[[alternative]]以嘉義縣中埔鄉為例

[[issue]]52

人因性危害之現場改善成效--以某製造業公司庫房為例

&lt;p&gt;目的：肌肉骨骼疾病已成為全球職業安全衛生重要議題，其與負重、姿勢不良、重複性動作造成累積性傷害有關。&lt;/p&gt; &lt;p&gt;方法：本研究以某公司庫房有肌肉骨骼酸痛問題個案為對象，到工作現場評估人因危害，提供介入措施，並探討此介入措施之成效。介入措施包括調整作業檯面及高度，提供現場工作人員符合人體工學的作業設備。介入期間安排人因危害教育訓練及現場海報張貼以強化作業人員使用正確肌群、管理面的介入進行工作調整等。在3個月的介入措施前後以北歐肌肉骨骼問卷調查表(The Nordic Musculoskeletal Questionnaire)及工作姿勢分析(Ovako Working Posture Analysis System)進行肌肉酸痛程度及工作姿勢風險之評估，以比較介入前後差異。統計採用無母數相依樣本Wilcoxon signed-rank test進行前後差異檢定。&lt;/p&gt; &lt;p&gt;結果：肌肉骨骼不適症狀部位前測主要部位以下背(n=30)占88.2%、左肩(n=29)占85.2%、右肩(n=28)占82.3%、以及右手/手腕(n=18)占52.9%。以無母數分析比較介入前後肌肉疼痛程度，結果顯示疼痛部位在下背、左肩、右肩、右手腕均有顯著性的改善(p&lt;0.05)。&lt;/p&gt; &lt;p&gt;結論：調整作業人員採以符合人體工學的姿勢工作，能有效控制職業肌肉骨骼疾病產生，有效改善人員肌肉骨骼不適之問題。&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;&lt;p&gt;Purpose: The increased occurrence of repetitive strain injuries involving poor postures in modern industries has rendered musculoskeletal disorders one of most prevalent occupational diseases.&lt;/p&gt; &lt;p&gt;Methods: In the study, the effectiveness of an onsite intervention was assessed before and after the occurrence of ergonomic hazards at the warehouse of a manufacturer, where the number of musculoskeletal complaints and occupational health consultation had reported an alarming rise. Occupational nurses, physicians, and safety and health administrators visited the warehouse to evaluate the situation and conduct engineering planning with workers receiving on-site assessments using the Nordic Musculoskeletal Questionnaire (NMQ) and Ovako Working Posture Analysis System (OWAS). An intervention was developed and performed to raise workers&amp;rsquo; awareness of ergonomic hazards and coping strategies and improve the ergonomic compliance of equipment. NMQ was used to compare the effectiveness of the intervention for muscle soreness after 3 months. Wilcoxon Sign Rank test was used for comparison before and after the intervention.&lt;/p&gt; &lt;p&gt;Results: Top 4 sites of musculoskeletal pain among the workers were respectively the lower back (88.2%; n=30), left shoulder (85.2%; n=29), right shoulder (82.3%; n=28), and right hand/wrist (52.9%; n=18). Nonparametric Wilcoxon Sign Rank analysis for before- and after-intervention comparison revealed that musculoskeletal pain at the lower back, left shoulder, right shoulder, and right wrist were all significantly alleviated (p&lt;0.05).&lt;/p&gt; &lt;p&gt;Conclusion: Appropriate engineering improvements were effective in this case, and the posture of the workers could be adjusted to reduce the occurrence of musculoskeletal disorders. &lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt; </jats:p

Concept analysis of delay in seeking medical care

[[abstract]]「延遲就醫」是一種複雜的行為，不僅受到個人生理與心理狀況的影響，也很容易受到周遭環境的左右。研究顯示「延遲就醫」常導致癌症或慢性病病人錯失接受治療的最佳時機，並對預後產生負面影響，故需積極預防之。而釐清延遲就醫的定義是有效偵測、改善及預防其發生的基石。目前雖有許多學者致力於延遲就醫相關行為的探討，但多數對此一概念缺乏清楚定義。因此，作者以Walker及Avant的步驟來分析此一概念，透過廣泛性的查證、確認定義性特徵、列舉模範、相反、邊緣及相關案例、確認行為之前因後果、佐以實證性資料並提出實務上之建議，以澄清此一概念。根據分析結果「延遲就醫」可被定義為「個人產生不適或異常之症狀後，並未立即尋求醫療照護；且此症狀若未在一定時間內接受治療將導致不良預後」。而「延遲就醫的時間」則為「個人初次產生不適或異常症狀，直到尋求醫療照護的時間」，上述定義期能作為未來發展相關測量工具及介入措施之考

The Application of Information and Communication Technology (ICT) in Nursing Education

[[abstract]]由於二十一世紀資通訊科技快速的發展，各行各業均產生了顛覆性變革，健康照護專業也不例外。護理師是醫療機構中為數最多的專業人員，面對醫療快速資訊化的時代，是否具備相關能力接受這樣的挑戰值得存疑。台灣目前開設培育護理學生的資訊素養必修課程不足，護理教學策略仍採用傳統講授方式居多，教師對於應用資訊科技於教學也多抱持被動心態。反觀國外將資通訊科技融入護理教學已近20年，且有不錯的教學成效。因應政府推動數位學習計畫，國內各領域教育界也陸續將資訊科技融入教學，這些推展經驗都值得做為台灣護理教育的借鏡。因此，本文將介紹資通訊科技融入教學的概念、國際間護理教育應用資通訊科技的現況，以及應用過程中衍生的議題，以做為國內護理教育推動資通訊科技融入護理教學的參考。 With the rapid development of information and communication technologies (ICT) in the 21st century, all walks of life have experienced disruptive changes, including the healthcare profession. Although nurses represent the largest number of professionals in medical institutions, it is doubtful whether nurses possess sufficient capabilities to face challenges in this era of rapid medical informatization. Currently, the courses necessary to cultivate information literacy in nursing students are insufficient in Taiwan, and traditional instruction methods are largely adopted as nursing teaching strategies. Additionally, most teachers hold a passive attitude towards the application of ICT in teaching. On the contrary, ICT have been integrated into nursing education in many countries around the world for nearly 20 years, achieving good levels of teaching efficacy. Reflecting the Taiwan government's promotion of digital learning projects, academic circles in various fields have also started to gradually integrate ICT into teaching. Nursing educators in Taiwan have much to reference and to learn from these disparate integration experiences. Therefore, this article introduces the concepts of integration of ICT into teaching, the current status of the application of ICT in international nursing education, and the issues faced during this application as a reference for nursing education in Taiwan in order to promote the integration of ICT into nursing education

Flipped Classroom: A New Teaching Strategy for Integrating Information Technology Into Nursing Education

[[abstract]]目前護理教育仍以「教師為中心」的傳統講授的教學模式，無法激發學生的批判性思考及培養自主學習的能力。近年來隨著資訊科技快速發展及教育理念變遷，發展出「翻轉教室」的概念及教學模式，它完全顛覆傳統的教學模式，讓e世代學生透過智慧型手機或平板電腦等資通訊科技工具在課前進行相關學習活動，課堂中增進老師與學生互動機會，藉以激發學生思考、引導解決問題，鼓勵合作學習及活用知識，落實以學生為中心的教育理念，此種以學生為中心的教學模式與護理教育理念及培育學生的專業能力不謀而合。在國際間翻轉教室蔚為潮流之際，國內各領域教育界也開始推動翻轉教室的教學模式，然而翻轉教室不論在國內外護理教育尚在萌芽階段，因此本文說明翻轉教室的概念及推展產生的迷思、國際間醫護教育應用翻轉教室的經驗及面臨議題，以做為國內護理教育未來推動翻轉教室教學策略的參考。 The traditional ＂teacher-centered＂ instruction model is still currently pervasive in nursing education. However, this model does not stimulate the critical thinking or foster the self-learning competence of students. In recent years, the rapid development of information technology and the changes in educational philosophy have encouraged the development of the ＂flipped classroom＂ concept. This concept completely subverts the traditional instruction model by allowing students to access and use related learning activities prior to class on their smartphones or tablet computers. Implementation of this concept has been demonstrated to facilitate greater classroom interaction between teachers and students, to stimulate student thinking, to guide problem solving, and to encourage cooperative learning and knowledge utilization in order to achieve the ideal of student-centered education. This student-centered model of instruction coincides with the philosophy of nursing education and may foster the professional competence of nursing students. The flipped classroom is already an international trend, and certain domestic education sectors have adopted and applied this concept as well. However, this concept has only just begun to make its mark on nursing education. This article describes the concept of the flipped classroom, the implementation myth, the current experience with implementing this concept in international healthcare education, and the challenging issues. We hope to provide a reference for future nursing education administrators who are responsible to implement flipped classroom teaching strategies in Taiwan