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研究生: 譚凱蓉
Tam, Kai-Jung
論文名稱: 發展「以復元病友為師」之精神衛生護理教育模式
Developing the “ patients as educators” into psychiatric mental health nursing education
指導教授: 林靜蘭
Lin, Esther Ching-Lan
學位類別: 碩士
Master
系所名稱: 醫學院 - 護理學系
Department of Nursing
論文出版年: 2024
畢業學年度: 112
語文別: 中文
論文頁數: 117
中文關鍵詞: 復元以病友為師護生
外文關鍵詞: recovery, patients as educators, nursing students
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  • 背景與目的:烙印對精神疾病患者的復元成效、整體醫療照護品質以及全民心理健康產生重大影響。隨著反烙印倡議在全球範圍內日益受到重視,「以病友為師」的教學方法已成為一種極具前景的教育策略。這種教學方式不僅能有效減少學生對精神疾病的烙印態度,同時也能增強復元病患的自我認同。然而,現有的復元課程在操作細節和中西方文化轉譯的適用性方面仍存在不足。因此,本研究旨在探討並發展符合台灣本土文化脈絡的具體策略。
    方法:本研究採用社群參與式研究方法,開發全面性的培訓方案,準備復元病患成為復元老師。通過觀察筆記、會議記錄和反思心得等方式收集數據,記錄護理學生和復元老師在課程實施過程中(前、中、後)的經驗和反應。研究著重於理解所有參與者之間的互動動態、學習過程和個人轉變。
    結果:分析歸納出四個主要主題,描述了課程的發展和實施:(1)招募社群夥伴時的願景、希望與擔憂 - 解決復元老師和教育機構的初始期望和顧慮;(2)從不同立場看待復元與促進健康平等 - 探索各利害關係人對復元的理解及其在實現醫療平等中的角色;(3)創新和發展反烙印融入課程之元素 - 創建和實施有效的教學策略以對抗烙印;(4)共學結合復元四階段於課程 - 將復元原則貫穿於整個教育過程。研究發現強調了平等對待復元老師的重要性,包括促進他們在課堂上有意義的分享和與護理學生的互動,以及在整個教育過程中展現自主性和賦能價值。
    結論:「以復元病友為師」的精神衛生護理教育模式代表一種轉化性的方法,通過直接互動和共同學習經驗使復元老師和護理學生均能受益。在此過程中,復元老師能在復元歷程中發展更大的自主性並對護理教育做出有意義的貢獻,而護理學生則能更深入地理解精神疾病,發展反烙印態度,並更好地理解其未來作為精神科護理師的角色。本研究為開發符合文化特性的復元導向教育課程提供了寶貴見解,並表明這種方法能有效地連結精神衛生護理教育中的理論知識和生活經驗。

    Stigma surrounding mental illness significantly impacts the recovery of individuals, the quality of care they receive, and overall mental health. In response to this challenge, anti-stigma initiatives have emerged globally, gaining traction as effective strategies to combat discrimination and promote understanding. One innovative approach involves utilizing recovering patients as educators, a method that not only helps to reduce stigma among students but also fosters a stronger sense of identity and self-worth in individuals on their recovery journey. This study focuses on developing a tailored anti-stigma strategy for Taiwan, employing community-based participatory research to train recovering patients to serve as educators. Through comprehensive analysis of observational notes, meeting minutes, and reflective experiences, we identified key themes that highlight the effectiveness of this approach. Ultimately, our findings suggest that the “recovery patients as educators” model not only empowers the educators themselves but also enhances nursing students' attitudes and understanding toward mental health.

    中文摘要 III 致謝 XI 第壹章 緒論 1 第一節 研究背景與動機 1 第二節 研究問題 4 第三節 研究目的 4 第貳章 文獻查證 5 第一節 烙印 5 一、烙印 5 二、與精神疾病相關之烙印 8 三、精神疾病烙印之文化脈絡 10 第二節 健康照護專業中的烙印 12 一、健康照護專業對於精神疾病所存烙印 12 二、精神科護理專業對於精神疾病所存烙印 14 第三節 融入烙印價值於護理教育 16 一、反烙印教學策略於護理教育之應用 16 二、以病友為師運用於醫護教育 19 第四節 文獻總結 22 第參章 研究方法 23 第一節 研究設計 23 一、 研究設計 23 第二節 研究步驟及流程 25 一、課程研發階段 25 二、課程實施階段 26 第三節 研究處置 27 第四節 研究工具 28 ㄧ、CBPR研發小組 28 二、課程學習小組 30 第五節 資料收集方式 32 第六節 資料分析 32 第七節 研究論理考量 34 第肆章 研究結果 36 第伍章 討論 61 第陸章 結論 65 第柒章 參考文獻 66

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