| 摘要: | 背景與動機
青少年正處於心理和情緒發展的關鍵階段，青少年護理門診的設立目的為透過專業的護理和諮詢提供適當的支持協助青少年應對情緒困擾和心理壓力，減少心理健康問題及未來形成疾病的風險，並提供主要照顧者適度支持和教育，增強家庭在青少年心理健康中的功能。本研究主要目的為探討青少年護理門診之服務經驗。
研究方法
本研究採質量性混合研究設計，量性方面採橫斷式研究方式，以病歷回顧分析個案及其主要照顧者基本資料，醫生轉介問題類別、實際發生問題之面向、及護理措施介入類別等。另外，以質性訪談個案及其主要照顧者進行資料收集，以了解個案及主要照顧者對於使用護理門診之經驗、感受及建議。量性資料以SPSS 22 統計軟體進行描述性統計分析。另以質性研究法探討青少年及其主要照顧者對於使用青少年護理門診經驗之看法及建議。本研究利用半結構開放式的訪談指引，個案及主要照顧者在安心的環境與個案及主要照顧者一對一的訪談、輔以錄音紀錄，引導青少年對自身相關敏感的話題深入的參與及表達，最後將錄音檔轉為逐字稿，逐一檢視文本及內容，並形成重要的訪談類屬。
研究結果
本研究量性分析共收集使用青少年護理門診服務之45位個案，年齡介於12-24歲，研究結果發現，多數的個案年齡在15歲以下，男女性別分布相對平均，教育程度較多介於國中階段，且多未接受過早期療育，主訴問題為情緒問題，轉診時診斷主要為鬱症，護理會談次數主要為10次以下，護理會談介入方法以支持傾聽同理、藥物衛教、心理衛教、認知行為介入策略、親職溝通技巧、情緒調適技巧、睡眠衛生指導、資源轉介及整合、自殺防範、討論手機及網路安全、處理人際關係衝突，精神科診斷部分以鬱症最多。主要照顧者之基本屬性方面，以母親為主，多數的病人被轉介護理門診的原因是，因為父母本身的擔心。
質性分析共訪談3位青少年個案及2位主要照顧者對於使用護理門診之經驗及感受，研究結果發現以下八個主題: 感到安全的場域及對象，提供情緒宣洩及支持，共同面對、增加自信及被認同、陪伴成長、學習自我改變及增進相互溝通；也同時體現護理門診服務之方便可近性，擔任代理人的角色等。
結論
本研究發現使用青少年護理門診之個案多為情緒問題，青少年及主要照顧者對於護理門診之使用經驗多表達能增進自我成長及改善家庭互動；本研究有助於政府針對青少年健康問題照護政策訂定，或是引入適當照護模式之參考依據，而醫療管理者可根據本研究結果，更加重視並積極推動各醫療機構加入青少年護理門診的行列，以期給予青少年更完善的照護。
Background and Motivation
Adolescence is a critical stage for psychological and emotional development. The establishment of adolescent nursing outpatient clinics aims to provide appropriate support through professional nursing and counseling to help adolescents cope with emotional distress and psychological pressure, reducing the risk of mental health problems and future diseases. These clinics also provide primary caregivers with appropriate support and education to enhance the family’s role in adolescent mental health. The main purpose of this study is to explore service experience of adolescent nurse clinic.
regarding the use of nursing outpatient services.
Research Methods
This study adopts a mixed-methods research design. The quantitative aspect employs a cross-sectional study, analyzing patient records and basic information of cases and their primary caregivers, categories of referral issues, dimensions of actual problems encountered, and types of nursing interventions. Additionally, qualitative interviews with cases and their primary caregivers are conducted to understand their experiences, feelings, and suggestions regarding the use of nursing outpatient services. Quantitative data are analyzed using descriptive statistics with SPSS 22. Qualitative data are explored using a qualitative research approach to gather insights from adolescents and their primary caregivers regarding their experiences and suggestions for the adolescent nursing outpatient clinic. Semi-structured open-ended interview guides are
used, and one-on-one interviews are conducted in a safe environment, recorded and transcribed verbatim, followed by a thorough review of the texts
and content to form important interview categories.
Research Results
The quantitative analysis collected data from 45 cases using the adolescent nursing outpatient services, aged between 12-24 years. The results show that most cases are under 15 years old, with a relatively even gender distribution. The primary caregivers are mostly mothers, and most referrals to the nursing outpatient clinic are due to parental concerns. The qualitative analysis involved interviews with three adolescent cases and two primary caregivers about their experiences and feelings regarding the use of nursing
outpatient services.
Conclusion
This study found that the adolescent nursing outpatient clinic at a medical center provided valuable services and nursing interventions to adolescents and their primary caregivers. Most cases were referred by emotional problems, and the experiences reported by adolescents and their caregivers indicated improvements in self-growth and family interactions. In terms of policy management, this study offers insights for the government in formulating policies for adolescent health care and provides a reference for introducing appropriate care models. Medical administrators can use the findings to emphasize and promote the establishment of adolescent nursing outpatient clinics in various medical institutions, aiming to provide better care for adolescents. |
