整合認知、主管與部屬交換關係與組織文化對
工作態度影響之研究－以離島某醫院為例

研究背景與目的本研究探討澎湖地區原隸屬兩家不同公務系統及組織文化的公立醫院，分別於不同時間委託同一醫學中心級的三軍總醫院經營管理迄今，從不同面向切入探討，進而瞭解整合認知及主管與部屬間的互動情形對員工工作態度之影響。研究方法採橫斷式調查法，以某離島地區的二家不同體系公立醫院員工為研究對象，進行結構式問卷調查，98年1月5日至1月19日期間，以問卷調查方式對兩院員工進行普查，總計發出438份問卷，回收391份問卷，扣除10份無效問卷，最後納入分析的有效問卷為381份，有效回收率為87％。調查所得資料以描述性及分析性等統計方法進行處理與分析。研究結果研究發現以下幾點：（1）性別、聘任身分、職務類別及整合前隸屬機構之個人特徵對整合認知達統計上顯著差異；（2）性別及聘任身分之個人特徵對主管－部屬間互動關係具有顯著差異；（3）整合前隸屬機構之個人特徵對「組織文化-合作型」達統計上顯著差異；（4）性別及整合前隸屬機構之個人特徵對「組織文化-紀律型」具有顯著差異；（5）個人特徵對情感性承諾達統計上顯著差異；（6）性別、聘任身份及整合前隸屬機構之個人特徵對持續性承諾達統計上顯著差異；（7）個人特徵對規範性承諾達統計上顯著差異；（8）性別、婚姻狀況、教育程度、聘任身份及職務類別之個人特徵對工作投入達統計上顯著差異；（9）工作投入、情感性承諾以及規範性承諾分別與個人特徵及工作態度具有顯著正相關性。（10）持續性承諾僅與年齡及整合認知無顯著相關性。（11）多元迴歸分析模式顯示，「組織文化之紀律型」與整合認知及工作投入皆有顯著之交互效果，「組織文化之紀律型」與整合認知及情感性承諾皆有顯著之交互效果。結論與建議研究得知，員工整合認知及主管－部屬間互動關係對於工作態度具有一定程度的正相關，整合認知對部分工作態度之影響受到組織文化的調節作用，而主管－部屬間互動關係對工作態度之影響不受組織文化的調節作用，此結果可提供政策決策者及醫院管理者對兩個不同組織文化整合為同一體系運作時，所遭遇問題及解決方案的參酌，並作為未來偏遠地區醫療整合及方案推行的決策參考。

關鍵字

整合認知；主管－部屬間互動關係；組織文化；組織承諾；工作投入

並列摘要

Objectives The purpose of this research was to explore, at two public hospitals with two different civil service systems and organizational cultures in Penghu, the employees’ perceptions of integration, the relationship between the managers and the employees hospital, as well as to understand the impact on organization commitment and job involvement. Methods This was a cross-sectional study design using an investigator-developed questionnaire. A convenience sample of 438 staff was taken from two public hospitals in penghu. A total of 391 employees responded to the survey. The response rate was 87%. Results The relationship between gender, position, job category, personal Characteristics and the perceptions of hospital integration was significant. (1) Employees’ gender, position, work category, and the hospital he/ she belong before the merger have an obvious impact to their cognition of integration. (2) Employees’ gender and position have profound impact on the management- staff interaction. (3) The hospital an employee belongs to before the merger has an obvious impact on organization culture-cooperation. (4)Gender and the hospital employees belong before the merger strongly influence the item of organization culture- discipline.(5) Personality traits have profound impact on employees’ commitment to the organization and organization bond. (6) Gender, position, and the hospital employees belong before the merger obviously influence employees’ commitment to the organization and the continuation of the commitment.(7) Personality traits obviously influence employees’ commitment to the organization and the norms.(8) Gender, marriage status, education, position, and work category of employees has obvious impact on their work devotion. (9) Work devotion, employees’ commitment to the organization and organization bond, and employees’ commitment to the organization and the norms has proportional relationship to personality traits and work attitudes.(10) Employees’ commitment to the organization and the continuation of the commitment is not influenced by their age and cognition of the integration.(11) Multiple regression analysis shows the organization culture- discipline, the cognition of the integration, and work devotion has interactive effects among them; the organization culture- discipline, the cognition of the integration, and employees’ commitment to the organization and the continuation of the commitment. Conclusions Results showed that the staff’s perceptions of hospital integration and the manager-staff relationship were related to work attitude positively. The effect of the staff’s perceptions of hospital integration on work attitude was buffered by organizational culture. The effect of the manager-staff relationship on work attitude was not regulated by organizational culture. These results contributed to understanding the difficulties and problems in terms of hospital integration with two different organizational context, and providing reference value with regards to the policy-making and implementation of health core integration on remote areas.