以北部某醫療體系探討護理人員職業倦怠與離職傾向之研究

背景：由於臺灣邁入高齡社會，老年人口增加，對於醫療照護的需求也因此增加，隨著臨床照護工作的日趨複雜，導致護理人員的工作負荷與壓力不斷增加，而醫院層級不同，其擔負的情緒勞務也會有所差異，使得護理職場穩定性不足，影響醫療品質服務。目的：在探討北部某醫療體系護理人員職業倦怠與離職傾向的相關性，並比較不同背景變項護理人員在職業倦怠與離職傾向上的差異性。方法：本研究採橫斷面結構式問卷進行資料收集，以國泰醫院綜合醫院醫療體系（醫學中心、區域醫院及地區醫院），選取自IRB審查通過後至2019年03月01日止，年齡滿20歲以上且年資滿3個月以上全職基層之護理人員為研究對象，共計回收有效樣本234份，問卷回收資料經由SPSS22.0來進行統計分析。結果：護理人員職業倦怠得分最高為個人疲勞，其次為工作疲勞、對服務對象疲勞。在不同婚姻狀況、工作單位、服務年資、每月平均超時天數、每次平均超時工作時數與離職傾向達顯著相關。而不同年齡、婚姻狀況、子女數、工作單位、服務年資、進階層級、班別種類、每月平均超時天數、每次平均超時工作時數與職業倦怠具有顯著相關性。離職傾向與職業倦怠整體呈現中度正相關，其中與工作疲勞的相關度最高，而工作過度投入的相關度最低。然而機構評鑑等級與職業倦怠和離職傾向無相關性。結論與建議：服務年資、個人疲勞、工作疲勞、服務對象疲勞、工作過度投入對離職傾向具有顯著影響。建議醫療管理者建構優質護理職場，提升合理化的工作待遇，護理部領導者從人手調配與資源配置方面著手，進而降低其離職傾向。

關鍵字

護理人員；職業倦怠；離職傾向

並列摘要

Background: As Taiwan enters an aging society, and the elderly population increases, so does the demand for medical care. With the increasing complexity of clinical care work, the workload and pressure of nursing staff are increasing, and different levels of hospitals have different emotional labor pressure, which makes nursing workplace stability inadequate and affects the quality of medical services. Objective: To explore the correlation between job burnout and turnover intention for nurses in a medical system of northern Taiwan, and to compare the differences between job burnout and turnover intention of nurses with different background variables. Methods: Data were collected by cross-sectional structured questionnaire, a total of 234 valid samples were collected from nurses over 20 years of age with more than 3 months of full-time employment in medical system of Cathay General Hospital (medical centers, area hospitals and regional hospitals) from the date of IRB review to March 1, 2019. The data collected were analyzed by SPSS22.0 for statistical analysis. Results: The highest score of job burnout was personal fatigue, the second was fatigue with work and fatigue with service object. There were significant correlations between turnover intention and marital status, work unit, length of service, average overtime days per month, average overtime hours per time. There were significant correlations between job burnout and age, marital status, number of children, work unit, length of service, advanced level, work shift type, average overtime days per month, average overtime hours per time. Turnover intention and job burnout were moderately positively correlated, with the highest correlation with job fatigue and the lowest correlation with over job involvement. However, there was no correlation between institutional rating and job burnout and turnover intention. Conclusion and Recommendations: Service seniority, personal fatigue, work fatigue, client fatigue and over job involvement have significant effects on turnover intention. It is suggested that medical managers should construct a high-quality nursing workplace and improve reasonable working benefits. The leaders of nursing department should start from the aspects of staff allocation and resource allocation to reduce their turnover tendency.