領導風格、工作特性與醫師工作滿意度關係之探討

A Study of the Relationship among Leadership , Job Characteristic and Job Satisfaction of Attending Physician

林佳茹(Chia-JU Lin)

指導教授 ： 張肇松

高雄醫學大學/健康科學院/醫務管理學研究所碩士在職專班/碩士(2011年)

摘要

在醫療產業中，醫師為機構內主要生產力與營運收入來源，加上醫師工作的獨特性與自主性，如何提昇主治醫師的工作滿意度，對於醫院管理者是極大的挑戰。領導行為與工作特性在組織行為領域裡是非常重要的研究變項，雖已有許多針對領導型態與工作特性對於工作滿意度進行探討的研究，並在許多企業研究當中得到驗證，唯在醫療產業卻鮮少有對醫院主治醫師來進行研究討論，因此本研究將針對主治醫師在領導型態與工作特性對其工作滿意度的影響來進行探討。不同於一般常見衡量的方法，研究中利用激勵潛能分數(Motivating Potential Score, MPS)，以代表是否具有激勵工作者潛能的特性，並使用Kano二維品質模式來歸類工作滿意度之屬性，藉此進一步找出主治醫師所在意的關鍵品質要素。
本研究以中部三家區域醫院主治醫師為主要對象，以問卷調查探討領導行為、工作特性與工作滿意度的關係，問卷內容包含領導風格、工作特性以及工作滿意度等共75個問項，研究期間從於2011年4月15日至6月15日間共發出128份問卷，回收有效問卷91份，有效問卷回收率為 71.1％，再利用SPSS 12.0來進行探討分析。
研究結果發現，主治醫師工作滿意度較不受主管領導行為之影響。除了婚姻及年齡以外，其他個人屬性並非影響工作滿意度的主要原因。單身及60歲以上的主治醫師有較高的潛在激勵分數，相較於整體具有較高內在動機與高工作滿足。工作特性五大構面中回饋性較為偏低，醫院宜多充實此屬性之強度。另外，從Kano二維品質所歸納出品質要素發現「不會做出違背良心的事情」、「醫院提供醫師的服務需求與工作的穩定性 」、「醫院薪資與獎金發放的高低，確實能反映工作能力與績效表現」等被醫師認定為基本的必要條件。另外「工作時與同事間互動關係良好」與「有為別人服務的機會」則可加強工作動機，激勵並提高工作績效。
綜合本研究的分析結果，對醫療機構如何提升主治醫師工作滿足，給予建議如下：促進醫師與同仁之間的互動、營造愉快的工作氛圍、提供醫師有發揮能力的機會、讓醫師在工作時不感到違背良心且可以在工作中獲得成就感。

關鍵字

領導風格 ； 工作特性 ； Kano模式 ； 工作滿意度 ； 主治醫師

並列摘要

Introduction：
Physicians are the most important factor to impact the productivity in healthcare and hospital revenue. Various factors affecting the physician’s job satisfaction including hospital leadership and job characteristics. Physician’s job satisfaction is a great challenge for the hospital managers. Although many studies concerning the leadership and job characteristics were performed in various professionalisms, few studies have been done on the medical industry. Therefore, the study aims at the relationship between leadership, job characteristics and job satisfaction of hospital attending physician. In this study, to identify the key factors influencing physician’s job satisfaction, our research employ the Motivating Potential Score (MPS) and the Kano model for classifying the quality attributes of physician’s job satisfaction.

Material and methods：
A total of 128 physicians from three regional hospitals were enrolled for study. A well-organized questionnaire with 75 items about leadership, job characteristics, and job satisfaction were sent to each physician. The study was completed from April 15, 2011 to June 15. 91 response out of the 128 physicians and valid (71.1% response rate) through analysis SPSS 12.0 ver. Software was used for statistical analysis.

Results：
The results showed that there was no significant influence of leadership on physician’s job satisfaction. Demographic factors including marital status and age were the main factors affecting job satisfaction. Physicians, single and more than 60 years old, had higher motivating potential score, motivation and job satisfaction. For the five dimensions of job characteristic, physician perceived the lowest in the feedback dimension. Using Kano Modeling we found " do the right things and not against their conscience," "hospital can provide the physicians services demand and job stability," "salary and bonus could really reflect their work performance" were the basic requirements for the physician. Besides, "get along well with their colleagues " and "have chance to serve the people" will enhance motivation, and improve physician’s performance.

Conclusion：
Based on above results, we conclude that promoting the interaction between physicians and colleagues, creating a pleasant working atmosphere, providing physicians the opportunities to serve the patients, and increasing the sense of achievement and with a conscience at work were important to enhancing physician’s job satisfaction. Further study is needed.

並列關鍵字

Leadership Behavior ； Job Characteristic ； Kano model ； Job Satisfaction ； Motivating Potential Score, Attending Physician

參考文獻

一、中文部份

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2. 周昌柏，國小校長轉型領導、交易領導與教師工作滿意度關係之研究，花蓮教育學報，95 年，第22期，P1~28。(2006)

3. 鄭嘉麟，「領導風格與領導效能」，國立中央大學企業管理研究所未出版碩士論文（2007）。

4. 陳玉鎂，「轉換型領導對工作滿足及組織承諾的影響」，國立中央大學企業管理研究所未出版碩士論文（2007）。