[[alternative]]A Study of School Nurses’ Loss Reaction and Coping Strategies after Severe Injury Incidents－An Example of Tao-yuan Area

[[abstract]]本研究旨在探討學校護理人員經歷校園重大意外事件後的失落反應與調適行為現況，及其相關因素。以桃園地區公私立國小、國中及高中職之現職學校護理人員為研究對象，共272人，採回溯式問卷調查法。所得資料以次數分配、描述性統計、單因子變異數分析及多元逐步迴歸進行資料分析。 研究結果發現：（一）學校護理人員經歷校園重大意外事件顯示有中度的失落反應。（二）學校護理人員經歷校園重大意外事件高度應用「直接主動」、「間接主動」層面的調適行為，而「直接被動」與「間接被動」層面的調適行為分別中度至低度應用。（三）受難者傷害程度宗教信仰及工作年資對學校護理人員的失落反應有顯著差異。（四）宗教信仰、教育程度、感受最深刻的受難對象、受難者的傷害程度與調適行為有顯著差異。（五）調適行為對失落反應具有預測力。（六）學校護理人員對生死教育課程及支持關懷活動有高度需求（占92.0％及96.8％）。 依據本研究結果，建議教育主管機關與行政單位應重視護理人員的生死教育、發展學校後續關懷之處遇計畫、發展助人者自助工作手冊、 落實學校安全教育；另外，建議實務工作者應增進自我覺察能力，表達失落情緒，學習自我照顧並強化悲傷的自我調適，鼓勵學校護理人員參與支持關懷團體。因為專業照顧者也需要關懷與照顧，照顧者唯有照顧好自己才能照顧需要幫助的人。[[abstract]]The purpose of this study is to explore school nurses’ loss reaction, coping strategies and related factors after severe injury incidents. This study is aimed at incumbent 272 school nurses of public or private high schools and below in Taoyuan area with regression questionnaire survey. The data were analyzed by frequency distribution, descriptive statistics, one way ANOVA and multiple stepwise regression.The major findings of this research are as follows:（1）When experiencing severe injury incident, school nurses’ loss reaction is intermediate.（2）When experiencing severe injury incident, school nurses use highly 「direct actively」,「indirect actively」to harmonize themselves, and the level of coping strategies for both 「direct actively」 and 「indirect actively」is intermediate and low respectively.（3）There are remarkable variations between school nurses’ loss reaction and injury degree of a victim, religious belief, working experience.（4）There are remarkable variations between coping strategies and religious belief, education level, most impressive victim, injury degree of a victim.（5）The coping strategies behavior to loss reaction of nurses is predictable.（6）Life and death education and grief support group are highly demanded by school nurses (92% and 96.8% respectively).According to this study, it suggests that the educational organization and administration should pay attention to nurses’ life and death education, developing the plan of follow-up caring treatment and self-helped working manual, carrying out school safe education; furthermore, it suggests practitioners should enhance their perceivable ability, expressing loss emotion, learning to take care of themselves and intensify the self-harmonized of grief, encouraging school nurses to support and participate in the grief support group. The professional nurses need to be concerned and cared of, too, and if nurses can take care of themselves well, they would have the competence to take care of people who need help