臨床護理人員工作壓力、工作疲潰與身心健康之相關性探討

背景：由於國家醫療保險政策在成本的控制和病人需求的改變，使得護理人員面臨工作負荷及壓力增加。目的：探討醫學中心和區域醫院護理人員的工作壓力、工作疲潰與身心健康之現況，以及工作壓力與工作疲潰對健康的影響程度。方法：採橫斷式描述相關研究設計，以方便取樣選擇兩所醫院，再以工作單位作為分層，隨機抽樣出498位工作滿三個月之正職護理人員，研究工具使用結構式問卷包括個人及工作屬性、付出回饋失衡問卷、哥本哈根疲潰量表、及一般身心健康量表等，以SPSS 19.0版統計軟體資料建檔與分析，採用描述性及推論性分析法進行分析，包括卡方檢定、單因子變異數分析、t檢定、皮爾森相關及階層迴歸等分析統計方法。結果：醫學中心與區域醫院的護理人員普遍認為其工作需耗費體力且責任重；而工作壓力、工作疲潰與身心健康的自覺程度在此二層級醫院間並無顯著差異。階層迴歸分析發現身心健康受社會人口學(在職進修、宗教信仰、上班天數)、過度投入、付出回饋失衡及工作疲潰所影響，各變項的單獨解釋力分別為社會人口學9.9%、工作壓力24.4% (含過度投入17.9%、付出回饋失衡6.5%)、工作疲潰12.5%。結論：本研究結果，將提供醫院管理者在人力資源管理及職場健康策略方針之參考。

關鍵字

臨床護理人員；工作壓力；工作疲潰；身心健康

並列摘要

Background: Clinical nurses have encountered increasing workload and job stress due to the cost containment of the national healthcare insurance policies and the societal changes of patient demands. Purpose: This study explored the clinical nurses’ job stress, burnout and physical-mental health in a medical center and a regional hospital and job stress and burnout degree of influence on physical and mental health. Methods: It is a cross-sectional descriptive correlatioal study design. A stratified random sampling by work unit was selected, at the ende a total of 498 full-time employed registered nurses were surveyed. The instruments included personal and work-related characteristics, Effort-Reward Imbalance questionnaire (ERI), Copenhagen Burnout Inventory (CBI), and General Health scale (GH), all of which are in Chinese version. Through SPSS 19.0 software, descriptive statistics, bivariate analyses, chi-square test , one-way ANOVA, t-test, Pearson correlation, and hierarchical regression analyses were used to analyze the data. Results: The results showed that nursing work was perceived as laborious and highly responsible. Also, there were no statistically significant difference, between the medical center and the regional hospital, on either ERI, CBI, or GH scales. Hierarchical regression analyses demonstrated that demographics (namely, on-job schooling, religion, work days per month), overcommitment, effort-reward imbalance, and burnout were predictors of physical and mental health of clinical nurses. For nurses’ physical-mental health, the independent explained variances among the predictors, were 9.9% by demographic variables, 24.4% by job stress (including 17.9% from overcommitment and 6.5% from effort-reward imbalance) and 12.5% by burnout. Conclusions: The results of the study provided important strategic suggestions for human resources management and hospital management.