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題名：護理人員參與擬真情境放射線治療皮膚照護工作坊之學習成效研究
書刊名：護理雜誌
作者：李玉珊／高毓秀 引用關係
作者(外文)：Lee, Yu-san／Kao, Yu-hsiu
出版日期：2016
卷期：63:4
頁次：頁80-89
主題關鍵詞：放射線治療皮膚照護；工作坊；擬真情境；直接觀察臨床技術評量；Radiation therapy skin care；Workshop；Simulation；Direct observation of procedural skills checklist
原始連結：連回原系統網址new window
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背景：接受放射線治療者中，有60-95%出現皮膚反應，易造成病人身心不適與治療延長。針對護理人員的皮膚照護教學，多以講授法而少實際操作，導致護理人員於臨床照護時無法處理多變的情境。目的：本研究探討護理人員參與擬真情境放射線治療皮膚照護工作坊的學習成效。方法：本研究採類實驗單組前測、後測及後後測（介入6週後）的研究設計，以北區某醫療體系有照護放射線治療病人經驗的護理人員（N = 34）為研究對象。於擬真情境放射線治療皮膚照護工作坊中，運用Ausubel的直接教學法及擬真豬皮傷口照護演練等教學策略，並以「放射線治療皮膚照護問卷」及「直接觀察臨床技術評量表」評量其學習成效。結果：擬真情境放射線治療皮膚照護工作坊介入後，以廣益估計方程式（generalized estimating equation）進行分析，結果在知識方面，後後測及後測比前測分別增加了3.14分（p ＜ .001）及2.64分（p ＜ .001）；在態度方面，後後測及後測比前測分別增加2.06分（p ＜ .05）及2.24分（p ＜ .001）；在技術方面，後後測及後測比前測分別增加2.79分（p ＜ .001）及1.68分（p ＜ .001）。結論：擬真情境放射線治療皮膚照護工作坊可顯著提升護理人員於放射線治療皮膚照護的學習成效，建議未來可多利用擬真情境演練作為臨床護理人員教育訓練之策略。
Background: The skin reaction rate is 60-95% in cancer patients that receive radiation therapy. This therapy is likely to cause physical and mental discomfort and prolong treatment for patients. The current emphasis on lectures rather than practice to help nurses learn proper skin care practices likely imposes difficulties for nurses to handle various clinical situations. Purpose: To investigate the learning effectiveness of a simulated radiation therapy skin care workshop for nurses. Method: A total of 34 nurses at a hospital in one health system in northern Taiwan who had never used radiation therapy to provide care to patients were enrolled in this quasi-experimental study. A single group pretest, posttest and post-posttest (6 weeks after intervention) approach was used. At the simulated radiation therapy skin care workshop, we used teaching strategies including Ausubel's direct instruction teaching method and practice on simulated wounds on pig skins. Outcomes were evaluated using ＂the questionnaire of radiation therapy skin care＂ and ＂direct observation of procedural skills checklist＂. Results: The results from the simulated radiation therapy skin care workshop were analyzed using GEE (generalized estimating equation). The post-posttest and posttest scores increased significantly; knowledge mean score 3.14 (＜ .001) vs 2.64 (＜ .001), attitude mean score 2.06 (p ＜ .05) vs 2.24 (p ＜ .001), and skill mean score 2.79 (p ＜ .001) vs 1.68 (p ＜ .001). Conclusion: The simulated radiation therapy skin care workshop demonstrated significant and positive effects on learning outcomes. Therefore, we recommend incorporating this workshop into clinical nursing education and training strategies in the future.
期刊論文
1.周繡玲、楊立華、馮容芬(20090600)。建立傷口照護標準--以壓瘡傷口為例。亞東學報，29，243-256。  延伸查詢new window
2.楊志偉、古世基、蔡詩力、葉啟娟、馬惠明、張上淳(20080900)。高擬真情境模擬在住院醫師急重症訓練的應用：臺大醫院的經驗。醫學教育，12(3)，142-152。new window  延伸查詢new window
3.李雅惠、梁穎、楊易宏、簡于芬、翁新惠(20121200)。接受放射線治療病人皮膚臨床照護指引。榮總護理，29(4)，395-404。new window  延伸查詢new window
4.周成蕙、黃慧芬、劉桂芬(20140900)。熟能生巧--情境模擬在護理教育的應用。榮總護理，31(3)，226-233。new window  延伸查詢new window
5.陳夏蓮、李美麗、廖怡珍、梁天麗(20130400)。高擬真病人模擬教學之發展與現況。護理雜誌，60(2)，87-92。new window  延伸查詢new window
6.陳祖裕、李發耀、陳震寰(20090600)。有效的教學技能工作坊模式。醫學教育，13(2)，133-139。new window  延伸查詢new window
7.郭書麟、鄭嘉惠、卓淑玲、洪聖惠、王拔群(20140600)。急重症高擬真模擬情境團隊訓練成效初探。輔仁醫學期刊，12(2)，89-96。  延伸查詢new window
8.Bultas, M. W.、Hassler, M.、Ercole, P. M.、Rea, G.(2014)。Effectiveness of high-fidelity simulation for pediatric staff nurse education。Pediatric Nursing，40(1)，27-42。  new window
9.Cook, D. A.、Hatala, R.、Brydges, R.、Zendejas, B.、Szostek, J. H.、Wang, A. T.、Hamstra, S. J.(2011)。Technologyenhanced simulation for health professions education: A systematic review and meta-analysis。The Journal of the American Medical Association，306(9)，978-988。  new window
10.Fourie, A.(2013)。The inadequacy of wound management training for medical professionals。Wound Healing Southern Africa，6(1)，21-24。  new window
11.Franco, R. D.、Sammarco, E.、Calvanese, M. G.、DeNatale, F.、Falivene, S.、Lecce, A. D.(2013)。Preventing the cute skin effects in patient's treated with radiotherapy for breast cancer: The use of comeometry in order to evaluate the protective effect of moisturizing creams。Radiation Oncology，8(57)，1-7。  new window
12.Haycock, A.、Koch, A. D.、Familiari, P.、van Delft, F.、Dekker, E.、Petruzziello, L.、Thomas-Gibson, S.(2010)。Training and transfer of colonoscopy s kills: A multinational, randomized, blinded, controlled trial of simulator versus bedside training。Gastrointestinal Endoscopy，71(2)，298-307。  new window
13.Jansson, M. M.、Ala-Kokko, T. I.、Ohtonen, P. P.、Merilainen, M. H.、Syrjala, H. P.、Kyngas, H. A.(2014)。Human patient simulation education in the nursing management of patients requiring mechanical ventilation: A randomized, controlled trial。American Journal of Infection Control，42(3)，271-276。  new window
14.Jeffries, P. R.、Beach, M.、Decker, S. I.、Dlugasch, L.、Groom, J. A.、Settles, J.、O'Donnell, J. M.(2011)。Multi-center development and testing of a simulation-based cardiovascular assessment curriculum for advanced practice nurses。Nursing Education Perspectives，32(5)，316-322。  new window
15.Kumar, S.、Juresic, E.、Barton, M.、Shafiq, J.(2010)。Management of skin toxicity during radiation therapy: A review of the evidence。Journal of Medical Imaging and Radiation Oncology，54(3)，264-279。  new window
16.Kent, D. J.(2010)。Effects of a just-in-time educational intervention placed on wound dressing packages: A multi-center randomized controlled trial。Wound, Ostomy and Continence Nurses Society，37，1-6。  new window
17.McQuestion, M.(2006)。Evidence-based skin care management in radiation therapy。Seminars in Oncology Nursing，22(3)，163-173。  new window
18.Roberts, D.、Gaspard, G.(2013)。A palliative approach to care of residents with dementia。Nursing Older People，25(2)，32-36。  new window
19.Sideris, M.、Papalois, A.、Georgios, T.、Majumder, S.、Toutouzas, K.、Koletsis, E.、Zografos, G.(2015)。Developing an international combined applied surgical science and wet lab simulation course as an undergraduate teaching model。BioMed Research International，2075(2015)，1-10。  new window
20.Vadnais, M. A.、Dodge, L. E.、Awtrey, C. S.、Ricciotti, H. A.、Golen, T. H.、Hacker, M. R.(2012)。Assessment of longterm knowledge retention following single-day simulation training for uncommon but critical obstetrical events。The Journal of Maternal-Fetal & Neonatal Medicine，25(9)，1640-1645。  new window
21.Norman, J.(2012)。Systematic review of the literature on simulation in nursing education。ABNF Journal，23(2)，24-28。  new window
圖書
1.余民寧(2012)。教育測驗與評量：成就測驗與教學評量。台北市：心理。  延伸查詢new window
2.于博芮、蔡新中、蔡新明、張美娟、黃靜君、林秋玉、胡名霞(2013)。最新傷口護理學。台北市：華杏。  延伸查詢new window
3.邱皓政(2012)。量化研究與統計分析--SPSS（PASW）資料分析範例。台北市：五南。  延伸查詢new window
4.張春興(2015)。教育心理學--三化取向的理論與實踐。台北市：東華。  延伸查詢new window
5.Nilson, L. B.(2010)。Teaching at its best: A research-based resource for college instructors。San Francisco, CA：Jossey-Bass Higher and Adult Education。  new window
6.Oermann, M. H.、Gaberson, K. B.(2013)。Evaluation and testing in nursing education。New York, NY：Springer。  new window
7.Slavin, Robert E.(2003)。Educational psychology: Theory and practice。Boston, MA：Allyn & Bacon。  new window
8.Ausubel, David Paul(1968)。Educational Psychology: a cognitive view。New York：Holt, Rinehart and Winston, Inc.。  new window
9.李石增、史清平、朱宗藍、吳茂昌、李明勳、王錦榮、顏志峰(2013)。臨床能力評量指引。台北：台灣愛思唯爾有限公司。  延伸查詢new window
其他
1.Radiation Therapy Oncology Group(2013)。Acute radiation morbidity scoring criteria，https://www.rtog.org/Research Associates/AdverseEventReporting/RTOGEORTCLateRadiation MorbidityScoringSchema.aspx。  new window
圖書論文
1.Bailey, C.、Johnson-Russell, J.、Lupien, A.(2011)。High-fidelity patient simulation。Innovative teaching strategies in nursing and related health professions。Sudbury, MA：Jones and Bartlett。  new window
 
 
 
 
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