護理長的領導風格與護理人員的留任意願及工作士氣之相關性研究

文獻指出領導風格會影響留任意願及工作士氣，但三者間相關性探討研究仍有不足。本研究旨在了解護理人員對於護理長領導風格的感受及此感受對其留任意願和工作士氣之相關影響，並進一步探討工作士氣在領導風格與留任意願間扮演的角色，並分析留任意願及工作士氣的重要預測因子。採描述性相關研究設計，方便取樣南部某醫學中心，以簡單隨機抽樣790位臨床基層護理人員，橫斷式調查領導風格、留任意願及工作士氣，共721位完成問卷，回收率達91.27%。以SPSS 22.0 for Windows軟體進行建檔與分析，結果發現(1)留任意願平均為中等程度(69.6%)；(2)工作士氣平均為中上程度(73.1%)；(3)護理人員知覺護理長兼具轉換型領導(平均81.1%)及交易型領導(平均80.7%)的領導風格；(4)個人屬性及工作屬性不同，對留任意願及工作士氣得分有差異，護理人員已婚、有子女、年齡50歲以上、N4層級、護理師職稱、有輪調其他單位、本院及本單位工作年資越高，其留任意願及工作士氣得分越高；(5)經皮爾森積差相關檢定，轉換型領導、交易型領導與留任意願、工作士氣等變項間有顯著正相關；進一步複迴歸分析發現不論轉換型領導或交易型領導，工作士氣都對留任意願具部分中介效果；(6)透過階層複迴歸分析發現：留任意願有30.4%變異量分別由個人屬性(3.5%)、工作屬性(6.2%)、及主管領導風格(20.7%)解釋；而工作士氣有40.1%的變異量分別由個人屬性(8.0%)、工作屬性(5.2%)、主管領導風格(26.9%)解釋。本研究發現領導風格對於留任意願及工作士氣有較高的解釋力，建議將領導統御納入基層護理主管行政培訓必要的課題，以期營造良好的工作士氣，使護理人員能勝任與留任護理職場。

關鍵字

護理長；護理人員；領導風格；留任意願；工作士氣

並列摘要

The literature has shown that leadership style has impact on intention to stay and job morale, yet less exploration to the correlates among them. This study aims to explore the relationships among nurses’ perceived leadership style of head nurses, their intention to stay and job morale, and the related factors. The descriptive correlational study employed a cross-sectional design. A convenience sample from a medical center in southern Taiwan was used. Seven hundred and ninety nurses, who worked for at least 6 months and did not assume any managerial positions, were selected by simple random method. At the end, 721 nurses completed the questionnaires of perceived leadership of head nurse, intention to stay, and job morale, with a response rate of 91.27%. Data were analyzed using SPSS (statistical package for social science) with version 22 for windows. The results showed that (1) the nurses’ intention to stay were at medium level (69.6%), (2) nurses’ job morale were above medium level (73.1%), (3) the nurses perceived head nurses’ leadership style as combining both transformational leadership (81.1%) and transactional leadership (80.7%), (4) nurses’ personal attributes (i.e., age >50 years old, has children, and married) and job attributes (i.e., Level 4 of clinical ladder, work tenure, and work experiences) varied their intention to stay and job morale, (5) the analysis of Pearson's correlation showed that leadership styles (transformational leadership and transactional leadership) had significant positive correlation with intention to stay and job morale. Further regression analysis found partial mediation effect of job morale to the relationship between intention to stay and either types of leadership style, (6) the hierarchical regression analyses showed that personal attributes, job attributes, and leadership styles could explain 30.4% variation of intention to stay; among which 3.5% by personal attributes, 6.2% by job attributes, and 20.7% by the leadership style of head nurse. Personal attributes, job attributes, and leadership styles could explain 40.1% variation of job morale; among which 8.0% by personal attributes, 5.2% by job attributes, and 26.9% by the leadership style of head nurses. The head nurses’ leadership style apparently had highest explained variance, among all correlates, for intention to stay and job morale. It is highly recommended that well-designed leadership training programs for head nurses are imperative to establishing positive environment of nursing practice. In doing so, the job morale can be sustained and nurses may have better intention to stay in their workplace.