精神科護理人員人格堅毅性與自覺職業危害相關性研究

A study of personality hardiness, perceived occupational hazards of psychiatric nurses in Medical Centers

周青波(Ching-Po Chou)

指導教授 ： 李選

中山醫學大學/醫學院/護理研究所/碩士(2005年)

https://doi.org/10.6834/CSMU.2005.00099

摘要

本研究目的在探討精神科護理人員人格堅毅性特質與自覺職業危害之相關性。以了解人格堅毅性之「控制性」、「投入性」、「挑戰性」與自覺職業危害之「生物化學物理」、「人因工程」、「心理社會」危害因素之關連。本研究採橫斷式問卷調查研究法，樣本來自全台之北、中、南、東部以立意取樣八家醫學中心精神科護理人員，採自填式結構問卷方式收集資料，共發函156份問卷，回收計150份，回收率達96.15%，有效問卷148份。以描述性統計標準差、平均數和百分比 、推論性統計T-test、One- Way ANOV、 Spearman correlation、Chi-square test檢定統計方法，以探討人格堅毅性與自覺職業危害相關性。 結果發現人格堅毅特徵總分平均158.19分，（各題平均得分4.66），表示大多數精神科護理人員具備中高度人格堅毅性特質，其中以挑戰性特徵最高總分平均62.8分（各題平均得分4.83），人格堅毅性特徵在總體評量年資、年齡有顯著差異，在分項評量婚姻與人格堅毅特徵中挑戰特徵有顯著差異。 對於自覺職業危害而言，自覺職業危害認知總評量3.71分，以生物化學物理危害認知最高平均3.75分，其中以睡眠紊亂危害最多平均4.43分，在人因工程危害認知平均3.73分，以照護病人中對於人格障礙患者操縱行為最困擾平均4.40分，在心理社會危害認知平均3.68分，以照護中遭受到病患家屬言語攻擊污衊最多平均4.32分，精神科病房職業危害是暴力，工作場所中以暴力事件壓力最大5.67±2.72分，遭受暴力事件以言語攻擊119人(80.4%)最多，遭受暴力受傷有111人（84.7%），處理自殺事件有49人（33.1%），遭受性騷擾43人（29.1%）經歷逃跑事件36人（24.3%）， 處理危害事件70%以上均以尋求同事協助最多。另在自覺職業危害年資方面有顯著差異p =0.026＊，與遭受暴力攻擊壓力有極顯著差異p=<.001**。 至於實際發生職業傷害方面在生物危害以失眠50人（33.8%）最多，在人因工程危害以肌肉骨骼酸痛最多67人（45.3%），在心理社會危害以焦慮56人(38.9%)最多。 檢定人格堅毅性與自覺職業危害（r=-.265，p<.1＊）有顯著負相關。因此結果已顯示精神科工作環境中，暴力為重要職業傷害，而人格堅毅性為自覺職業危害重要影響因素，人格堅毅性得分較高者，會將工作中改變視為有益且轉化為刺激自我成長之機會，相信自己能控制與影響並主動運用內外在環境資源之動機，降低生理傷害，本研究結果可提供精神科護理人員，再進一步瞭解自覺職業危害之現況與人格堅毅性之相關性，並可作為護理實務、教學、研究及未來改善精神科職場政策參考之依據。在此樣本研究中論證得到支持性結果，希望此研究可提供醫療相關單位以做為降低護理人員職場傷害之參考。

關鍵字

醫學中心 ； 精神科護理人員 ； 人格堅毅性特質 ； 自覺職業危害

並列摘要

The purpose of the research is to study the correlation between the psychiatric nurse’s personality hardiness and perceived occupational hazards.That is, to understand the correlation between the elements of the personality trait “hardiness” (1) controls, (2) commitment, and (3) challenges and the perceived occupational hazardous factors of (1) biology, chemistry and physics, (2) human gene engineering, and (3) psycho-social occupational hazards.
This research applied questionnaire research based on the cross- sectional descriptive and correlatonal survery method. The samples are from nurses in eight medical centers which are covering North, Central, South, and East Taiwan, and is based on defined samples. The self-filling structure questionnaire method was used to collect the data.A total of 156 questionnaires were distributed, with 150 returned (96.15%). Out the 150 returned, 148 were deemed valid (94.97%). With descriptive statistics deviation, average and percentage, deductive statistics test, One-Way ANOV, Spearman correlation, Chi-square test statistics methods to research the correlation between the personality hardiness and perceived occupational hazards.
The results showed that the characteristics of personality hardiness has total average score of 158.19. (each question average received a score of 4.66). This indicates that the majority of the psychiatric nurse’s posses middle to high levels of the hardiness characteristic. Among those, the highest total average score of 62.8 is the characteristic of challenging (each question average got score of 4.83). The characteristic of personality hardiness is that the overall evaluation on the years of service and age has a significant difference.In a separate evaluation of marriage and personality characteristics, the challenging characteristics have significant difference. For perceived occupational hazards, understanding perceived occupational hazards overall evaluation has a score of 3.71. The highest total average score of 3.75 is the bio-chemistry and physics understanding. Among those, sleeping disturbance hazards has the highest average score of 4.43. The understanding of human gene hazards has average score of 3.73. Among taking care of patient, the personality obstacle patient controlling behavior the most troublesome average score of 4.40. The understanding of psychological hazards has averages score of 3.68.
While looking after patients, the mental health nurse suffer the client’s family verbal abuse and insult with the highest average score of 4.32. However, the most dangerous element for the mental health clinic professional is violence in the workplace. The violence accident pressure is the highest score 5.67±2.72. suffering violent behavior by verbal abuse has 119 people (80.4%) the highest, because of the violent behavior and injured has 111 people (84.7%), handled suicide incidents - 49 people (33.1%), suffered sexual harassment - 43 people (29.1%) and experienced patient escape incident 36 people (24.3%). In dealing with occupational hazards , over 70% will ask for a co-worker’s assistance.. As to perceived occupational hazard years site have obvious difference p=0.026*, and suffer violent attack pressure have a very obvious difference (p<.001**.)
As to actual occupational hazards, in physical hazards for sleep disturbance (insomnia) 50 people (33.8%) the most, in human gene engineering hazards get muscle and skeletal injuries the most - 67 people (45.3%), in psycho-social occupational hazards got anxiety 56 people (38.9%) the most, Define personality hardiness and perceived occupational hazard (r =-0.265, p<.1*) received apparently minus correlation.
Therefore, the study results have shown in the psychiatric working environment, violence is the most important occupational hazard, and personality hardiness is the most important element to influence the perceived occupational hazards.As per my survey, one gets the higher score mark on personality hardiness, one will take advantage of the changes at work, and transform this into a self-growth opportunity, and believe oneself can control, influence and be self-motivated to utilize the internal and external environment resources. This will significantly reduce the physically injury damage.
Apparently, the study result can submit further understanding in related between perceived occupat ional hazard and personality hardiness to psychiatric nurses, this also can provide reference to clinical nursing, educational, research and future polices for psychiatric work place accordingly.Overall, based on the above research result has found it’s very supportive consequence. Hopefully, this study can provide the reference to medical related organization in order to reduce nurse’s injury in the work environment.

並列關鍵字

Psychiatric nurse ； hardiness personality ； perceived occupational hazard

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