臨床護理人員自覺賦權與工作疲潰之相關性探討

The Relationship of the Perceived Empowerment & Job Burnout of The Clinical Nurses

安妮(Nie An)

指導教授 ： 李選

中山醫學大學/護理學院/護理研究所/碩士(2009年)

https://doi.org/10.6834/CSMU.2009.00137

摘要

護理人員是醫療照護體系中，工作壓力易造成疲潰的最大團體，賦權常被應用於以上相關研究領域，以降低工作疲潰帶來的負面反應，如情緒耗竭、漠視人性與增加個人成就感，賦權對工作疲潰具有影響性及預測力。本研究目的在探討中部某醫學中心，臨床護理人員自覺賦權與工作疲潰之相關性。應用賦權理論，採橫斷性調查研究法，以分層隨機取樣，發出292份問卷，有效問卷275份(94.2%)。研究工具包括：Liu(2008)的中文翻譯版的組織賦權量表、心理賦權量表，及許(1996)的中文翻譯版馬氏疲潰量表，以描述性統計分析，百分比、平均數、標準差、排序、單因子變異數分析、皮爾森積差相關、Scheffee事後比較及逐步迴歸分析等，探討相關性並預測工作疲潰影響因子。
研究發現：(一)護理人員組織、心理賦權得分均屬中等程度；情緒耗竭得分屬高等程度、漠視人性屬中低程度、個人成就屬中高等程度，整體工作疲潰屬中等程度。(二)組織與心理賦權皆與工作疲潰顯著負相關，心理賦權相關係數大於組織賦權。(三)組織賦權得分高低依序為：機會最高、非正式權力、支持與資訊、資源與正式權力。(四)心理賦權得分高低依序為：能力、意義、自我決策與影響。(五)組織賦權中支持與情緒耗竭、漠視人性呈負相關，與個人成就呈正相關；心理賦權中意義、自我決策與情緒耗竭、漠視人性呈負相關，與個人成就呈正相關。(六)影響情緒耗竭的重要因子，是工作班別、科別、目前身體健康狀況，及組織賦權中的機會、資源兩構面，及心理賦權中自我決策構面，可解釋變異量達20.2%；在漠視人性方面，僅心理賦權中能力、意義兩構面，可解釋變異量達10.4%；在個人成就方面，組織賦權中的機會構面、心理賦權中能力、意義兩構面，可解釋變異量達32.5%。整體而言，工作疲潰重要預測因子，是心理賦權中意義、能力兩構面及科別、目前身體健康狀況，可解釋變異量達24.9%。
研究結果：賦權是改善護理人員工作疲潰策略之一，對資淺，專業進階層級低，宜先增強心理賦權，再強化組織賦權，強調工作意義；參與專業活動能增加組織賦權；加強能力培養，提升自我效能，達自我決策，重視個人成就；行政管理者提供機會、資訊，分享資源，臨床指導者或諮詢者可充分協助。對人力資源不足，建議成立護理人力庫，採取輪調及彈性排班制度，配置於白班；對超時工作者，簡化工作流程，減少工作負荷，共謀解決人力不足問題之策，重視護理人員目前健康狀況，除定期健康檢查，制訂與落實健康促進策略，減輕工作負擔；重視基層服務表現後之回饋，獎勵個人成就，均能降低工作疲潰發生。

關鍵字

組織賦權 ； 心理賦權 ； 工作疲潰 ； 臨床護理人員

並列摘要

Background: The clinical practice nurses are generally considered as a large high risk group regarding job burnout in study. Empowerment is usually applied in nursing administration & clinical management to reduce the job burnout on the emotional exhaustion (EE), depersonalization (DP) & increase the personal accomplishment (PA). It had been significantly influenced as the indicator of job burnout.
Aim: The aim of this research was to examine the relationship between the perception of empowerment & the job burnout in a teaching hospital.
Methods: A cross-sectional design was used, Two hundred & night-two clinical nurses selected by stratified random sampling (response rate 94.9%, n=277；useable n=275). Research instruments included the Structural Empowerment Scale (SES), Psychological Empowerment Scale (PES) both translated in the Chinese by Liu (2008) & the Maslach Burnout Inventory (MBI) translated by Sheu (1996). Beyond descriptive statistics, correlation & multiple regression analyses were computed.
Results: (1) The perception of the structural empowerment & psychological empowerment of the clinical practice nurses, both were on the moderate level; but the EE was on the high level, DP was on the moderate-low level, & PA was on the moderate-high level. (2) Average score of each subscale of SES ranked by oppertutity, informal power, support & information, resource, formal power; The competence, meaning, self- determination & the impact were ranked in the PES, Only “support” subscale negative related with EE & DP, but positive related with PA; ”Meaning”& “self-determination”two subscales negative related with EE & DP, but positive related with PA. (3) The significant variance related the EE were the shifting duty, current unit, the present personal health condition, the opportunity & the resources two subscales of the structural empowerment, also the self-determination subscale of the psychological empowerment, all were accounted for 20.2% of total variance. Two subscales competence & meaning of the psychological empowerment were related with DP, both were accounted for 10.4% of total variance. The opportunity subscales of the structural empowerment & the competence, meaning two subscales of the psychological empowerment, were related to the PA, which were accounted for 32.5%.of total variance. (4) Overall, the predictor of “Job Burnout” were the meaning & the competence, two subscales of psychological empowerment, also the current unit, the present health status, all accounted 24.9% of total variance.
Conclusions: Enhance the perception of psychological empowerment, then emphasis on the self-efficiency, with indeed support & professional training which forcus on achieveing her personal accomplishment by her substantial ability. Provide the oppornity, information, share the resourses, promote the personal impact on the unit or the department, and pay much more attention on the present health status of nurses. Setting the manpower pool for nurses’ shortage, dispose the nurses in the different units or take around in the shifting work variablely for surgical unit & maternal-children unit, even in the day or night shift. Simplify the work procedure, making the health promotion strategy & will be carried out, then the job burnout will be reduced.

並列關鍵字

Perceived Structural Empowerment ； Psychological Empowerment ； Job Burnout ； The Clinical Practice Nurses

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