護理人員的職場暴力事件與情緒商數、個人特性及工作環境因子探討—以軍醫院護理人員為例

Exploring the correlation of work violence and emotional quotient, personal characteristics, environment factors of nurses in army hospitals

黃素慧(Su-Hui Huang)

指導教授 ： 李素幸

長榮大學/健康科學學院/職業安全與衛生研究所/碩士(2009年)

摘要

本研究目的在了解軍醫院護理人員遭遇職場暴力情形之現況，並進一步探討個人情緒商數、個人特性、工作環境因子等因素對護理人員遭遇職場暴力之影響。本橫斷研究以結構式問卷進行資料收集，內容包括人口學特徵、暴力事件、暴力事件的來源、班別、地點、工作單位及受傷部位、情緒商數、工作負荷及個人觀感等因素。樣本之選取採立意取樣方式，以軍方所屬區域教學醫院之護理人員作調查。本研究共發出問卷541 份，回收有效問卷502份，有效問卷回收率93 %，所得資料以SPSS 15.0 for Windows 統計軟體為分析工具。研究結果顯示如下：
一、護理人員遭遇職場暴力情形以言語暴力佔最多44.22%，肢體暴力次之佔21.91%、性騷擾最少佔7.57%，在這三種職場暴力的對象來源中皆以病患佔最多45.91~86.36%；這三種職場暴力的工作單位以精神科佔最多24.43~37.84%。
二、多因子逐步邏輯迴歸分析顯示，工作單位、身分、工作負荷及情緒商數與肢體暴力事件有重要相關，相較於病房護理人員，精神科護理人員遭受肢體暴力傷害之OR為14.46（95%CI＝6.69 - 31.26），門急診護理人員之OR為3.86（95％CI＝1.78 - 8.38)；相對於一般聘僱人員，軍職身份之OR為2.33（95％CI＝1.14 - 4.75）；相對於工作負荷低者，工作負荷高者之OR為5.79（95％CI＝2.80 - 11.96)；相對於情緒商數低者，情緒商數高者OR為2.06（95％CI＝1.13 - 3.75)。
三、多因子逐步邏輯迴歸分析顯示，工作單位、工作負荷、個人情緒感受及上過言語攻擊在職教育與言語暴力事件有重要相關，相對於病房護理人員，精神科護理人員遭受言語暴力之OR為6.73（95％CI＝3.18 - 14.23），門急診護理人員之OR為3.34（95％CI＝1.72 - 6.48）；相對於工作負荷低者，工作負荷高之OR為4.28（95％CI＝2.34 - 7.81）；認為在護理工作中暴力事件是無法避免的人員OR為3.35（95％CI＝1.80 - 6.25）；上過言語攻擊在職教育者OR為2.07（95％CI＝1.31 - 3.28）。
四、多因子逐步邏輯迴歸分析顯示，工作單位及個人情緒感受與遭受性騷擾事件有重要相關。相對於病房護理人員，精神科護理人員遭受性騷擾的OR為8.19（95％CI＝3.09 - 21.74），門急診護理人員之OR為3.44（1.22 - 9.68），認為在護理工作中暴力事件是無法避免的人員OR為4.61（95％CI＝2.01 – 10.57）。
本調查發現在護理工作環境中，言語暴力、肢體暴力和性騷擾都普遍存在著，醫院管理階層和職業安全衛生主管機關勞委會均應正視此問題，加強精神科及門急診的暴力防範，減低護理人員的工作負荷及增加護理人員的情緒商數訓練。

關鍵字

職場暴力、性騷擾、工作負荷、情緒商數

並列摘要

The aim of this study was to study occurrence of workplace violence among nurses in army hospitals, and to further explore the association of emotional quotient, personal characteristics, working environments and workplace violence. This cross-sectional study used a structured questionnaire to collect information, including demographics, events of violence, sources, shift and location of the events, body parts of the injury, emotional quotient, workload, and perception of violence at work. Study nurses were selected purposively from the regional army hospitals. Five hundred and two nurses returned the questionnaires (93% response rate). Data was analyzed with statistical software SPSS 15.0. The study results showed that:
1. Verbal abuse was the most common type of violence occurred among army hospital nurses (44.22%), followed by physical assaults (21.91%), and sexual harassment (7.57%). For the events, primary source was patient, consisted of 46% - 86%. Psychiatry ward was the most often found work unit, ranged from 24 to 38% of the events.
2. Statistical analysis based on stepwise Logistic Regression revealed that work unit, type of work contract, workload and emotional quotient were importantly associated with physical assaults. Compared to ward nurses, psychiatry nurses and nurses at OPD/Emergency department had higher risk of physical assault (OR=14.46, 95%CI=6.69-31.26 and OR=3.86, 95%CI=1.78-8.38, respectively). Relative to contract nurses, military nurses had higher physical assault risk (OR=2.33, 95%CI=2.80-11.96). Nurses with higher workload and lower emotional quotient were at higher risk of physical assault (OR=5.79, 95%CI=1.14-4.75 and 2.06, 95%CI=1.13-3.75, respectively).
3. Verbal abuse was significantly associated with work unit, workload, perception of violence at work, and ever received verbal abuse training. Compared to ward nurses, psychiatry nurses and nurses at OPD/Emergency department had higher risk of verbal assault (OR=6.73, 95%CI=3.18-14.23 and OR=3.34, 95%CI=1.72-6.48, respectively). Nurses having higher workload or received training for verbal abuse had higher risk of verbal abuse (OR=4.28, 95%CI=2.34-7.81 and 2.07, 95%CI=1.31-3.28, respectively). Nurses who regarded violence at work to be inevitable were at higher risk of verbal abuse (OR=3.35, 95%CI=1.80-6.25).
4. Work unit and perception of violence at work were importantly associated with sexual harassment. Compared to ward nurses, psychiatry nurses and nurses at OPD/Emergency department had higher risk of sexual harassment (OR=8.19, 95%CI=3.09-21.74 and OR=3.44, 95%CI=1.22-9.68, respectively). Nurses who regarded violence at work to be inevitable were at higher risk of sexual harassment (OR=4.61, 95%CI=2.01-10.57).
Violence including Verbal abuse, physical assault and sexual harassment was common in nursing working environment. Hospital managers and officials from Council of Labor Affairs should regard this issue seriously. They should reinforce violent prevention strategies in psychiatry and OPD/Emergency department, reduce workload for nursing staffs, and enhance nurses’ training in emotional quotient.

並列關鍵字

workplace violence, sexual harassment, Emotional Quotient, working load

參考文獻

王麗容（2001）。大專院校性騷擾防治工作手冊（教育部委託辦理）。台北市：台灣大學社會工作學系暨研究所。

方逸芸（1999）．電視暴力對兒童的影響．生活科技教育，32（5），13-18。

林秀美、陳陹堃、莊世杰（2006）．護理人員在職場遭遇性騷擾之研究．中華職業醫學雜誌，13（1），21-28。

吳淑容、王秀紅（2005）．護理人員情緒勞務及其相關因素探討．實證護理，1（4），243-252。

周文祥（1997）．運動與情緒管理．一般論述，31，120-125。