不同部門護理人員工作壓力之生理指標研究

A Study on Biomarkers for Nurses’ Job Strain

陳姿伶(Tzu-Ling Chen)

指導教授 ： 陳振和

長榮大學/健康科學學院/職業安全與衛生研究所/碩士(2009年)

https://doi.org/10.6833/CJCU.2009.00160

摘要

過去的研究發現，工作壓力不僅能導致生理、心理及生活行為症狀，並造成疾病，甚而可能產生職業上的傷害。護理被認為是具壓力性的工作，病人護理、工作環境、工作時間不足、角色衝突、角色認同、行政管理面、人際關係與專業知識技巧不足等都是護理人員的工作壓力源。從事護理工作的人員需要面對上述種種的壓力，也相對有一些心理健康的效應如挫折，憂鬱，疲乏工作滿意度下降甚至離職等。亦有研究發現在不同工作部門的護理人員承受的壓力不同。本研究的目的是以問卷調查及量測生物參數的方式，比較中部某醫學中心各科部門的護理人員工作壓力的相關性。本研究採問卷調查及生物參數檢測方式，以中部某醫學中心中各部門之護理人員做為比較。問卷第一部份將採用工作量表；第二部分為工作壓力量表。本研究亦同時收集受試者的唾液，以量測唾液中的醣皮素，免疫球蛋白A以及??-澱粉?﹞壯t量，作為壓力之生理指標。量測後，我們分析工作壓力量表所得之壓力指數與實際量測之生理參數之相關性。結果發現:在急診加護病房的護理人員比一般病房的護理人員在工作壓力量表的分數有增高的趨勢。在次量表方面，急診加護病房的護理人員在組織結構、缺乏資源、及與其他專業人員的衝突上的分數顯著高於一般病房的護理人員，但是在工作負荷上的分數則是顯著低於一般病房的護理人員。在唾液中的生理指標上，急診加護病房的護理人員唾液中的醣皮素，免疫球蛋白A以及??-澱粉?﹞壯t量與一般病房的護理人員唾液中的醣皮素，免疫球蛋白A以及??-澱粉?”繭L顯著差異。同時，壓力量表與次量表對唾液中的醣皮素，免疫球蛋白A以及??-澱粉?﹞壯t量亦無相關性。此結果的可能原因是由於急診加護病房的護理人員其工作年資較長及婚姻狀況不同，而降低了工作壓力，使得急診加護病房的護理人員在工作上所受到的壓力可能會較小，進影響了壓力量表的分數甚至生理參數。

關鍵字

護理人員、工作壓力、生理指標、醣皮素、免疫球蛋白A、a-澱粉?

並列摘要

Previous studies have found that work stress can not only lead to physical, psychological and behavioral symptoms of life, but also causes disease, and even lead to occupational injury. Nursing was considered as a highly stressed work. It has been shown that working environment, insufficient working hours, role conflict, the role approval, the administration surface, interpersonal skills and insufficient of specialized knowledge are potential pressure sources for nurses. Nursing staff not only have to face the pressure listed above, but also have problems of the mental health effects such as frustration, depression, fatigue and even decline in job satisfaction. Research has also found that nursing staffs encounter different pressure in different departments. The purpose of this study is to assess the relationship of worker’s pressure in nursing staffs from different departments of a medical center in Central Taiwan, based on questionnaire survey and measurement of biological parameters survey. The first questionnaire of the survey is working scale; the second part of the survey is the Working Stress Scale. The saliva from subjects of this study were collected and measured the concentration of cortisol, immunoglobulin A as well as ??-amylase. On professional stress scale (PSS), emergency department (ED) nurses had higher scores than those in general department (GD) nurses. The scores of PSS subscales, such as organizational structure and processes, lack of resources, and conflict with other professionals were higher in ED nurses than in GD nurses. However, the score of work load was higher in GD nurses than ED ones. The secretion of salivary cortisol, ??-amylase and immunoglobulin A in ED nurses had no significant difference from GD nurses. There is no correlation on PSS/PSS subscales and log cortisol, for ??-amylase and immunoglobulin A. The possible reasons were that ED nurses who had longer working experience and more more than 1/3 of the ED nurses were married. It has been shown that longer working experience and married status would reduce the working stress, which in turns change the score of PSS and eventually change the biological markers of stress such as cortisol, ??-amylase and IgA.

並列關鍵字

nurses, work stress, biomarkers, cortisol, immunoglobulin A, a-amylase

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