牙醫助理的工作壓力、工作滿意度與職業倦怠相關因素之探討－以高高屏澎為例

Related Factors of Work Stress, Job Satisfaction and Burnout among Dental Assistants In Kaohsiung, Pingtung, and Penghu Areas.

陳鈞卿(Chun-Ching Chen)

指導教授 ： 黃純德

高雄醫學大學/口腔醫學院/口腔衛生科學研究所碩士在職專班/碩士(2005年)

摘要

中文摘要
背景：台灣目前在口腔衛生照護方面有重大的變動，包括口腔健康法實施、衛生署口腔醫學委員會成立、口腔衛生學系設立等，顯示口腔照護工作正邁向團隊醫療的方式，因此需要相關牙醫輔助人員的工作資料做為政策制定與教學參考。此外國內尚未有任何關於牙醫助理的工作壓力、工作滿意與職業倦怠相關的研究發表，因此有必要調查牙醫助理相關的工作情況。
研究目的：本研究旨在調查牙醫助理的人力分佈、工作內容和其所面臨的工作壓力、工作滿意與職業倦怠的程度以及相關的影響因素，以提出相關資料與建議供需要者參考。
研究方法：對高高屏澎地區所有的牙醫助理於2003年10月至2004年2月之間，藉由電話訪問及郵寄問卷的方式進行調查。
結果：全部牙醫醫院及診所共904家，實際電話訪問共890家，牙醫師總人數為1332人，調查之助理總人數為1923人。問卷共寄發1778份，回收710份，回收率為39.93%。86%（761家）牙科醫療院所有聘請牙醫助理，平均每位牙醫師任用1.44位助理，14.49%醫療院所（129家）未任用牙醫助理，24.38%（217家）只請一位牙醫助理。助理的工作中：印模、排齦、潰瘍塗藥、傷口換藥及拆線、臨時假牙製作、溝隙封填、牙套重黏、塗氟、裝置及移除橡皮帳和矯正環、拍攝X光片、清除牙結石、移除暫時封填劑、暫時填補，這些多項是國外受過訓練且有政府認證登記的牙科衛生士才能做的工作內容。逐步回歸分析顯示：對工作壓力感受量表有顯著影響為工作地點在聯盟牙科、每週工作時數不同、有參加過學分班、無明確的職責說明、工作單位有兼職牙醫師、大專以上學歷、專職助理人數不同、無閱讀牙科相關雜誌以及不同的年齡層。對工作滿意度量表有顯著影響為工作地點在診所、每週工作時數不同、有在職教育、有明確職責說明、有閱讀牙科相關雜誌、薪資不同以及高中職以下學歷者。對職業倦怠量表有顯著影響為工作地點在聯盟牙科、無閱讀牙科相關雜誌、無明確職責說明、薪資以及年齡層不同。線性回歸分析顯示工作壓力越大、工作滿意度越低則職業倦怠越高。\r
結論：研究地區之牙醫師任用牙醫助理之人力比值較美國、加拿大、日本稍低。牙醫助理工作壓力大但工作滿意高而職業倦怠不大。工作單位的政策如：排班與休假方式、工作時數、調薪制度、舉辦在職教育、明確的職責說明、提供牙科相關的雜誌等對牙醫助理的工作壓力、工作滿意度與職業倦怠有顯著的影響。目前助理的工作內容多項與國外牙科衛生士相符，但國內法規尚未確立牙醫助理的工作範圍，這值得政府及牙醫界人士關注。

關鍵字

工作壓力 ； 牙醫助理 ； 工作滿意 ； 職業倦怠

並列摘要

Abstract
Background：There has been significant change in the oral health-care system in Taiwan, including Oral Health Act practice, the Department of Health of the Executive Yuan established a Committee on Dental Medicine, and the set-up of the dental hygiene schools. It’s reveal that the style of oral care is stepping in a form of dental teamwork. Therefore, informational databases of dental auxiliaries are needed to build up the related law and the educational system. In addition, there are no investigative studies that deal with work stress, job satisfaction and burnout among dental assistants. It is necessary to collect and analyze such data related to the work of dental assistants.
Study object：The purpose of this study is to investigate the distribution, work content, the extent of work stress, job satisfaction and burnout of assistants, and related factors in order to provide a reference and suggestions.
Methods：The survey was performed by mailing questionnaires to dental assistants in Kaohsiung, Pingtung and Penghu areas during Oct. 2003 to Feb. 2004. These dental assistants were contacted by phone prior to getting the survey.
Results：From all the subjects of the 890 dental offices, a total of 1778 questionnaires were distributed and 710 were returned. The response rate was 39.93%. There were 1.44 dental assistants in average worked for one dentist. There were fourteen percent dental offices in the survey that didn’t hire any assistants, and twenty-four percent only hired one assistant. A large amount of work included items such as：taking impressions, gingival retractions, application over ulcerations, wound dressing, removing sutures, temporary prosthesis fabrication, pit and fissure sealants, re-cementing crowns, applying fluoride, placing or removing rubber dams and orthodontic bands, taking X-rays, removing calculus, removing temporary restorations, and temporary fillings, which were also the duty of dental hygienists in other countries who were certified and trained under the law in their countries. The factors significantly associated with higher work stress by stepwise regression were the higher education, dental league jobs, the unclear and undefined work duties, taken in-service study, work-hours differentiation per week, the unavailability of dental related magazines, the association with part-time dentists, difference in age group, and full-time staff sector differentiation. The factors significantly associated with higher job satisfaction were the shorter period of study, salary differentiation, the on-job education, well defined and clear work duties, and the habit of reading dental related magazines. The factors significantly associated with higher burnout were unclear and undefined work duties, the unavailability of dental related magazines, younger age group, dental league jobs, salary differentiation, and more work-hours per week. The linear regression analysis showed that higher work stress leaded to higher levels of burnout and higher satisfaction leaded to lower levels of burnout.
Conclusion：The ratio of dentist to assistant in this study is lower than America, Canada and Japan. Work stress and job satisfaction among dental assistants are slightly above average, and the burnout is slightly below average. This study reveals that the administration of the dental department, including arrangement of working schedules, holidays and working hours, a regulated salary, the conduct of continued education, well defined and clear work duties, the availability of dental related magazines etc. can significantly affect work stress, job satisfaction and burnout of dental assistants. Currently, the duties of dental assistants in Taiwan are similar to the dental hygienists in other countries, but there are no rules or policy to confirm the duties of dental assistants. It’s important for our government and dentists to pay attention and more serious on it.

並列關鍵字

Work Stress ； Job Satisfaction ； Burnout ； Dental Assistants

參考文獻

參考文獻－中文

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