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研究生: 張君威
Chun-Wei Chang
論文名稱: 醫學系學生畢業後一般醫學訓練精神醫學教育介入成效研究
The Effectiveness of Psychiatry Education Intervention for Post-Graduate Year One
指導教授: 姜逸群
Chiang, I-Chyun
學位類別: 博士
Doctor
系所名稱: 健康促進與衛生教育學系
Department of Health Promotion and Health Education
論文出版年: 2010
畢業學年度: 98
語文別: 中文
論文頁數: 181
中文關鍵詞: 醫師畢業後一般醫學訓練精神醫學教育精神科
英文關鍵詞: Physician, PGY1, Post-graduate one, Psycchiatry education, PGY
論文種類: 學術論文
相關次數: 點閱:105下載:8
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  • 本研究旨在發展及驗證一套適用於醫學系學生參與畢業後一般醫學訓練「精神醫學教育」課程,並探討介入課程對參與醫師之「精神醫學知識」、「處理精神疾病的態度」、「處理精神疾病的自我效能」與「處理精神疾病的行為意向」之影響效果。
    本研究採準實驗設計(quasi-experimental design)之「實驗組、對照組前、後測設計」,以北部地區參與畢業後一般醫學訓練之第一年非精神科住院醫師為母群體。立意取樣,以分派至國軍北投醫院接受一個月「社區醫學相關選修-精神科」之40位醫師為實驗I組,施以一個月的精神醫學教育課程。母群中,另隨機選取40位醫師為實驗II組,給於「精神醫學教育」課程講義自行研讀;另隨機選取40位醫師為對照組未施予任何精神醫學教育課程,以便進行比較。
    本研究以「精神醫學知識」、「處理精神疾病的態度」、「處理精神疾病的自我效能」與「處理精神疾病的行為意向」為實驗介入的重要效標,以第一次評估的結果為共變量,將第二次評估結果進行單因子共變數分析,結果顯示實驗I組在「精神醫學知識」、「處理精神疾病的態度」、「處理精神疾病的自我效能」與「處理精神疾病的行為意向」四方面與實驗II組及對照組都有顯著的差異。
    經薛費氏事後考驗,在「精神醫學知識」效標,實驗I組高於實驗II組,實驗II組高於對照組。在「處理精神疾病的態度」、「處理精神疾病的自我效能」與「處理精神疾病的行為意向」等效標,實驗I組得分顯著高於實驗II組與對照組;實驗II組與對照組間則無差異。
    一個月完整的精神醫學教育訓練,可提升非精神科醫師之「精神醫學知識」、「處理精神疾病的態度」、「處理精神疾病的自我效能」與「處理精神疾病的行為意向」。只給講義自行研讀,無其他教學介入活動組,只能提升部份「精神醫學知識」,在「處理精神疾病的態度」、「處理精神疾病的自我效能」與「處理精神疾病的行為意向」等效標則無成效。

    The purpose of this study was to develop a psychiatry education program for non-psychiatry physicians and to explore the effect of “psychiatry education intervention on psychiatry knowledge, attitude to psychiatry disease, self-efficacy in dealing with psychiatry disease and intention to deal with psychiatry disease.
      A quasi-experimental design was utilized in a psychiatry hospital in Taipei. Cluster sampling was conducted. One hundred and twenty subjects were assigned to three groups. The subjects in experimental group I were recruited 40 physicians who take part in one month psychiatry education programs in Beitou Armed Forces Hospital, another 40 physicians in experimental group II only received the same handout as Group I and read by themselves, and the other control group with no psychiatry education activities intervention.
      Before the program, pretest was conducted to establish the baseline data to compare in three groups. After this program, posttest was conducted to understand the immediate effect.
      Data analysis was analyzed by SPSS 17.0 Statistical analyses included descriptive statistics, chi-square test, t-test, analysis of variance (ANOVA) and analysis of covariance (ANCOVA).
      The findings of the study were as follows: one month psychiatry education can improve psychiatry knowledge, attitude to psychiatry disease, self-efficacy in dealing and intention toward mental disease. The group who only read handout by themselves, without receiving any other intervention; only can improve in psychiatry knowledge, and no effects in attitude, self-efficacy and intention toward psychiatry disease.

    中文摘要 I 英文摘要 III 目錄 V 表目錄 VIII 圖目錄 IX 第一章 緒論 1 第一節 研究動機與重要性 1 第二節 研究目的 6 第三節 研究問題 6 第四節 研究假設 7 第五節 名詞操作型定義 7 第六節 研究限制 10 第二章 文獻探討 13 第一節 醫學系畢業生精神醫學教育現況 13 第二節 畢業後一般醫學訓練 15 第三節 精神醫學教育相關研究 20 第四節 社會認知理論與醫學教育 27 第三章 研究方法 35 第一節 研究設計 35 第二節 研究架構 36 第三節 研究對象 37 第四節 研究工具 37 第五節 實施步驟 52 第六節 資料處理與分析 55 第四章 結果與討論 57 第一節 研究對象基本資料 57 第二節 研究對象精神醫學知識、處理精神疾病的態度、處理精神疾病的自我效能與處理精神疾病的行為意向之現況 63 第三節 實驗組與對照組研究對象在前測各項效標之比較 67 第四節 精神醫學教育介入效果評價 69 第五節 過程評價 77 第六節 綜合討論 83 第五章 結論與建議 95 第一節 結論 95 第二節 建議 96 參考文獻 98 附錄 附錄一 人體試驗委員會同意書 126 附錄二 問卷內容專家效度考驗名單 127 附錄三 問卷內容專家效度考驗專家審查 128 附錄四 畢業後一般醫學訓練精神醫學教育成效問卷 135 附錄五 教學過程評價問卷 141 附錄六 畢業後一般醫學訓練精神醫學課程教學教案 143 附錄七 畢業後一般醫學訓練精神醫學教育門診教學教案 179 附錄八 畢業後一般醫學訓練精神醫學教育病房實務訓練教案 180 附錄九 精神醫學知識量表評量題目的難易度與鑑別度資料 181

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