資深護理人員工作壓力與生活品質之相關因素探討

Factors Associated with working stress and quality of life in senior nurses.

黃琡珺(Shu-Chun Huang)

指導教授 ： 呂筑韻

義守大學/管理學院/管理碩博士班/碩士(2017年)

摘要

研究目的：醫院是照顧民眾健康的重要機構，其中護理人員爲此產業的主要人力，負責臨床照護病人的工作，承受許多的工作壓力。了解資深護理人員的工作壓力與生活品質相關因素可協助護理專業的永續發展。
研究方法：本研究採橫斷式問卷調查研究法，將以在醫院臨床工作資深護理人員（2006年12月31日到職），以自填式問卷調查方式進行資料收集2015/5/1-2015/5/31，發出188份問卷，回收155份。問卷內容包含（一）個人基本資料、（二）生活習慣、（三）自覺工作壓力量表（Effort-Reward imbalance、ERI）、（四）生活品質量表（WHOQOL-BREF）。結果分析軟體為SPSS19版，分析方法包括描述性分析、相關分析、與逐步迴歸（stepwise regression analysis）等。
研究結果：
資深護理人員年齡範圍介於29歲至49歲之間，平均年齡36.1歲，標準差(SD 3.58)，多數已婚，佔70.3% (n = 109)。工作職級以大於等於N2爲最多，佔81.9% (n = 129)，護理組長佔24.5%（n=38）。在自覺工作壓力量表分數中付出/回饋比值(E/R ratio)之平均數爲.80 ± .40，其中E/R ratio > 1佔21.9%，顯示有21.9%的護理人員認爲工作壓力大。在生活品質的四個層面中，生理健康範疇的得分最高(13.83分)、心理層面得分最低(12.32分)。
相關分析結果，已婚與工作壓力的外在付出及內在付出有顯著負相關，護理人員的職級高與喝酒在工作壓力的內在付出有顯著正相關。已婚與生活品質的生理健康、心理、社會關係、環境、總體生活品質均有顯著正相關；教育高程度在生理健康、心理、環境、總體生活品質均有顯著負相關；有運動在生理健康、總體生活品質均有顯著正相關。
迴歸分析結果，已婚狀態爲外在付出構面、回饋構面及付出/回饋比值的重要預測因子；喝酒爲內在付出構面的重要預測因子。已婚及教育高程度爲生理健康範疇的重要預測因子，教育高程度同時也是心理範疇的重要預測因子。
結論與建議. 雖然護理工作壓力大，但透過家庭支持與運動有助於資深護理人員工作減壓與生活品質維持。

關鍵字

護理人員 ； 工作壓力 ； 生活品質 ； 健康

並列摘要

Research Purpose: Hospitals are important places in delivering health care for people in general. Nurses play an essential role in health care system, because they are responsible in providing patient care in clinical setting, and heavy work-load and stress are parts of their daily jobs. To understand work related stress and quality of life in senior nurses would be helpful in the development of nursing profession.
Research Methods: The research is a cross-sectional survey design, using self-reported questionnaires. Eligible participants were senior registered nurses who were recruited prior 2006/12/31, and data were collected between 2015/5/1 and 2015/5/31. A total of 188 questionnaires were distributed and 155 were returned. The questionnaire consists of four parts: (1) individual basic information, (2) health related habits and physiological conditions, (3) effort-reward imbalance (ERI), and (4) WHO quality of life brief (WHOQOL-BREF). IBM SPSS v12 was used for statistical analysis. The analytic methods include descriptive and bivariate analysis (i.e., correlation), and multivariate analysis (i.e., stepwise regression).
Research Results:
The range of participants’ age was between 29 and 49 years with mean age 36.1 and standard deviation (SD) 3.58 years. Majority (70.3%, n = 109) of the sample were married, 68.4% (n = 106) were Level Two Nurses (N2), and about one fourth were leader nurses (24.5%, n = 38). ERI model is used to measure one’s perceived effort and reward imbalance. The ratio of effort and reward (E/R ratio) larger than 1 represents high levels of work related stress. The average of E/R ratio was .80, with a SD .40. However, 21.9% of the sample reported E/R ratio > 1. Of the four dimension of the WHOQOL scale, the highest average score is in the physical health dimension with 13.83, and the lowest average score is in the psychological health dimension with 12.32.
Bivariate Analysis. According to correlation analysis, several variables are associated with ERI model and WHOQOL-BREF scales. Married status is negatively associated with effort and over-commitment dimension, while nursing level and drinking is positively associated with over-commitment. Married status is positively associated with various dimensions of quality of life, including physical health, psychological health, social relationships, environment, and overall. High education status is negatively associated with physical health, psychological health, environment, and overall quality of life. Being exercise regularly is positively associated with physical health and overall quality of life.
Multivariate analysis. Married status and exercise are two predictors significantly associated with ERI model. Similarly, married status, education level, and exercise regularly are predictors significantly associated with WHOQOL-BREF.
Conclusions and implications: Although nurses reported perceived imbalance work related stress, through family support and exercise might be helpful in stress management and quality of life improvement.

並列關鍵字

nurses ； work stress ； quality of life ； health

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