背景 部分公立醫院的約用護理人力已高達47.6%,且約用護理人員的流動率通常為正式護理人員的五至八倍。鑒於護理人員的高流動率易負面影響護理照護的持續性,近來有關護理人員的任職形態與護理品質間的關聯,已引起高度的關注。 目的 探討某公立醫院的護理人員是否會因其任職形態(約用或正式)之不同,而在組織承諾、工作滿意、組織公民行為與工作績效上出現差異。 方法 本研究樣本選自一家具代表性的署立醫院。自評問項外,為避免共同方法偏誤,亦採用主管評核的結構式績效問卷。統計分析以迴歸分析探討護理人員是否會因其任職形態(約用或正式)之不同,而影響其工作滿意、組織承諾、組織公民行為與工作績效。 結果 研究發現:⑴組織承諾、工作滿意、組織公民行為與工作績效間呈正相關;⑵約用或正式護理人員在組織承諾、工作滿意、組織公民行為與自評工作績效上無差異,但在主管評核的工作績效上,正式護理人員的工作績效顯著優於約用護理人員;⑶組織公民行為在組織承諾、工作滿意與工作績效上具中介效果。 結論 在主管評核的工作績效上,正式護理人員的工作績效顯著優於約用護理人員的結果,值得後續研究深入探討。
Background: According to the 2007 Taiwan Labor Front Human Resources Report, as much as 47.6% of nurses at some public hospitals were contracted rather than full time. Furthermore, turnover rates for contract nurses were found to be as high as five to eight times of those for full-time nurses. Because high turnover rates are likely to induce negative impacts on the stability of care provided in the absence of staffing continuity, the association between nursing employment arrangement and nursing care quality is attracting greater attention. Purpose: This study was designed to investigate the work status of contract versus full-time nurses at a public hospital in Taiwan and to examine the impact of such on work-related attitudes, organizational citizenship behavior, and job performance. Methods: Samples were recruited from a public hospital in Taiwan. In addition to self-rated items, researchers used supervisor-rated structured questionnaires for job performance to attenuate the possible effect of common method bias. The study investigated the impact of hospital nurse employment status on work-related attitudes, organizational citizenship behavior, and job performance using a regression model that included the critical work-related attitudes variables of job satisfaction and organizational commitment. Results: Study findings included the following: (a) organizational commitment, job satisfaction, organizational citizenship behavior, and job performance correlate positively with one another. (b) No significant difference between contract and full-time nurses was found in terms of organizational commitment, job satisfaction, organizational citizenship behavior, and self-rated job performance. However, when rated by supervisors, reported job performance levels for full-time nurses were significantly higher than those of contract nurses. (c) Organizational citizenship behavior exhibited a mediating effect between job satisfaction, organizational commitment, and job performance. Conclusions: In this study, supervisors gave higher job performance ratings to full-time nurses than to contract nurses. This result deserves further investigation.