感染症防治醫院護理人員工作壓力及其相關因素之探討
-以高高屏區為例

目的一、探討感染症防治醫院護理人員工作壓力之感受程度。二、探討感染症防治醫院護理人員工作壓力在不同個人屬性上之差異。三、探討感染症防治醫院護理人員工作壓力在不同工作特性上之差異。四、探討感染症防治醫院護理人員人格特質傾向與工作壓力感受程度之相關性。五、探討感染症防治醫院護理人員工作壓力之預測因子。方法本研究設計為橫斷式（cross-sectional）問卷調查研究法，其工作壓力量表乃參考吳敏鳳老師（1996）所發表之「臨床護理人員工作壓力量表」共有五個構面分別為工作本身、行政管理、人際關係、工作環境與知識技巧等，其Cronbach’s α為0.94；另人格特質量表係採用呂勝瑛博士於民國七十三年所編訂之量表Cronbach’s α為0.88，顯示其內部一致性信度係數佳。研究對象為高屏區感染症防治醫院之從事臨床護理工作的所有護理人員，本研究問卷採用紙筆方式由受試者自行填寫，所有資料均屬於初級資料（Primary data），總共發出365份問卷，回收325份，回收率89.04﹪經剔除填答不完整，回答方式錯誤等無效問巻之後，得有效樣本數為308份（84.4﹪）。資料收集期間為民國九十五年一月十日至二月二十五日止。結果一、感染症防治醫院之護理人員年齡以20-30歲佔多數43.2﹪，平均年齡35.0歲，教育程度以專科以下居多68.8﹪，有宗教信仰者居多數66.9﹪，已婚佔58.1﹪，有子女者佔53.2﹪，護理年資以6-15年者為多36.7﹪，平均年資12.4年，職位以護士佔多數74.4﹪，服務科別以內科居多為24.0﹪，無固定班別者佔多數54.2﹪。二、感染症防治醫院之護理人員之整體工作壓力感受程度屬於中等（指標分數為55,滿分為220），其五項壓力中以人際關係（指標分數為71）之壓力排行第一位，其次是工作本身（指標分數為60），第三為工作環境（指標分數為54），第四為行政管理（指標分數為53），第五為知識技巧（指標分數為50）。三、年齡在工作本身及知識技巧之平均壓力上達顯著性差異（F＝5.29，p＝0.00；F＝4.21，p＝0.01），顯示年齡31-40之工作壓力大於41歲以上之護理人員；年資及科別在整體工作之平均壓力達顯著性差異（F＝4.46，p＝0.01；F＝2.36，p＝0.05）；年資在6-15年之護理人員大於1-5年及16年以上者，內科、外科、小兒婦產及急重症位之護理人員大於其它單位（精神科、門診）；教育程度在行政管理的平均壓力達顯著性差異（t＝-2.89，p＝0.004），顯示大學以上大於專科以下之學歷；職位在工作本身之平均壓力上達顯著性差異（F＝3.07，p＝0.05），護理師大於護士，班別在人際關係的平均壓力達顯著性差異（F＝12.72，p＝0.00）；無固定班別之護理人員大於有固定班別者，有無子女、有無宗教信仰及婚姻狀況在工作壓力之平均值上則無顯著性差異。四、人格特質與整體工作壓力達顯著正相關0.45（p＝0.00），其預測工作壓力可解釋之總變異數百分比（R2）為20.5﹪，Beta係數0.453，顯示人格特質量表得分愈高(越A型性格頃項)其工作壓力感受越大（t＝8.88，p＝0.00）。結論與建議一、由於目前並沒有因疫情而啟動感染症防治醫院，故仍維持社區醫院之功能與角色，因而護理人員的整體工作壓力程度並沒有很高。但為了提升突發疫情所帶來的壓力及適應大環境與社會結構的改變，平時對於壓力紓緩的訓練課程應被重視與推動，以增進護理人員身心健康、提昇服務士氣。二、五項壓力中以人際關係之壓力排行第一位，故建議機構建立完善之組織管理及溝通管道，藉以改善互動方式增進人際關係。三、人格特質偏向A型者可妥善運用壓力因應策略，並透過休閒活動緩和內心之焦慮與不安的精神。

關鍵字

感染症防治醫院；護理人員；工作壓力；人格特質

並列摘要

Objectives： 1. To explore the levels of the work stress that nursing staffs in the appointed hospitals of infection control. 2. To compare the differences of the work stress that nursing staffs in the appointed hospitals of infection control in personality aspect 3. To compare the differences of the work stress that nursing staffs in the appointed hospitals of infection control in different works 4. To explore the correlation between the personality of the nursing staffs in the appointed hospitals of infection control and the levels of work stress. 5. To establish the predictors for the nursing staffs’ work stress in the appointed hospitals of infection control Methods： The study design is a cross-sectional questionnaire survey. The work stress scale applied in this study, was published in 1996 by clinical nursing staffs’ work pressure scale that Min-Feng, Wu. It contains five different aspects: job itself, administrative management, relationship with people, work environment, and knowledge and skills. The questionnaire’s content validity was examined and corrected by five experts and the result of reliability analysis was also protested. Cronbach’s αare 0.94 and 0.88 respectively, which showed that it had a good performance in internal consistency reliability. The subjects of this research are all the clinical nursing staffs in the appointed hospitals of infection control in Kao-Ping district. The questionnaire is a pencil and paper survey, all the data is primary data. The total number of questionnaires that were sent out were 365 and 325 of them were responded. The response rate of questionnaire was 89.04%. After excluding the invalid questionnaires with uncompleted answers or incorrect ways to answer questions, 308 valid questionnaires (84.4%) were obtained. The data had been collected from Jan 10th, 2006 to Feb 25th, 2006. Results： 1. A large number (43.2%) of the nursing staffs in the appointed hospitals of infection control is between ages 20 to 30. 68.8%, and the staffs have the average age of 35.0 and a under college education background. The percentage of the staffs with religion belief is 66.9%. 58.1% of the staffs are married. The percentage of the staffs with children is 53.2%. A large number (36.7%) of the staffs have 6-15 years working experiences in nursing. 74.4% of the staffs work as nurses and have average 12.4 years working experiences. 24% of the staffs serve in internal medicine departments. 54.2% of the staff has fixed shifts. 2.The overall level of the work stress that the nursing staff in the appointed hospitals of infection control feels is in the medium range (the target score is 55 out of 220). The rankings of the five different kinds of stress that the staffs feel are listed as follow: first, relationship with people (target mark 71); second, work itself (target mark 60); third, work environment (target mark 54); fourth, administrative management (target mark 53), followed by knowledge and skills (target mark 50). 3.Age in the average stress in work itself and in knowledge and skill reaches an significant difference (F=5.29, p=0.00; F=4.21, p=0.05), which shows that the work stress that the staffs at the ages of 31-40 below is heavier than the staffs above 41 years old. The average stress of overall work in working experience and working department reaches an significant difference (F＝4.46，p＝0.01；F＝2.36，p＝0.05)，the staffs with 6-15 years working experience suffers heavier work stress than the staffs with 1-5 and 16 above years working experience. The staffs work in internal medicine departments, surgical departments, children & women departments, and emergency and critical care medicine departments suffers heavier work stress than the ones in other departments. The average pressure of administrative management in education background reaches an significant difference (t＝-2.89，p＝0.004). It shows that the staffs with a university and above degree is under heavier stress than the one holds a under college degree. The average work stress itself in position reaches a significant difference (F＝3.07，p＝0.05). The nurse practitioner feels more stressed than the nurses. The average stress of personality in working shift reaches an significant difference (F＝12.72，p＝0.00. The staffs with no fixed shift has heavier stress than the ones has. The average of work stress in having children or not, having religion belief or not and marriage situation reaches no significant difference. 4.Personality and overall work stress reaches an obviously positive correlation 0.45（p＝0.00）; the percentage of total variance explained by work stress is 20.5%（R2）; regression coefficient is 0.453. These results show that the higher score a person got in personality scale (type A behavior tendency), he/she has heavier work pressure (t=8.88, p=0.00). Conclusion and Suggestion： 1. Due to the reason that none of the appointed hospitals of infection control has occurred epidemic; therefore, those hospitals still maintain their function and their role as community hospitals. For this reason, the nursing staffs’ overall level of work stress is not fairly high. However, in order to raise the staffs’ stress control ability for the sudden epidemic of disease and the ability to adapt the change of the environment and the social structure, training courses for easing stress should be paid attention to and be set into action. Therefore, the health of the staff’s body and spirit can be improved and the service that they offer can be better. 2. Personality is ranked no.1 among the five different kinds of stress; hence, the establishments of a good organization management and a communication channel in the organization are suggested. These two methods can be used to improve staff’s interactions with each other to make a better relationship. 3. For those whose personalities toward type A are suggested to take the advantage of stress management, and use leisure activities to ease their anxiety. Key Words: hospitals of infection control, nursing staffs, work stress, personality