[[alternative]]The Psychosocial Reaction of Nurses for caring experience in Abused Elderly

[[abstract]]本研究旨在探究護理人員照護受虐老人經驗之心路歷程，經由口述史方法，探討護理人員面臨老人受虐情境時，與其生命經驗交織後之心境轉折，爾後所表現的行為、採行的處理措施與影響因素。 由研究發現-「就讀護理學校的初始動機」關係到護生對護理知能的學習態度，進而影響到對護理的體認與使命、投入職場後對護理角色的定位，與工作中自信和能力的提昇與否，更進一步關聯到面對老人受虐事件的角色覺知與處置;此外，護理人員傳承自「家中長輩身教、言教」的養老、孝順觀念，也習於以此評判施虐之家屬；但又同時受到現實社會結構、價值觀改變之強烈衝擊，致使護理人員不斷求證自己的價值觀的對錯，在此過程中，護理人員醒悟到事情的判定並非只分“對、錯”二面，須多面向的考量，因此抱持著更包容、體諒的心對待施虐的家屬，認為支持、教導家屬，即是間接保護老年病患。而護理人員曾受「心靈溝通的訓練」，關係到能否自我覺察-在老人受虐事件中，自身的價值判斷對護理行為的影響；對「老人受虐相關知識」認知有限，亦侷限了護理人員處理老人受虐時的角色功能與時效性；「家庭問題的錯綜複雜」、「別人的家務事」以及「社會風氣」也讓護理人員沒有足夠的勇氣去“淌這個渾水”；此外「時間不夠」也常令護理人員感到“心有餘而力不足”。 希望研究結果將能幫助從事臨床的護理工作者，在面對老人受虐情境時，能自省到避免使自身的價值判斷影響其處置措施，以及對護理養成教育、醫療院所在職教育的課程編排參考，與護理人力合理的調整之重要性受到重視。[[abstract]]The purpose of this research is to explore the psychosocial reaction of nurses for their experience in caring for the abused elders. By means of oral history, it probes into the transformations of nurses’ psychological situation by this interaction both the situation to facing elderly being abused and their own life experience. Then, it reveals their behaviors, the measure taken in dealing with the matter, and its influential factors.The result reveals that “the initial motive to study nursing school” can affect the study of nursing students’ attitude towards nursing knowledge, and further affecting the awareness of the mission about nursing professional and the awareness of professional role of nurses once when they join the work force. Also, it affects whether nurses can enhance their self-confidence and ability at work after themselves are involved. Further, it relates to how they come to awareness of their own role in this matter and how they manage to cope with cases of the abused elders. In addition, the nurses are influenced by what they constantly see and hear as “their own elderly relatives” teach them by example, so it forms a tradition of how they would take care of their own parents and showing filial duty which in terms of making them tend to criticize the family members of the abused elderly; however, their traditions are also strongly impacted by changes of social structure and value in reality, so that the nurses would constantly search for the precise answers to affirm their own values. In the process, nurses have realized that they cannot only focus on simple answer of “right or wrong” because the matters should be thought about multi-dimensionally. Thus, they are more forgiving and considerate for the family members who abuse the elderly. They believe by supporting and educating the family members can also indirectly protecting the elderly patients. However, the nurses have accepted “the communicational training of the mind” connect whether they can detect themselves the phenomenon that the nurses’ values can make the effect of the nursing behavior themselves. The nurses do not know much about “specific knowledge of abused elderly”, so it restricts their role functions and the efficiency while they are coping with cases of abused elderly. Since matter can be seen as “Complicated family problems,” “someone else’s business,” and “climate of society” therefore this type of situation would frustrate the nurses, so they do not have enough courage to “bring trouble upon oneself”. Moreover, that “not having enough time” is another reason that nurses feel “willing but inadequate”.It is expected that the results would be helpful for the nursing staff in clinic to have self-awareness so as to avoid influencing the measures by the judgment of self-values while facing the situation of abused elderly. Also, it could be a reference for both of arranging courses in forming nursing education and the training course in hospital, and raising the importance of making reasonable adjustment of nursing manpower as well