| 摘要: | 背景: 實習是理論與實務的結合，是護生進入護理生涯成為護理師必經之路，藉由累積臨床的經驗，可增長個人的技能及獲得實際經驗的重要途徑，但是對護生來說是極具壓力的，如果護生於實習期間無法適應，容易產生挫折感，進而影響身、心健康狀況。
Background: Internship combines theory and practice, and it is a pathway for student nurses to launch their nursing careers and become nurse practitioners. Accumulating clinical experience is an important way for them to increase their personal skills and gain practical experience. However, this is
extremely stressful for student nurses. If student nurses cannot adapt themselves during their internship, they will easily become frustrated, affecting their physical and mental health.
Objective: To explore the correlation between internship stress and internal symptoms (anxiety and depression) of student nurses during internship.
Methods: A cross-sectional and purposive sampling research design was adopted, and a total of 118 advanced student nurses in the nursing department (Grade 4 of a five-year junior college program and Grade 3 of a four-year technical program) were enrolled as subjects. The research questionnaire included basic data, an internship stress scale, a depression scale, and an anxiety scale. The Student Nurses’ Internship Stress Scale developed by Hsu et al. (1997) was used, where the higher the score, the higher the stress. According to the Adolescent Depression Scale developed by Huang and Hsu (2003), a score of more than 19 points indicates that the depression is higher than that in ordinary adolescents, and the higher the score, the higher the degree of depression. In the Chinese version of the Beck Anxiety Inventory, a total score of 0–7 points indicates “little anxiety,” 8–15 points indicates “mild anxiety,” 16–25 points indicates “moderate anxiety,” and 26–63 points indicates “severe anxiety.” The higher the score of the anxiety inventory, the greater the anxiety.
Results: The mean internship stress scale score, mean depression scale score, and mean anxiety scale score of student nurses were 41.2±13.7, 5.3±6.2, and 4.7±6.0 points, respectively. In addition, 9 subjects (7.9%) were diagnosed with depression as their depression scale scores reached 19 points and above. In terms of internship stress, only tasks and workload were found to be significantly correlated with depression (p = 0.02), whereas the other variables did not show significant impacts. We also found that the total internship stress score, teachers’ and nursing staff’s stress, tasks, and workload were significantly correlated with anxiety (p < 0.05), whereas the other variables did not show significant impacts.
Conclusion: The study results showed that nearly 10% of the interns were depressed, and more than 20% had mild anxiety. Suggestions for improvements were put forward according to the causes, so as to reduce student nurses’ frustration, anxiety, and depression; avoid affecting their interest in nursing; and increase their willingness to devote themselves to the nursing industry. Moderate pressure or anxiety can exert positive stimulation, make people face pressure more actively and change the current situation, and improve student nurses’ responsiveness and attention, thereby strengthening the learning effect and making them perform better. Internship instructors should guide student nurses to ask more questions and learn more, and regularly assess whether their learning ability and effectiveness meet the internship objectives. If interns are found to be depressed or anxious during the internship, they should be promptly counseled or referred to relevant experts, and assistance should be provided to solve student nurses’ problems in their internship.
目的: 探討實習期間護生實習壓力與內在症狀（焦慮、憂鬱）之相關性。
方法: 採橫斷式、立意取樣研究設計，以護理系高護實習護生（五專四年級及四技三年級）至醫院實習為對象，共收案118人。研究問卷包含基本資料、實習壓力量表、憂鬱量表、焦慮量表。許淑蓮等人（1997）所發展之「護生實習壓力量表」，所得分數愈高，表示其壓力愈高。憂鬱量表以黃君瑜與許文耀（2003）的青少年憂鬱量表，得分數達19分以上代表憂鬱高於一般青少年，分數越高表示憂鬱程度越高。中文版貝克焦慮量表，量表總分為0-7分者屬「很少的焦慮」，8-15分為「輕度焦慮」，16-25分為「中度焦慮」， 26-63分為「嚴重焦慮」，焦慮量表的分數越高，表示焦慮越大。
結果: 護生實習壓力量表平均得分41.2±13.7分，憂鬱量表平均得分為5.3±6.2分，焦慮量表平均得分為4.7±6.0分，憂鬱量表達19分以上表示有憂鬱者有9人(佔7.9%)，實習壓力中作業及工作量的部分與憂鬱有相關，且達統計學上顯著差異(p = 0.02)，其餘變項皆未顯著。實習壓力總分、教師及護理人員之壓力、作業及工作量之壓力與焦慮成相關，且達統計學上顯著差異(p < 0.05)，其餘變項皆未顯著。
結論: 研究結果發現有近一成實習生有憂鬱情緒，有兩成以上的實習生有輕度焦慮以上的情形，針對其原因提出建議改善，以減低護生實習挫折感並降低焦慮以及憂鬱程度，避免影響對護理之興趣，進而增加投入護理行業之意願，適度的壓力或焦慮可以發揮正向的刺激，使人更積極去面對壓力改變現況，提高護生的反應力和注意力，進而提升學習效果，讓護生有更佳的表現，實習指導老師應引導護生多問、多學，並定期評估學習能力與成效是否達到實習目標，若在實習過程中發現實習生有憂鬱或焦慮情形，應及時輔導或轉介，並協助解決護生實習上的困擾。 |
