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研究生: 張詩愉
Chang, Shih-Yu
論文名稱: 新進護理師專業能力量表之發展與驗證
Development and Validation of Professional Competency Scale for Newly Graduated Nurses
指導教授: 李歡芳
Lee, Huan-Fang
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: 2026
畢業學年度: 114
語文別: 中文
論文頁數: 118
中文關鍵詞: 新進護理師專業能力能力評估信度效度
外文關鍵詞: Newly graduated nurses, professional competency, competency assessment, reliability, validity
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  • 研究背景:新進護理師的能力既複雜又具動態性,儘管已有相關量表來評量,但世代變化和健康照護體制差異仍會導致測量成果變異。因此,建構符合世代特性並具本土文化的新進護理師專業能力量表有其必要性。
    研究目的:發展與驗證新進護理師專業能力量表。
    研究方法:依據DeVellis和Thorpe所提出之九大步驟進行量表發展,以範疇文獻回顧方式蒐集並整合相關文獻以確認新進護理師應具備之專業能力,透過修正式德爾菲法(Modified Delphi Technique)結合目標族群訪談以建立量表之內容效度,並進行前驅試驗以檢視題項可行性與理解度。資料收集採用網路問卷之橫斷式研究設計,研究對象為各急性醫療機構之台灣醫學中心、區域醫院及地區醫院目前在職一年內之新進護理師。資料整理與統計分析以Microsoft Excel及R軟體進行。正式問卷資料將先進行項目分析,再透過探索性與驗證性因素分析檢驗建構效度,並以效標關聯效度、聚合效度與區辨效度評估量表效度;信度部分則以Cronbach’s α、McDonald’s ω及折半信度進行檢驗。
    研究結果:本研究依據量表建置程序由初始52題修訂為51題進行前驅試驗,結果顯示量表具良好內部一致性。正式問卷共650份新進護理師自評資料。項目與總分相關係數(r)介於0.414至0.696之間,具良好項目區分度,故未刪除任何題項。進行信效度檢測前之適切性評估,KMO值為0.93,Bartlett球形檢定達顯著水準(p < .001),顯示資料適合進行因素分析;依據陡坡圖與平行分析結果,決定擷取三個因子。探索性因素分析採主成分分析法,並以oblimin斜交旋轉進行因素萃取,過程中共刪除11題,最終保留40題。三個構面之各題項因素負荷量皆大於0.40,予以保留,並重新命名為「臨床照護能力」、「軟實力」及「教育與管理」,累積解釋變異量為44%。後續驗證性因素分析採對角加權最小平方法(DWLS)進行估計,模型適配指標均達良好水準,聚合效度與區辨效度亦獲支持。與工作適應進行效標關聯效度檢驗結果顯示,兩者之間呈現正向單調相關,相關程度介於中度至高度。信度方面,整體量表之Cronbach’s α與McDonald’s ω均為0.96,各構面介於0.85至0.91之間;折半信度經Spearman-Brown校正後,整體信度為0.940,各構面介於0.856至0.915。
    結論:整體而言,本量表展現良好之心理計量特性,信度與效度皆達可接受以上水準,可作為衡量台灣新進護理師核心專業能力之工具。量表包含三面向40題,其具有良好之心理計量學特性,適用於台灣新進護理人員專業能力之測量,可提供教學、臨床實務及研究發展之實證工具使用。

    Newly graduated nurses need to possess strong professional competencies to effectively respond to complex clinical environments and support their continued practice. However, professional competence is multidimensional and complex in nature. In this regard, the research paper aimed to create a professional competence scale among newly graduated nurses in Taiwan using systematic literature review and school of scale development. The instrument created was analyzed using item analysis, exploratory and confirmatory factor analysis to determine construct validity and comparing the instrument against other variables using criterion-related analysis; reliability was measured using internal consistency measures. The results showed that the scale developed has good psychometric characteristics and can be used as a useful instrument to assess the essence of the professional competencies of newly graduated nurses in Taiwan.

    口試合格證明頁 I 中文摘要 II 致謝 VII 第壹節 緒論 1 第一節 研究背景 1 第二節 研究動機 2 第三節 研究目的 4 第四節 名詞解釋 5 第貳章 文獻查證 7 第一節 新進護理師的定義 7 第二節 新進護理師專業能力面向 8 第三節 新進護理師專業能力影響因素及結果 9 一、新進護理師專業能力之影響因素 9 二、新進護理師專業能力不足之後果 10 第四節 現有新進護理師能力評估工具介紹與侷限性 11 第五節 量表發展與驗證步驟 18 第參章 研究方法 20 第一節 研究階段與設計 20 第二節 倫理考量 28 第四章 研究結果 29 第一節 量表建構 29 第二節 正式問卷施測 48 第三節 台灣新進護理師專業能力量表最終版本 71 第伍章 討論 75 第陸章 結論、研究限制與建議 79 第一節 結論 79 第二節 研究限制 79 第三節 研究貢獻與未來應用 80 參考文獻 82 附件 97 附件一 IRB 通過證明 97 附件二 工作適應量表授權書 99 附件三 新進護理師專業能力前驅版本 100

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