已婚女性護理人員的工作壓力、家庭壓力、社會支持及其健康之狀況

本研究之目的在探討已婚女性護理人員的護理職場工作壓力、家庭壓力、社會支持及其身心健康狀況。使用橫斷式及相關性研究設計，主要研究工具為結構式問卷，包含個人基本資料、付出–回饋失衡工作壓力量表、家庭壓力量表、社會支持量表和健康量表。實施時間為2012年8月3日至2012年8月19日兩週，共收案233位服務於區域教學醫院之已婚女性護理人員。使用SPSS 15.0 版套裝軟體進行次數、百分比、平均值及標準差之描述性統計分析，以及單因子變異數分析、獨立樣本t檢定和多元邏輯式複迴歸之推論性統計分析。研究結果發現，研究對象工作壓力之高低、是否「過度投入」、社會支持程度的高低、家庭壓力程度及每週護理工作時數會影響已婚女性護理人員的健康狀況。而且「每週護理工作時數過長(≧48小時) 」、「工作-付出大於回饋」以及「工作過度投入」為已婚女性護理人員健康狀況的重要預測變項。已婚女性護理人員每週護理工作時數大於或等於48小時其不健康狀況是小於44小時者的4.17倍；付出回饋比大於1者，其不健康狀況是付出回饋比小於或等於1者的5.93倍﹔工作過度投入者(前三分之一)其不健康狀況是無過度投入者(後三分之二)者的2.59倍。根據本研究結果在護理實務、研究、教育方向提出建議: (一)護理實務方面: 建議主管宜妥善建立排班原則，以避免護理人員超時工作。(二) 護理研究方面:建議未來可採用世代追蹤，較能確認工作壓力、家庭壓力與健康狀況的因果關係。(三) 護理教育方面:醫院之繼續教育可安排緩解壓力及時間管理的課程。另外醫院主管可給予護理主管適當的教育訓練，使護理主管能主動提供已婚女性護理人員在家庭需要上的協助。

關鍵字

工作壓力；家庭壓力；社會支持；健康狀況

並列摘要

This study explored married female nurses’ job stress, family stress, social support and their health status. This study used Cross-Sectional correlation design and structured questionnaires which included the questionnaire of demographic data, the job stress scale of Effort-Reward imbalance, the scale of family stress, social support scale (S.S.S.) and the Chinese health questionnaire (Chinese Health Questionaire-12, CHQ-12) . 233 married female nurses were recruited in this study from August 3, 2012 to August 19, 2012 for two weeks. SPSS（Statistical Product and Service Solutions）for Windows 15.0 was used for the number, percentage, average and standard deviation of the descriptive statistics analysis, as well as one way Anova test, independent t-test and multiple regression analyses. The results of this study showed the degree of job stress, whether over-commitment or not, the degree of social support , the degree of family stress and the number of working hours per-week affected the health status of the married female nurses. The number of working hours per-week (≧48hrs/＜44hrs), effort-reward ratio and over-commitment were the main predictors of the health status of the married female nurses. The number of working hours per week bigger than or equal to 48 hours had 4.17 times more risk of unhealthy status than that of working hours per week smaller than 44 hours. Married nurses with the ratio of effort-reward larger than 1 had 5.93 times more risk of unhealthy status compared with those with the ratio of effort-reward larger or equal to 1. Married nurses with over-commitment had 2.59 times more risk of unhealthy status compared with those without over-commitment. According to the results of this study, some suggestions are recommended: A. In the respect of nursing practice, the manager should set up scheduling rules to avoid overtime work. B. In the respect of nursing research, prospective cohort studies are suggested to confirm the cause-effect relationships among the job stress, the family stress and the health status. C. In the respect of nursing education, the medical institutions (hospitals) should include classes related to how to relieve stress and the skills related time management. Moreover, the hospital managers should provide education programs to nurse managers to let them provide assistances on family needs of the married female nurses.