支持團體對腫瘤病房護理人員工作壓力及職業疲潰之成效

The Effectiveness of Support Group on Job Stress and Burnout among Oncology Nurses

林惠蘭(Hui-Lan Lin)

指導教授 ： 盧美秀

臺北醫學大學/護理學院/護理學研究所/碩士(2010年)

https://doi.org/10.6831/TMU.2010.00256

摘要

護理工作是醫療照護體系中具高度壓力的工作之ㄧ，而照護腫瘤疾病患者對護理人員而言更是極富挑戰性的工作，因為惡性腫瘤是威脅生命的疾病，病人及家屬面對身心健康、事業及家庭生活巨大的衝擊，腫瘤病房護理人員則須面對長期受疾病折磨的病人與身心俱疲的家屬、日新月異的治療方式、繁瑣多變的化學藥物療程，更要經常面對照護末期及瀕死病人的無力感，使得腫瘤病房護理人員承受相當程度的工作壓力。當長期工作壓力無法有效因應時，即可能經驗到生理、情緒及心智耗竭等職業疲潰現象，甚而降低留任的意願及影響病人照護品質，因此，非常値得賦予深切的關注。
本研究目的在瞭解腫瘤病房護理人員工作壓力與職業疲潰感受程度及其相關因素，並探討支持團體介入對工作壓力及職業疲潰之成效。研究設計採兩組前後測之類實驗研究法，以台灣北部某醫學中心腫瘤科病房護理人員為母群體，招募60名護理人員，隨機分派為實驗組或對照組各30人，再將實驗組護理人員分為兩組，每組成員15人。研究者針對實驗組護理人員施予每週一次，每次2小時，共8次之支持團體介入措施，對照組則未給予任何介入措施。研究工具包括護理工作壓力量表、職業疲潰量表及支持團體計畫。於進行支持團體前及完成8次支持團體後，分別進行兩組護理人員之問卷測量。研究資料以SPSS 17.0中文版統計軟體處理，以描述性統計、卡方檢定、獨立樣本t檢定、相依樣本t檢定、單因子變異數分析、皮爾森積差相關、迴歸分析、及重複測量變異數分析等統計方法進行資料分析，統計顯著水準訂為α=.05。
研究結果顯示：(1)腫瘤病房護理人員之工作壓力總分平均值為156.1分，單項平均值為3.6分；職業疲潰總分平均值為54.8分，單項平均值為2.5分，顯示工作壓力及職業疲潰均屬中等程度。(2)腫瘤病房護理人員之工作壓力與職業疲潰有顯著正相關，即工作壓力感受程度愈高者其職業疲潰程度愈高，工作壓力可顯著預測職業疲潰程度，其預測力達36.8％。(3)年齡、腫瘤護理年資及護理工作年資與工作壓力有顯著負相關，即年齡愈小、腫瘤護理年資及護理工作年資愈資淺者，其工作壓力程度愈高；不同僱用職別其工作壓力及職業疲潰程度均有顯著差異，契約護理師顯著高於公職護理師。(4)腫瘤病房護理人員接受支持團體介入後，其工作壓力及職業疲潰程度均顯著低於支持團體介入前；接受支持團體介入的腫瘤病房護理人員，其工作壓力及職業疲潰程度均顯著低於未接受支持團體介入者，驗證支持團體介入對於改善腫瘤病房護理人員之工作壓力及職業疲潰確實具有成效。
本研究結果可提供護理主管於安排工作場所相關支持計畫之參考，以營造優質的護理工作環境，減少工作壓力及預防職業疲潰，進而提升護理照護品質。

關鍵字

腫瘤病房護理人員 ； 工作壓力 ； 職業疲潰 ； 支持團體

並列摘要

Oncology nurses have been seen as a group at risk for job stress and burnout. In general, they are exposed to patients’ and their relatives’ suffering, an increase in the complexity of cases and available treatment options for patients, being unable to control the results of efforts, the need to cope with death, and a high level of physical exhaustion without psychological support to their need. Moreover, job stress and burnout may consequently negative impact on the retention of oncology nurses and quality of patient care. Therefore, it will be beneficial for oncology nurses, if administrator can be sensitive to potential factors that lead to job stress and burnout, and construct an effective psychological support mechanism.
The aim of this study was to understand the job stress and burnout level in oncology nurses, and to explore the effectiveness of support group on job stress and burnout among oncology nurses. The two-group Quasi-experimental design was use in this study. Sixty nurses working in oncology ward of a medical center were invited. Thirty nurses were random assigned to an experimental group, in which they received a 8-weeks support group serve as intervention, and thirty nurses were random assigned to a control group without intervention. The questionnaires included the Nurse Stress Checklist and the Maslach Burnout Inventory. Data were collected before and after the 8-weeks support group. The SPSS 17.0 for windows statistic software was apply as the tools for statistic analysis. The statistic methods are as follow: descriptive statistics, Chi-Square, t-test, ANOVA, Pearson correlation, regression, and repeated measure ANOVA. α=.05 was considered as statistically significant.
The important findings were as the following: (1) the mean score of the subjects’ total job stress and burnout were 156.1 and 54.8, respectively. the mean score of the subjects’ each item of job stress and burnout were 3.6 and 2.5, respectively; (2) there was a significant positive correlation between job stress and burnout; (3) it was determined that variables influencing job stress were age, years in oncology nursing, years in nursing, and employment status. oncology nurses who were younger and junior suffered significantly higher level of job stress; (4) by affiliation support group can reduce the level of job stress and burnout among oncology nurses. These results might provide ideas for nursing administrator to develop effective support group, in order to release job stress and burnout effectively, and then work effectively.

並列關鍵字

oncology nurses ； job stress ； burnout ； support group

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