Exploring the Self-Evaluation of Family Nursing Therapeutic Competency for Psychiatric Mental Health Nurse

[[abstract]]本研究目的乃由精神衛生護理人員經過實際提供家庭護理治療的體認、經驗，進行家庭護理治療過程中護理人員應具備的實務能力自我評價之探討。研究方法採質性現象學研究法。研究對象為研究者本身，於北市某精神專科醫院進行研究者實際提供之照護對象收案。研究過程依據蕭氏情境家庭護理治療模式，由研究者提供照護對象家庭護理治療照護。資料收集與分析方法為在照護過程中依情境家庭護理治療元素：心、識、觸、智紀錄，依序以文字紀錄完成照護過程實錄，共計照護個案五例、紀錄照護過程實錄42篇，並據此研究紀錄資料，以內容分析方法進行分析，運用Benner's Dreyfus model能力層級的概念，進行家庭護理治療能力必備要項之五項能力自我評價。研究結果得展現與反思自我成長的經驗、具備家庭護理治療之理論及進行家庭護理治療評值能力為精熟者，而在執行家庭評估能力為勝任者與精熟者之間，展現家庭護理治療處置能力為勝任者。討論與結論發現護理人員能在自我評價過程中瞭解提供家庭護理治療過程的適宜性與應繼續精進修習之護理重點、方向，並獲得成就感。此結果有助於提升護理人員提供家庭護理治療之品質、信心與意願，期待本研究成果能作為未來學者發展家庭護理專業之參考。 The aim of this study was to explore self-evaluation of family nursing, a therapy provided by a mental health nurse with clinical experience to measure its therapeutic competency. The research method used phenomenological research. The conductor was also the researcher, in charge of family nursing therapy in a mental hospital in Taipei City. In the Research process, we apply Shiau's contextual family health nursing model of the therapeutic care. Data collection and analysis were done during actual care process, such as the factors of contextual family nursing therapy: heart, acknowledge, touch and wisdom to be recorded. In addition, content analysis method was also used in the research process where 5 cases and 42 nursing process recordings were completed. According to the analysis result of the nursing process recording, we further used Benner's Dreyfus Model to self-evaluate family nursing therapeutic competency and achieved the research aim.The results showed that the researcher's self-evaluation of family therapeutic competency has the following properties: able to show the reflection on the experience of self-growth, to conduct family care and treatment theory accordingly, and to obtain therapeutic effects. The fore-mentioned competency is required to be proficient, including performing family assessment with competency and proficiency, operating family therapy treatment, and showing competency as well. Discussion and conclusions illustrated that the nurse could appropriately understand the nursing therapeutic methods during the self-evaluation process. These results help the psychiatric mental health nurses to improve the quality of family nursing therapy, to enhance the confidence and willingness of participating family care. All in all, this research can be used as a reference for future development of family nursing therapeutic competency