花蓮縣長照A單位個案管理師高齡營養照護訓練優先性調查

Survey on the Priority of Elderly Nutritional Care Training for Case Managers in Hualien County Long-Term Care Unit-A

背景：不同專業背景之長照A單位個案管理師（A個管）的營養照護訓練經歷亦不同。本研究調查花蓮縣A個管對高齡營養照護能力的重要性及其自我能力評估，以分析營養照護訓練的優先性。方法：採用橫斷性設計。本研究自擬結構式問卷「營養照護能力重要性及自我效能評估表」，專家效度為.863。以面對面訪談蒐集資料，採普查方式，共收案62位A個管。運用重要度—表現分析法，依重要性及自我效能評估結果建立維持優勢、優先加強、低順位改善、能力充備等四個優先性。結果：正式施測後，研究工具內在一致性達.9以上。A個管對營養照護能力的重要性評分高，達101.13（滿分119），自我效能評分偏低，為76.15（滿分119），皆不因背景而有差異；僅年齡（r =.269, p = .035）、年資（r = .283, p = .026）與自我效能有正相關。整體而言，以「能夠提供衰弱個案適當的營養照護建議」項目為最優先訓練項目。結論：不同背景的A個管在高齡者營養照護的訓練需求有所不同，建議提供彈性、專業性的培訓課程，有系統地提供繼續教育課程，並針對新進人員及早賦能。

Background: Case managers in long-term care unit-A (unit-A CMs) with various professional backgrounds have different level of nutrition care training experience. This study investigated the perceived importance of and self-efficacy in elderly nutrition care among unit-A CMs in Hualien County, in order to analyze their training priorities. Methods: A crosssectional design was employed. Data were collected through face-to-face interviews using a self-developed structured questionnaire, the “Importance and Self-efficacy of Nutrition Care Competency assessment tool.” A census approach was utilized, with 62 CMs participating. Based on the assessment results of importance and self-efficacy, four priority categories were established: maintain strengths, priority strengthening, low-priority improvement, and sufficient competency. Results: The internal consistency of the research tool reached above .9 in the present study. The findings revealed that unit-A CMs rated the importance of nutritional care competency highly (mean score 101.13 out of 119), while their self-efficacy scores were relatively low (mean score 76.15 out of 119). These scores did not vary significantly across different backgrounds; however, both age (r = .269, p = .035) and years of experience (r = .283, p = .026) were positively correlated with self-efficacy (r = .269, p = .035). Overall, “ability to provide appropriate nutrition care recommendations for frail clients” emerged as the highest priority item for training. Conclusions: Training needs for elderly nutrition care varied among unit-A CMs with different background characteristics. It is recommended to provide flexible, profession-specific training programs, implement systematic continuing education programs, and empower new staffs early in their careers.