本研究主要目的是在探究內科臨床護理人員所須具備哪些健康諮商技巧，以協助慢性病人因應各種身-心-社會問題；再據以設計一套護生的健康諮商技巧訓練方案，實際實施並評估方案成效。本研究分兩階段進行研究。
第一階段進行「內科護理人員健康諮商技巧的需求評估」：是以焦點團體研究法；分別蒐集病人、護士、看護、護生和護理老師的意見，結果發現：內科慢性病人和家屬都期待護理人員協助其因應生病所引發的各種心理困擾和生活問題，因此護理人員須具備的健康諮商技能應包括1.透過照顧病人身體的專業技術和態度，贏得病人的信賴與合作；2.教導病人實踐衛生教育；3.敏銳留意並協助處理病人的身-心-社會問題；4.建立病人的社會支持、信心和希望；5.控制並調適自己和病人情緒等五大項。
第二階段進行「內科護理習學生健康諮商訓練方案之設計、實施與成效評估」：是依據前一階段的研究結果設計訓練方案，在大四護生的「諮商原理與技術」課程中進行實驗；另外又設計「人際關係訓練方案」在大四護生的「人際關係」課程中進行對照；再以未接受訓練的護生為控制組，進行三組間比較。同時為了評估訓練方案效果而自編兩種研究工具，在實驗進行前後一週施測：一是「護病互動經驗問卷」，讓護生自評其自我效能感是否提昇；另一是「健康諮商技巧實作量表」，讓護生、模擬病人和諮商專家三者，一起評估護生與模擬病人諮商的實作技巧表現是否提昇。所得的資料分析是以前測為共變項，後測為依變項，進行單因子共變數分析，結果第二階段的四個研究假設大致獲得支持：不論是護生自評其護病互動中自我效能感，或護生、模擬病人和諮商專家對護生在模擬情境的健康諮商技巧實作表現，大致是認為接受「健康諮商訓練方案」的護生比接受「人際關係訓練方案」或未接受訓練方案的護生更有進步。因此健康諮商訓練方案的有效性得到驗證，研究者乃進一步對慢性病、醫護教育和未來研究等三方面提出落實健康諮商的建議。

Two main purposes were being investigated in the study: (1) To explore nessasary counseling skills for nursing practitioners to deal with paitients’ bio-psycho-social problem. (2) To develop a health counseling skill training program for nursing college students and assess its effects.
The research contained two different stages. The first stage of the research was “Needs assessment of health counseling skills for nurses in chronic ward”. Focus group interviews were conducted to collect opinions from different perspectives, including patients, nurses, nursing assistants, college nursing students, and nursing college instructors. The result revealed that patients and their family members did expect nurses to have the ability to help them cope with desease related questions. Five most necessary counseling skills that a nurse was expected to have were identified as following: (1) Gaining patients’ trust and cooperation by professional skills and attitudes. (2)Being able to educate patients regarding to health issues. (3) Paying attetion and being sensitive to patients’ bio-psycho-social problems. (4)Assisting patients’ to establish their social support system and hopes. (5) Being able to control and adjust emotional status of both nurses and patients.
Based on the findings of the first stage, Health Counseling Skill Training Program(HCSTP) for nurses working in chronic ward was designed. Three groups were formed to complete the second stage of the research. In the first group, HCSTP was conducted and assessed in the class of “Counseling Theories and Skills”. By contrast, “Interpersonal Relationship Training Program（IRTP）” was designed and examined in the second group and assessed in “Interpersonal Relationship” class. Third group, consitituted by untrained nursing college students, was formed as a controlling group. In order to assess the effects of HCSTP and IRTP, two instruments were thus designed by the researcher : （1）Nurse-Patient Interaction Scale and （2）Health Counseling Skill Practice Scale. Data obtained were analyzed by one-way analysis of covariance. The result of the second stage generally supported the four assumptions of the research.
Combining two stages of the study, two major results were found: (1) HCSTP showed significant effects than IRTP regarding to the impovement of students’ efficacy on nurse-patient interaction. (2) By assessing students, role-play patients,and counselors, HCSTP showed significant effects than IRTP and non- trained student group on the improvement of health counseling skills for college nursing students.
Based on the results of this study, implications and suggestions were proposed for chronic illness and nursing education. Further possible research directions were discussed at the end.

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