第四章 研究結果
第五節 研究限制
一、本研究屬於橫斷式研究，在因果關係推論上無法提供明確的証明。
二、本研究採自我填答方式，故受測者之認真填答程度及真實度，都有可 能影響到研究結果。
三、本研究採問卷施測，屬事後回溯，因此，可能因受測者之回憶偏差而 造成研究結果之偏差。
四、本研究之「公衛護理人員專業能力量表」，係研究者參考國內外文獻編 製而成，且採事先分類法設計，故可能有些專業能力無法完整列入，
有些專業能力可能未偵測到。故未來亦可考慮以質性訪談公衛護理人 員，發展出一套更合適之專業能力量表。
五、本研究於問卷完成後針對未回覆問卷之衛生所，電話了解其原因，多 因為太忙碌無法填寫，與本研究問卷內容無關。
參考文獻 一、中文部份
于漱、金蓓莉(1996)．公共衛生護理人員在不同型態衛生所的角色探討和比 較．公共衛生，23(1)，17-25。
于漱、馬鳳歧(1993)‧不同學制應屆畢業護生護理能力比較與相關因素分析 之研究‧護理研究，1(1)，35-49。
白玉珠、徐南麗、汪蘋(1999)‧醫學中心護理人員護理能力及其相關因素之 研究‧護理研究，7(2)，209-220。
尹祚芊(1994)．提昇社區護理人員的角色與功能．護理新象，4(4)，8-14。
中華民國內政部全球資訊網(2005，2 月 3 日)‧九十四年第五週內政統計通 報‧內政統計資訊服務網‧2005年9 月 1 日，取自
http://www.moi.gov.tw/stat/
中華民國內政部全球資訊網(無日期 a)‧現住人口按三段、六歲年齡組分‧
內政統計資訊服務網‧2005年9 月 1 日，取自 http://www.moi.gov.tw/stat/
中華民國內政部全球資訊網(無日期 b)‧現住人口出生、死亡、結婚、離婚 登記‧內政統計資訊服務網‧2005年9 月 1 日，取自
http://www.moi.gov.tw/stat/
中華民國內政部全球資訊網(無日期 c)‧育齡婦女生育率‧內政統計資訊服
務網‧2005年9 月 1 日，取自 http://www.moi.gov.tw/stat/
中華民國護理師護士公會全國聯合會(1994)‧護理倫理規範內容 2005‧ 年 10 月 15 日取自
http://www.nurse.org.tw/km-master/front/bin/ptlist.phtml?Category=10001 7
石曜堂(2000)‧全民健康新主張：健康管理─兼談衛生所功能之改造‧國家 衛生研究院簡訊，19-21。
台中縣大甲鎮衛生所(無日期)‧簡介 2005‧ 年10 月 1 日取自
http://daj-tch.doh.gov.tw/pub/LIT_6.asp?ctyp=LITERATURE&pcatid=0&c atid=1829&ctxid=2286&single=Y
台北市北投區健康服務中心(無日期)‧健康服務中心業務項目 2005‧ 年10 月 1 日取自
http://pto-tpc.doh.gov.tw/pub/LIT_6.asp?ctyp=LITERATURE&pcatid=0&c atid=1859&ctxid=1878&single=Y
台東縣延平鄉衛生所(無日期)‧衛生所簡介 2005‧ 年10 月 1 日取自
http://yap-tth.doh.gov.tw/pub/LIT_6.asp?ctyp=LITERATURE&pcatid=0&c atid=2005&ctxid=2023&single=Y
台灣護理學會(2005，8 月)．社區衛生護理專業範疇與專業人員職責規範手 冊．2005 年 12 月 10 日取自
http://www.twna.org.tw/Uploadfile/web_data/1207.pdf
左如梅(1998)‧緒論‧於左如梅、郭憲文、于祖英、尤姵文合著，公共衛生 護理概論(二版，1-49 頁)‧台北：華杏。
行政院衛生署(1999)‧中華民國公共衛生年報—八十八年版‧台北：作者。
行政衛生署(2005)‧中華民國九十三年台灣死因統計結果摘要 2005‧ 年10 月21 日取自 http://www.doh.gov.tw/statistic/data/死因摘要/93 年/93.htm 邱啟潤(1998)‧社區健康評估與診斷‧護理雜誌，45(3)，70-76。
邱啟潤(2000)‧衛生所公共衛生護理人員提供社區老人健康照護能力之探 討‧長庚護理，11(2)，1-8。
邱淑芬、莊琴英、陳瓊香、楊馥美、毛錦玉、湯靜怡(1996)‧探討骨科護理 在職教育對護理人員之影響‧榮總護理，13(3)，332-342。
汪惠芬(2002)．提昇社區護理在基層保健醫療中的角色與功能．護理雜誌，
49(3)，73-76。
李引玉、劉向援(1994) ．護理專業的成長—從生手到臨床專家．護理雜誌，
41(2)，72-76。
李淑婷、謝臥龍、邱啟潤(2001)．衛生所護理師角色功能之探討—德爾菲研 究．護理研究，9(3)，269-277。
李逸(2004)．公共衛生護理人員工作壓力感受、因應策略與壓力結果之探 討—以互動型工作壓力模式為架構．台灣衛誌，23(5)，398-405。
阮玉梅(1997)‧緒論‧於阮玉梅總校閱，公共衛生護理概論(1-28 頁)‧台 北：永大。
林綽娟(2005)‧緒論‧於許智皓總校閱，社區衛生護理學(初版，1-1~1-26 頁)‧台中：華格那。
林麗英(1988)‧護理人員的護理技能、溝通技巧與行政能力之探討‧榮總護 理，5(3)，283-288。
徐南麗、李茹萍、李芸茹、賴正芬、彭台珠(2003)‧護理人員進階制度實施 後主客觀護理能力差異之比較‧慈濟護理，2(1)，53-62。
徐南麗、林碧珠、徐曼瑩、楊克平(2002)‧比較護理進階制度實施前後護理 能力及影響因素分析‧慈濟護理雜誌，1(1)，76-85。
陳靜敏(1998a)．社區衛生護理是…．護理雜誌，45(1)，51-56。
陳靜敏(1998b)‧緒論‧於陳靜敏總校閱，社區衛生護理學(初版，3-26 頁)‧
台北：偉華。
許瑛真、于漱、鄭雪英(1997)‧公共衛生護理人員對預防接種之知識、態度、
執行能力及其影響因素之研究‧護理研究，5(6)，524-533。
張峰鳴、林綽娟、郭憲文、鄧玉貴、李俊年(1995)‧台灣省衛生所護理人員 工作評價及滿意度之調查‧中華衛誌，14(1)，78-87。
詹長權(2005)‧全球「社區整合式疾病篩檢模式」的先驅者─陳秀熙教授‧
台大校友雙月刊，40，7-12。
臺北市衛生局(無日期)‧組織沿革 94‧ 年10 月 10 日取自 http://www.health.gov.tw/Desktop.aspx
黃彩雲(1981)‧如何提高護理服務的品質—推行護理在職教育實施護理品 質評估‧醫院，14(1)，38-46。
蔡幸娥(2004)‧護理的信心─走過台灣歷史的足跡‧台北：華騰。
鄭雪英、于漱、許瑛真、林佳欣(1996)‧公共衛生護理人員照護老年個案之 知識、態度與能力之研究‧護理研究，4(4)，321-332。
劉成英(1998)‧公共衛生護理人員其實務工作專業能力與實務工作內涵之 差距分析‧未發表的碩士論文，台北：國立陽明大學。
劉建芬(2003)．社區護理．於張淑芳總校閱，社區護理學(一版，1-22 頁)．
台北：五南。
衛生所所長、主任、組長暨護理長遴用資格參考標準(2000).
澎湖縣衛生局(無日期)‧馬公市第一衛生所 2005‧ 年10 月 1 日取自 http://www.phshb.gov.tw/org/health/health1.htm
盧孳艷(1994)．街頭抗議的聯想--公共衛生護理理論的省思．護理雜誌，
41(4)，33-38。
盧孳艷、劉成英(2000)．公共衛生護理實務工作評估之分析．護理雜誌，
47(3)，71-75。
嚴玉華(2004)‧醫院護理人員在職教育訓練與專業能力進階制度‧安泰醫
護雜誌，10(2)，70-76。
二、英文部分
Abrams, S. E. (2004). From function to competency in public health nursing, 1931 to 2003. Public Health Nursing, 21(5), 507-510.
Ahrens, T. S., & Padwojski, A. (1990). Economic effectiveness of an advanced nurse clinician model. Nursing Management , 21(11), 72.
Allender, J. A., & Spradley, B. W. (2001). Roles and settings for community health nursing practice. In J. A. Allender, & B. W.Spradley(Eds.),
Community health nursing: concepts and practice (5th ed., pp.39-56). New
York: J. B.Lippincott.
American Nurses’Association.(1986).Standards of community health nursing practice. Kansas City, MO: The American Nurses’ Association.
American Public Health Association. (1981). The definition and role of public health nursing: A statement of the public health nursing section.
Washington, DC: The American Public Health Association.
American Public Health Association. (1996). The definition and role of public health nursing: A statement of the public health nursing section.
Washington, DC: The Author.
Anderson, E. T. (1989). Public health content in nursing curricula. Nursing
Outlook, 37(5), 233-235.
Ashworth , P., & Morrison, P.(1991). Problems of competence-based nurse education. Nurse Education Today, 11(4), 256-260.
Bartee, R. D., Winnail, S. D., Olsen, S. E., Diaz, C., & Blevens, J. A. (2003).
Assessing competencies of the public health workforce in a frontier state.
Journal of Community Health, 28(6), 459-469.
Baldwin, J. H., Conger, C. O., Abegglen, J. C., & Hill, E. M. (1998).
Population-focused and community-based nursing moving toward clarification of concepts. Public Health Nursing, 15(1), 12-18.
Bramadat, I. J., Chalmers, K., & Andrusyszyn, M. A. (1996). Knowledge, skills and experiences for community health nursing practice: the perceptions of community nurses, administrators and educators. Journal of Advanced Nursing, 24, 1224-1233.
Brown, M. A., & Waybrant, K. M. (1988). Health promotion, education,
counseling, and coordination in primary health care nursing. Public Health Nursing, 5(1), 16-23.
Bruno, A. A. (1999). Community-based nursing competencies and roles. In M.Martha Ayers, A. A.Bruno, & R. W. Langford(Eds.), Community-based nursing care: making the transition(6th ed., pp. 53-75). St. Louis, MO:
Mosby.
Chambers, L. W., & Underwood, J. (1994). 1992 Ontario survey of public health nurses: perceptions of roles and activities. Canadian Journal of Public Health, 85(3), 175-179.
Chalmers, K. I., Bramadat, I. J., & Andrusyszyn, M. A. (1998). The changing environment of community health practice and educations: perceptions of staff nurses, administrators, and educators, Journal of Nursing Education, 37(3), 109-117.
Chen, T. H., Chiu, Y.H., Luh, D. L., Yen, M. F., Wu, H. M., Chen, L. S., Tung, T.
H., Huang, C. C., Chan, C. C., Shiu, M.N., Yeh, Y. P. Liou, H.H., Liao, C.
S., Lai, H. C., Chiang, C. P., Peng, H. L., Tseng, C. D., Yen, M. S., Hsu, W.
C., & Chen, C.H.(2004). Taiwan Community-Based Integrated Screening Group. Community-based multiple screening model: design,
implementation, and analysis of 42,387 participants. Cancer, 100(8), 1734-43.
Clark, M. J. (2003). Community health nursing. In M. J. Clark(Ed.), Community Health nursing: caring for populations(4th ed.,pp.171-189). Upper Saddle River, N.J.: Prentice Hall.
Clemen-Stone, S. (1996). Defining community health nursing. In S. Clemen-
Stone, S. L. McGuire, & D. G. Eigsti(Eds.), Comprehensive community health nursing: family, aggregate & community practice. (6th ed.,
pp.30-51). St. Louis, Mo: Mosby.
Cooney, A. T. (1992). An orientation program for new graduate nurses: The basis of staff development and retention. The Journal of Continuing Education in Nursing, 23(5), 216-219.
Deane, D., & Campbell, J. (1985). Developing professional effectiveness in nursing. Renton: A Prentice-Hall Company.
Dieckmann, J. (2004). History of public health and public and community health nursing. In M. Stanhope, & J. Lancaster(Eds.), Community & Public Health Nursing (6th ed., pp.22-49). St. Louis, MO: Mosby.
Emblem, J.D., & Gray, G. T. (1990). Comparison of nurses self-directed learning activities. The Journal of Continuing Education in Nursing, 21(2), 56-61.
Exstrom, S. M. (2001). The state board of nursing and its role in continued competency. The Journal of Continuing Education in Nursing, 32(3), 118-125.
Fisher, M. E. (2002). Community health nursing in the local health department.
In M. Stanhope, & J. Lancaster(Eds.), Foundations of community health nursing: community-oriented practice(pp.439-447). St. Louis, MO: Mosby.
Fromer, M. J. (1983). Functions of the community health nurse. In M. J.
Fromer(Ed.), Community health care and the nursing process. (2nded., pp.155-173). St. Louis, MO: Mosby.
Gebbie, K. M., & Hwang, I.(2000). Preparing currently employed public health nurses for changes in the health system. American Journal of Public Health, 90(5), 716-721.
Grumbach, K., Miller, J., Mertz, E., & Finocchio, L. (2004). How much public health in public health nursing practice. Public Health Nursing, 21(3), 266-276.
Hall-Long, B. A., Perez, G. B., & Allbright, P. K. (2001). A public
health-academic education partnership. Public Health Management Practice, 7(1), 60-66.
Hefferin, E. A. (1987). Trends in the evaluation of nursing inservice education programs. Journal of Nursing Staff Development, 3(4), 28-34.
Institute of Medicine(IOM)(1988). The future of public health. Washington, D.C.: National Academy Press.
Jakonen, S., Tossavainen, K., Tupale, M., & Turunen, H. (2002). Health and society in Finland: public health nurses’ daily practice. British Journal of Community Nursing, 7(5), 265-272.
Kellor, L. O., Strohschein, S., Lia-Hoagberg, B., & Schaffer, M. A. (2004).
Population-based public health interventions: practice-based and evidence-supported. part I. Public Health Nursing, 21(5), 453-468.
Kellor, L. O., Strohschein, S., Schaffer, M. A., & Lia- Hoagberg B. (1998).
Population-based public health interventions: A model from practice.
Public Health Nursing, 15(3), 207-215.
Kreider, M.C., & Barry, M. (1993). Clinical ladder development: implementing contract learning. The Journal of Continuing Education in Nursing, 24(4), 166-169.
Kuss, T., Girouard, L. P., Lovitt, S., Katz, C. B., & Kennelly, P. (1997). A public health nursing model. Public Health Nursing, 14(2), 81-91.
Leavell, H. R., & Clark, E. G. (1965). Preventive medicine for the doctor in his community: an epidemiologic approach (3rd ed.). New York: McGraw-Hill.
Loos, G. P. (1995). Minimum competencies for public health personnel. Asia Pac Journal Public Health profession, 8(3), 195-200.
MacDonald, M. B., & Schoenfeld, B. M.（2003）. Expanding roles for public health nursing. Canadian Nurse, 99(7), 19-22.
Mayer, J. P. (2003). Are the public health workforce competencies predictive of essential service performance? A test at a large metropolitan local health
department. Journal Public Health Management Practice, 9(3), 208-213.
McConnel, E. A. (2001). Competence vs. competency. Nursing Management.
32(5), 14.
McDonald, A. L., Langford, I. H., & Boldero, N. (1997). The future of
community nursing in the United Kingdom: District nursing, health visiting and school nursing. Journal of Advanced Nursing, 26(2), 257-265.
Miller, E., Flynn, J. M., & Umadac, J. (1998). Assessing, developing, and maintaining staff’s competency in times of restructuring. Journal of Nursing Care Quality, 12(6), 9-17.
Nickel, J. T., Pituch, M. J., Holton, J., Didion, J., Perzynski, K., Wise, J., &
McVey, B. (1995). Community nursing competencies: a comparison of educator, administrator, and student perspectives. Public Health Nursing, 12(1), 3-8.
Okura, M. (2004). A study by the Delphi technique of expected competencies of public health nurses working in government organizations. Japanese
Journal of Public Health, 51(12), 1018-1028.
Quad Council of Public Health Nursing Organization. (2004). Public health nursing competencies. Public Health Nursing, 21(5), 443-452.
Polit, D. F., & Beck, C. T. (2004). Nursing Research: Principles and Methods.
(7th Ed.). Philadelphia: Lippincott Williams & Wilkins.
Public Health Functions Steering committee. (1994). Pubic health in America.
Retrieved September 1, 2005, from
http://www.health.gov/phfunctions/public.htm.
Rath, D., Boblin-Cummings, S., Baumann, A., Parrott, E., & Parson, M. (1996).
Individualized enhancement programs for nurse that promote competency.
The Journal of Continuing Education in Nursing, 27(1), 12-16.
Reutter, L. I., & Ford, J. S. (1996). Perceptions of public health nursing: views from field. Journal of Advanced Nursing, 24(1), 7-15.
Robertson, J. F. (2004). Dose advanced community/public health nursing practice have a future. Public Health Nursing, 21(5), 495-500.
Robinson, S. M., & Barberis-Ryan, C. (1995). Competency assessment: a systematic approach. Nursing Management, 26(2), 40-44.
Roques, J. M. (1999). Public health nurses and core functions. Pelican news, 55(4), 8-9.
Saeki, K., & Kawaharada, M., Hayama, M., & Igarashi, M. (1999).
Development of professional competence in public health nurses. Japanese Journal of public health, 46(9), 779-789.
Sakamoto, S. D., & Avila, M. (2004). The public health nursing practice manual:
a tool for public health nurses. Public Health Nursing, 21(2), 179-182.
Schoenfeld, B.M., & MacDonald, M. B. (2002). Saskatchewan public health nursing survey: Perceptions of roles and activities. Canadian Journal of Public Health, 93(6), 452-456.
Selvey, C., Bontrager, J., Hirsh, L., & Daley, M. (1991). Clinical evaluation day:
Measuring competency. Nursing Management, 22(1), 50-51.
Smith, K., & Barakat, N. B. (2003). A public health nursing practice model:
melding public health principles with the nursing process. Public Health Nursing, 20(1), 42-48.
Stafanson, D. (1985). Varied roles of community health nursing. In J. E.
Hitchcock, P. E. Schubert, & S. A. Thomas(Eds.), Community health nursing (2nd ed., pp.458-479). St. Louis, MO: Mosby.
Taylor, K. (2000). Tackling the issue of nurse competency, Nursing Management, 31(9), 34-38.
The Canadian Public Health Association. (1990). Community health ~ public health nursing in Canada: Preparation & practice. Ottawa: The author.
Tzeng, H. M. (2004). Nurses’self-assessment of their nursing competencies, job demands and job performance in the Taiwan hospital system. International
Journal of Nursing Studies. 41(5), 487-496.
Western, P. (1994). QA/QI and nursing competence: a combined model. Nursing Management, 25(3), 44-46.
Williams, C. A. (2004). Community-oriented population-focused practice: the foundation of specialization in public health nursing. In M. Stanhope, & J.
Lancaster (Eds.), Community & public health nursing (6th ed., pp.1-21). St.
Louis, MO: Mosby.
Zhang, Z., Luk, W., Arthur, D., & Wong, T. (2001). Nursing competencies:
personal characteristics contributing to effective nursing performance.
Journal of Advanced Nursing, 33(4), 467-474.
附錄一 授權書
授 權 書
授權人 林綽娟 於九十四年接受行政院衛生署護理及健康照護處補助之
「公共衛生護理人員照護能力提升計畫」(
計畫編號：DOH94-NH-06
)。本計畫中研究工具之人口學資料及公衛護理人員專業能力量表之實務執行 頻率，同意以無償方式，授權給中國醫藥大學護理學系碩士班研究生郭曉 菁，作為其碩士論文「公共衛生護理人員專業能力之探討」的研究工具之 部份內容。
授 權 人：林綽娟
中 華 民 國 九十四 年 十 月 十一 日
附錄二 公共衛生護理人員專業能力問卷
二、公衛護理人員專業能力量表
《續》 執行頻率 自評能力