/健康科學學院/醫學研究所/2006/碩士
    8 醫學中心護理人員之勞動條件對其工作壓力、工作負荷及疲勞影響之研究
    王昭儀/臺灣大學/公共衛生學院/衛生政策與管理研究所/2006/碩士
    9 安寧療護醫療團隊工作壓力與壓力調適之研究
    李榕峻/慈濟大學/人文社會學院/社會工作研究所/2006/碩士
    10 護理人員工作壓力與自覺身心健康狀況之相關性研究
    李葆瑋/慈濟大學/醫學院/護理研究所/2006/碩士
    有關於『現實休克』的期刊:
    劉雪娥(1986),現實休克的處理。護理雜誌;33:109-113。

    有關於『現實休克』的論文:
    1 護理科系應屆畢業生從事護理工作之意願及其相關因素
    賴妤甄/中國醫藥大學/公共衛生學院/醫務管理學研究所/2008/碩士
    2 臨床護理輔導員制度對新進護理人員輔導成效之探討
    陳小蓮/臺北醫學大學/護理學院/護理學研究所/2000/碩士
    3 應屆畢業新進護理人員對工作環境的知覺與因應策略
    余斯光/高雄醫學大學/護理學院/護理學研究所/1999/碩士
    11 精神科護理人員因應策略與自覺職業危害之探討
    王懿琨/中山醫學大學/醫學院/醫學研究所/2005/碩士

    12 精神科護理人員人格堅毅性與自覺職業危害相關性研究
    周青波/中山醫學大學/醫學院/護理研究所/2005/碩士

    13 SARS期間感控護理人員之焦慮、特定困擾及不確定感對工作壓力之影響
    陳孟娟/臺北醫學大學/護理學院/護理學研究所/2005/碩士

    14 牙醫助理的工作壓力、工作滿意度與職業倦怠相關因素之探討-以高高屏澎為例
    陳鈞卿/高雄醫學大學/口腔醫學院/口腔衛生科學研究所碩士在職專班/2005/碩士

    左永安顧問 於 2012年2月11日下午4:38 寫道: 


    左永安顧問 於 2012年2月10日下午8:57 寫道:


    左永安顧問 於 2012年2月10日下午8:27 寫道:
    Keywords:China;intention to leave;job satisfaction;nurses;nursing;Shanghai;workforceJump to…Top of pageAbstractIntroductionBackground and literature reviewMethodsResultsDiscussionLimitationsConclusionRelevance to clinical practiceAcknowledgementsContributionsConflict of interestReferences AbstractAim.  To explore nurses’ views and experiences regarding job satisfaction and their intention to leave in Shanghai.Background.  The widespread nursing shortage and nurses’ high turnover rate has become a global issue. Job satisfaction is the most consistent predictor of nurses’ intention to leave and has been reported as explaining most of the variance on their intention to leave.Design.  A cross-sectional survey.Methods.  A convenience sample of nurses was recruited from 19 large general hospitals in Shanghai and the research assistants distributed 2850 questionnaires to nurses. The response rate of this study was 78·95%, and 2250 nurses completed the questionnaire.Results.  Regarding the overall job satisfaction, 50·2% nurses were dissatisfied and 40·4% nurses reported that they had intention to leave the current employment. Respondents’ characteristics had an impact on job satisfaction and their intention to leave. The results showed that age, marital status, work experience, overall job satisfaction, job satisfaction: extrinsic rewards, interaction, praise/recognition and control/responsibility were significant factors contributing to nurses’ intention to leave.Conclusions.  The finding may be a cause of concern for hospital management and highlights the importance of the two concepts (job satisfaction and intention to leave) in Shanghai. Innovative and adaptable managerial interventions need to be taken to improve nurses’ job satisfaction and to strengthen their intention to stay.Relevance to clinical practice.  Our findings outline some issues contributing to these problems and provide nurse administrators with information regarding specific influences on nurses’ job satisfaction and intention to leave in Shanghai and innovative and adaptable managerial interventions that are needed. Our findings may also provide direction for nurse managers and healthcare management to implement strategies to improve nurses’ job satisfaction and their intention to stay.Jump to…Top of pageAbstractIntroductionBackground and literature reviewMethodsResultsDiscussionLimitationsConclusionRelevance to clinical practiceAcknowledgementsContributionsConflict of interestReferences IntroductionThe widespread nursing shortage and nurses’ high turnover rate has become a global issue (Kingma 2001). Job satisfaction is the most consistent predictor of nurses’ intention to leave and has been reported as explaining most of the variance on intention to leave (Hsiao & Lu 1996, Borda & Norman 1997, Thorpe & Loo 2003, Sourdif 2004, Morrell 2005). There is an abundance of international research on nurses’ job satisfaction and intention to leave, however, in China, few studies has focused on nurses’ job satisfaction. As the nursing workforce in Mainland China also faces similar challenges in recruitment and retention, there is an urgent need for rigorous research regarding variables of Chinese nurses’ job satisfaction and intention to leave.Jump to…Top of pageAbstractIntroductionBackground and literature reviewMethodsResultsDiscussionLimitationsConclusionRelevance to clinical practiceAcknowledgementsContributionsConflict of interestReferences Background and literature reviewNurses’ job satisfactionJob satisfaction is defined as all the feelings that an individual has about his/her job (Spector 1997). Job satisfaction has been identified as a key factor to nurses’ intention to leave and turnover (Cavanagh 1992, Cowin 2002, Strachota et al. 2003), but job satisfaction is a complex fact affected by many components. Researchers have attempted to identify the various components of job satisfaction, measure the relative importance of each component and examine what effects these components have on workers’ productivity (Lu et al. 2005). Components of job satisfaction involve any aspect of the job and those frequently assessed including nursing care delivery models and organisational climate (Adams & Bond 2000), working environment (Adamson et al. 1995, Shaver & Lacey 2003, Moon et al. 2008), remuneration (Price 2002, Wang 2009), praise and recognition (Nolan et al. 1995, Lundh 1999), personal growth and promotion (Tzeng 2002, Khowaja 2005), leadership styles (Fang 2001, Fletcher 2001, Wang 2009), stress (Ma 2003), autonomy (O’Rouke et al. 2000, Upenieks 2000, Finn 2001, Larrabee et al. 2003) and relations with patients and co-workers. Job satisfaction was also positively affected by personal factors such as age (Moon et al. 2008), marital status (Cimete 2003), economic level (Cimete 2003), educational level (Cimete 2003, Moon et al. 2008), work experience (Moon et al. 2008) and so on.Nurses’ intention to leaveIntention to leave is defined as nurses’ anticipation of vacating the job in the foreseeable future (Price 1981). Throughout the literature, job satisfaction has been reported as the primary predictor of intention to leave and has been reported as explaining most of the variance on intention to leave (Borda & Norman 1997, Aikenet al. 2002, Ingersoll et al. 2002, Larrabee et al. 2003, Sourdif 2004, Morrell 2005). Many studies have reported positive relationships between job satisfaction and intention to leave (Chan & Morrison 2000, Shields & Ward 2001). Shields and Ward found that nurses who reported overall dissatisfaction with their jobs had a 65% higher probability of intending to leave than satisfied nurses (Shields & Ward 2001). Some studies have also reported positive relationships between nurses’ intention to leave and specific components of job satisfaction, including satisfaction with pay and benefits (Morrell 2005), support (Sourdif 2004), autonomy and responsibility (Larrabee et al. 2003), scheduling (Roberts et al. 2004), professional opportunities (Joshua-Amadi 2002), and good relationships with patients/co-workers (Adams & Bond 2000, Chan & Morrison 2000). Other associated factors include the following: age (Borda & Norman 1997), marital status (Shader et al.2001), work experience (Shader et al. 2001) and education (Roberts et al. 2004). Some studies have reported that nurses were more likely to stay in their jobs when they were older, worked in specialised clinical areas and had more years of work experience (Chan & Morrison 2000, Shader et al. 2001, Hu et al. 2004), and nurses who were single and not had children at home were more likely to stay (Shader et al. 2001).Nursing in Mainland ChinaWith continuing economic reform, China has made some major policy changes in health care. The health care system is in a restructuring phase of moving to autonomous management with a market-driven economy (Ho 1995, Hsiao 1995). Additionally, nursing model reforms have had an impact on the delivery of health care. The patient-centred holistic nursing care model has gradually replaced the traditional disease-centred nursing care model (Ministry of Health, China 2003). To ensure that the nurses provide safe and effective practice for the community, a regulatory mechanism was established in the Mainland China. The Registration Ordinance for nurses, published in 1993, established a licensing examination and registration system. The Nurses’ Regulation, published in Mainland China in 2008, provided the conditions of application for registration to practice nursing.At present, there are five levels of nursing education in Mainland China: diploma program delivered by health schools, associate degree program mainly provided by colleges of nursing, bachelor degrees, master’s degree and PhD through university-based education. There are four professional levels of registered nurse (RN): junior RN, senior RN, associate professor nurse and professor nurse according to the Health Technicians Title and Promotion Regulations, published in 1979. ‘Nurse in charge’ was added in 1981 to perfect the professional title systems of nursing staff.Shanghai, located on the east coast of Asia, is one of the largest cities in mainland China. There are 518 public and private medical agencies in Shanghai, including 37 large hospitals and tertiary hospitals (19 general hospitals and 18 special hospitals), 161 district hospitals and secondary hospitals and 320 community healthcare centres and primary hospitals (Cao et al. 2009). With a population of more than 18 million, there are only 38,700 nursing staff in Shanghai. According to 2007 Nursing Human Resources Survey, the number of RNs was 2·15:1000 of the population. Du et al. reported that 58·59% nurses had the intention to leave current employment in Shanghai (Du et al. 2007). The current nursing shortage and nurses’ high turnover in Shanghai highlight the importance of understanding nurses’ views and experiences regarding job satisfaction and intention to leave so that health care organisations can implement effective interventions to improve the retention of their nursing workforce.Jump to…Top of pageAbstractIntroductionBackground and literature reviewMethodsResultsDiscussionLimitationsConclusionRelevance to clinical practiceAcknowledgementsContributionsConflict of interestReferences MethodsAim and objectiveThe study aimed to explore nurses’ views and experiences regarding job satisfaction and intention to leave in Shanghai. The following objectives were set:•  To explore variables of nurses’ job satisfaction in Shanghai.•  To investigate factors associated with nurses’ intention to leave.Research design and sampleA cross-sectional survey design using questionnaires was selected to fulfil the research objectives. A convenience sample of nurses was recruited from 19 large general hospitals in Shanghai. The research assistants distributed 2850 questionnaires to nurses. The response rate of this study was 78·95%, and 2250 nurses completed the questionnaire.InstrumentsThe following instruments were used:Mueller-McCloskey Satisfaction Scale (MMSS, Mueller & McCloskey 1990): This tool consists of seven subscales with 31 items: satisfaction with extrinsic rewards (three items), scheduling (seven items), family/work balance (two items), coworkers (four items), interaction (five items), praise/recognition (six items) and control/responsibility (four items). The MMSS uses a five-point Likert scale with the following ratings: 1 = very dissatisfied, 2 = moderately dissatisfied, 3 = neither satisfied nor dissatisfied, 4 = moderately satisfied and 5 = very satisfied. Reliability and validity for the scales used in this study have been established by Huber et al.(2000). The original MMSS had a Cronbach α that ranged from 0·52–0·84 for each subscale. Correlations among subscales ranged from 0·53–0·75 for similar dimensions, indicating criterion-related validity. In this study, the Cronbach a of the nurses’ job satisfaction subscale ranged from 0·34–0·846.Demographic characteristics were collected regarding personal profile and age, marital status, educational level, professional level and years of experience in nursing. In addition, a question was asked to each nurse, ‘Do you intend to leave the current employment?’, to which they replied using one of two choices, ‘Yes’ or ‘No’.Instrument translationTo avoid the problems inherent in translation, this study used a combination of Brislin (1970) model for translating and back-translating instruments and committee approach. One bilingual expert translated the instruments from English to Chinese and a second bilingual expert back-translated blindly. A panel of four experts in the area of health care workforce management measured the face validity of the translated questionnaire. The instrument has been piloted in 58 nurses in a large general hospital in Shanghai. All of them said they understood all the items.Ethical considerations and negotiation of accessEthical approval was gained from the Second Military Medical University’s Research Ethics Committee. The main ethical issues were respondents’ right to self-determination, anonymity and confidentiality. Prior to data collection, approvals were obtained from hospital administrators and nurses. All nurses were sent a letter that invites them to participate in the study. The letter included a brief description of the purpose of the study, the questionnaire and the demographic form. Completed questionnaires were recruited in sealed envelopes via a collection box places in ward offices. All returned questionnaires were handled by the research team only. Participation was voluntary, and the names of the respondents were not recorded on the questionnaire, thus rendering the data anonymous.Analysis of data
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     5 International Journal of Nursing Practicehttp://ejdb.lib.ntu.edu.tw/cgi-bin/ej/browse.cgi?q=iMY+%C2%E5%B9%CF%28%C5%40%B2z%29.cl&ccd=SPc3NN&sentry=1&o=select2002-2003Webpac   
     6 Journal of Advanced NursingWiley-Blackwell1976-Webpac
     7 Journal of Advanced Nursinghttp://ejdb.lib.ntu.edu.tw/cgi-bin/ej/browse.cgi?q=iMY+%C2%E5%B9%CF%28%C5%40%B2z%29.cl&ccd=SPc3NN&sentry=1&o=select2001-2003Webpac   
     8 Journal of Clinical NursingWiley-Blackwell1992-Webpac
     9 Men in Nursinghttp://ejdb.lib.ntu.edu.tw/cgi-bin/ej/browse.cgi?q=iMY+%C2%E5%B9%CF%28%C5%40%B2z%29.cl&ccd=SPc3NN&sentry=1&o=select2006-2008Webpac   2008 OVID LWW Collection
     10 MidwiferyElsevier Science(Elsevier)/SDOL1985-Webpac
     11 Nurse Education in PracticeElsevier Science(Elsevier)/SDOL2001-Webpac
     12 Nurse Education TodayElsevier Science(Elsevier)/SDOL1981-Webpac
     13 Nurse Researcherhttp://ejdb.lib.ntu.edu.tw/cgi-bin/ej/browse.cgi?q=iMY+%C2%E5%B9%CF%28%C5%40%B2z%29.cl&ccd=SPc3NN&sentry=1&o=select2002-2004Webpac   
     14 Nursing Standardhttp://ejdb.lib.ntu.edu.tw/cgi-bin/ej/browse.cgi?q=iMY+%C2%E5%B9%CF%28%C5%40%B2z%29.cl&ccd=SPc3NN&sentry=1&o=select2003-2004Webpac   
     15 Public Health NursingWiley-Blackwell1984-Webpac
     16 Western Journal of Nursing ResearchSage Publications Inc. (Sage)1979-Webpac




    http://journals.lww.com/jonajournal/Abstract/1999/05000/Leader_Behavior_Impact_on_Staff_Nurse_Empowerment,.5.aspx



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    TCM China:
    Introduction To Hundreds Commonly Used Chinese Herbs 
           
             
     

    Note: The introduction to the following hundreds commonly used  Chinese herbs is from the English textbook "The Chinese Material Medica" produced by Academy Press [Xue Yuan], Beijing, China. The Chief Editor is Long Zhixian, while the responsible editor is Mr. Chen Hui. We get the permission from the responsible editor to list the contents only in this website.
     
     
    Category 1 Herbs for Relieving Exterior Syndromes
    Part 1 Herbs Pungent in Flavour and Warm in Nature for Relieving Exterior Syndromes
    Part 2 Herbs Pungent in Flavour and Cool in Nature for Relieving Exterior Syndromes
     
    Category 2 Heat-Clearing Herbs
    Part 1 Heat-Clearing and Fire-Purging Herbs
    Part 2 Heat-Clearing and Dampness-Drying Herbs
    Part 3 Heat-Clearing and Blood-Cooling Herbs
    Part 4 Heat-Clearing and Detoxication Herbs
    Part 5 Herbs for Clearing Heat of Deficiency Type
     
    Category 3 Purgative Herbs
    Part 1 Purgatives
    Part 2 Laxatives
    Part 3 Drastic Hydragogues
     
    Category 4 Anti-Rheumatics
     
    Category 5 Aromatic Herbs for Resolving Dampness
     
    Category 6 Herbs for Inducing Diuresis and Excreting Dampness
     
    Category 7 Herbs for Warming the Interior
     
    Category 8 Herbs for Regulating Qi
     
    Category 9 Herbs for Removing Food Stagnation 
     
    Category 10 Anthelmintics
     
    Category 11 Hemostatics
     
    Category 12 Herbs for Promoting Blood Circulation and Relieving Blood Stasis
     
    Category 13 Herbs Resolving Phlegm and Relieving Cough and Asthma  
    Part 1 Herbs Relieving Cold-Phlegm by Warming
    Part 2 Herbs for Clearing Heat-Phlegm
    Part 3 Herbs for Relieving Cough and Asthma
     
    Category 14 Tranquilizers
     
    Category 15 Herbs for Calming the Liver and Checking Wind 
     
    Category 16 Herbs for Resuscitation
     
    Category 17 Tonics for Deficiency Syndromes
    Part 1 Herbs for Invigorating Qi
    Part 2 Blood Tonics
    Part 3 Yin Tonics
    Part 4 Yang Tonics
     
    Category 18 Astringents 
     
    Category 19 Herbs for External Use and Others 
     
     
     



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