結核病個案管理師工作壓力探討

Exploring Job Stress on TB case manager

林慧卿(Hui-Chin Lin)

指導教授 ： 秦兆瑋

長榮大學/健康科學學院/醫務管理學系(所)/碩士(2016年)

摘要

結核病一直是影響我國民健康的傳染病之一，結核病防治成為當前傳染病防治中一個非常重要的議題，結核病個案管理師透過個案管理方式，除了協助病人完成治療，期間也必須時刻評估加以整合運用醫療資源以期作最有效之利用。是故，本研究以結核病個案管理師作為研究對象，因探討其職務工作特性對情緒勞務及工作壓力相關影響。
本研究為橫斷式研究，採問卷調查法，選擇地區醫院層級以上共233家醫療機構(地區143家、區域69家、醫學中心21家)之結核病個案管理師進行問卷調查。利用便利抽樣法發出260份問卷，回收162份，刪除填答不完整之問卷5份，共計有效問卷為157份，有效回收率為60%。資料整理後，除描述性統計結果外，採用結構方程模式進行分析。
研究發現，結核病個案管理師工作特性程度愈高者，愈能減輕其工作壓力。結核病個案管理師雖為高情緒勞務者，但可經由表層情緒控制降低其工作壓力。結核病個案管理師工作特性會透過表層情緒控制負向影響工作壓力。
研究建議：針對研究發現建議結核病個案管理師充實專業知識與技能，訂定目標及個人情緒管理控制；對醫院端建議增進員工對組織認同感及關心員工情緒變化，適時輔導；對衛生主管機關則建議積極整合各級醫療院所之資訊管理、加強公共衛生單位教育訓練以及發展更完善之個案管理制度。

關鍵字

個案管理師 ； 工作特性 ； 情緒勞務 ； 工作壓力

並列摘要

Tuberculosis(TB) is one of infectious diseases which has long been a huge impair to our folk people and this disease has become a very important issue among the prevention of many contagious diseases. Tuberculosis Case Manager uses case management in addition to helping patients recover from the illness, needs to be evaluated on a regular basis during the course of treatment. With the assessment and available medical resource, the TB managers hope they can make the most effective use for TB patients. For this reason, TB case managers play a very important role in TB treatment. Therefore, this research subjects is TB case managers. To explore their job characteristic affect the emotional labor and job stress in this research.
The research conducted a cross-sectional study in the form of questionnaire survey. Our sample subjects are mainly included some TB Case managers from Taiwan’s area hospitals,district-level hospitals and above,233 in total(area143,regional 169,medical center21).We use convenience sampling sent out 260 questionnaires and took back 157 valid copies,plus 5 uncompledted ones. The effective response rate is 60 percent. After data compilstion, this research adpted the SEM(structural equation modeling) as a statistic method.
Signficant results were as followed：TB case managers have more job characteristics, they can alleviate more pressure. TB case managers are a group of high emotional labor worker, we can reduce the job stress surface by via emotional control. Through surface acting , TB case managers’ job Characteristic will negatively affect their job stress.
This research finds that TB case managers enrich professional knowledge and skills, set goals and personal emotional control. The research suggested the hospital end promotes the staff organizational commitment, care about the staff mood change, and give the right moment counsels. To the health controlling organization suggested information Integration, the enhancement public health unit education and training the positive conformity all levels of healing institute as well as develops the more perfect case control system.

並列關鍵字

Case Manager ； Job Characteristics ； Emotional Labor ； Job Stress

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