長期照護機構照顧服務員自我效能、社會支持與幸福感之關係研究

研究背景：照顧服務員是國內長期照護工作第一線的照護提供者，與住民的互動頻繁且接觸時間長，攸關住民的照護安全及品質，其工作繁瑣費時，但照顧工作的貢獻不容易被察覺，工作價值的肯定也容易被忽略。目前照顧服務員研究多偏向工作壓力、服務滿意度、離職及留任率為主軸，關於照顧服務員幸福感相關的研究只有少數，然而幸福感增加，將使人們更有能力處理照護需求並減少壓力反應，因此若能針對照服員幸福感相關影響因子的探討，並了解他們的正向心理能量，未來將可以做為提升其心理健康與幸福感的介入措施之參考，亦將有助於未來創造更優良的照護品質。研究目的：探討長期照顧機構照顧服務員自我效能、社會支持與幸福感之相關研究。研究方法：採橫斷面研究設計，以雲嘉地區某長期照顧機構照顧服務人員為研究對象，採結構式問卷資料之收集，研究工具包含：人口學屬性資料、自我效能量表、社會支持量表、及幸福感量表。所得資料以SPSS 22.0系統套裝軟體進行資料分析，統計方法為單因子變異數、皮爾森積差相關分析、與多元迴歸分析。研究結果：本研究共有148位長期照護機構照顧服務員參與問卷調查，以女性居多（81.1%），平均年齡為46.48歲，已婚、有子女及宗教信仰者占多數，照顧服務員自我效能、社會支持、及幸福感皆有中度以上正向感受。自我效能與幸福感呈現顯著正相關（r = .43，p < .001），而社會支持與幸福感相關係數亦達顯著正相關（r = .56，p < .001）。而多元迴歸分析顯示子女數「有 vs 無」（β = .18，p = .035）、「自我效能」（β = .18，p = .014）、「社會支持」（β = .47，p < .001）對幸福感的迴歸係數皆達顯著正值，顯示人口學有子女、自我效能、及社會支持是幸福感之預測因子（R² = .41）。結論：長期照護機構照顧服務員「自我效能」、「社會支持」、與「幸福感」皆達顯著正相關，代表自我效能知覺程度越高，感受到的幸福感程度就越高；社會支持知覺程度越高，感受到的幸福感程度就越高。因此欲提升機構照顧服務員幸福感，可積極透過自我效能及社會支持的提升來達成目標。

關鍵字

長期照護機構；照顧服務員；幸福感；自我效能；社會支持

並列摘要

Background: Nurses’ aides are first-line care providers in domestic long-term care work. They frequently interact with residents and have long contact time, which is related with the safety and quality of the residents' care. Although their work is cumbersome and time-consuming, their care work's contribution is often overlooked. Furthermore, the affirmation of their work value is easily ignored. Previous studies on nurses’ aides mostly focused on work pressure, service satisfaction, and turnover and retention rate. Limited studies exist on their well-being. Nurses’ aides have the most direct contact with residents in long-term care institutions. However, the greater the well-being, the greater the ability to manage patient’s care needs and reduce self-stress responses. Thus, researchers should explore the factors that influence the well-being of nurses’ aides and understand their positive psychological energy. The results can be used as a reference for an interventional program to improve their future mental health and well-being and help create better quality of care. Aim: The purpose of this study was to explore the correlation between self-efficacy, social support and well-being in nurses’ aides in long-term care institutions. Methods: A cross-sectional study design was adopted to collect data from a structured questionnaire on the nurses’ aides of a long-term care institution in southern Taiwan. The research tools included demographic questionnaire, Self-Efficacy Scale, Social Support Scale, and Well-Being Scale. The data obtained were analyzed by SPSS 22.0 software package, and the statistical methods included one-way ANOVA, Pearson product moment correlation analysis, and multiple regression analysis. Results: A total of 148 nurse aids in long-term care institutions participated in the questionnaire survey. Most of them were women (81.1%), with an average age of 46.48 years. The majority were married, with children and religious beliefs. The self-efficacy, social support, and well-being of the nurse aids all have moderate or above positive feelings. Self-efficacy and well-being were significantly positively correlated (r = .43, p < .001), while social support and well-being were also significantly positively correlated ((r = .56, p < .001). The multiple regression analysis show that number of children (β = .18, p = .035), self-efficacy (β = .18, p = .014), social support (β = .47, p < .001), and the regression coefficients on the well-being are all significantly positive. These result indicted that having children, self-efficacy, and social support were predictors of well-being (R² = .41). Conclusion: The self-efficacy, social support and well-being of nurse aids were significantly positively correlated. In the other words, nurse aids who perceive higher self-efficacy and social support present greater well-being. Therefore, improving the well-being of institutional nurse aids can be achieved through improvement of self-efficacy and social support.