長期照護機構護理人員工作負荷與工作壓力關係之研究

A Study on the Relationship of Nurses’ Work Stress and Workload in Long Term Care Facilities

石善德(Shan-Te Shih)

指導教授 ： 陳芬如

義守大學/醫學院/醫務管理學系/碩士(2014年)

https://doi.org/10.6343/ISU.2014.00233

摘要

摘 要
研究目的
本研究依實證研究理念，以長期照顧機構護理人員工作負荷與工作壓力為主軸，擬定四個研究目的：（一）探討長期照顧機構護理人員工作負荷與工作壓力之之實際狀況；（二）探討長期照護機構不同屬性的護理人員其工作負荷之差異情形；（三）探討長期照護機構不同屬性的護理人員其工作壓力之差異情形；（四）探討長期照護機構護理人員工作負荷與工作壓力之相關性。
材料與方法
研究方法採用採橫斷式調查研究法，結構式問卷進行收集，使用「工作負荷問卷」及「護理人員壓力量表」作為研究工具，以立便利收集抽樣方式選擇高屏區養護機構、醫院附設護理之家及獨立護理之家，工作滿6個月以上護理人員為研究對象，共取得200 份有效問卷。問卷所得資料以SPSS 18.0版套裝軟體進行統計分析與驗證，統計方法包括描述性統計分析、T檢定、單因子變異數分析事後檢定薛費法、Pearson相關。
研究結果
研究結果發現：（一）整體工作負荷感受平均得分90.07，屬中等程度，以「一般工作負荷」傾向高負荷，其餘各面向「行政負荷」、「工作委派督導」、「溝通困難度」也皆屬中等程度以上的負荷；影響整體工作負荷源因素有機構性質、任職機構、任職機構規模床數與每月所得。（二）整體工作壓力平均得分為164.39，屬中等程度，以「個人反應部分」壓力感受最高，「工作專注部分」次之，而「工作勝任度」與「無法完成私人工作」較低；男性較女性整體工作壓力高；未婚者較已婚者高。（三）機構護理人員認為「照顧服務員教育訓練」與「照顧服務員工作資歷」不足，照顧服務員的教育訓練有待加強。（四）護理人員認為「照顧服務員教育訓練」、「照顧服務員工作資歷」與「整體工作負荷」、「行政負荷」、「工作委派督導」、「溝通困難度」等面向皆呈現正相關，護理人員認為照顧服務員教育訓練、工作資歷越少，各面向的工作負荷感受越高。（五）皮爾森積差相關分析結果工作負荷各面向與工作壓力各面向之間皆呈顯著正相關，即對工作負荷感受越大者之工作壓力情形越高。
建議
根據研究結果，提出以下建議：（一）機構提供團體資源與教育計畫，推動工作負荷與壓力改善機會。（二）加強護理人員、照顧服務員與之訓練與素質。（三）落實主管單位與負責人和單位管理者對於評鑑、管理等在職教育，建立雙向溝通管道，增加機構品質的適切性。

關鍵字

長期照護機構 ； 機構護理人員 ； 工作負荷 ； 工作壓力

並列摘要

Abstract
Purpose
There are four aims of this study. first, to investigate the actual state of workload and work stress of staff nurses in long term care facilities; second, to explore the difference of workload borne by different characteristics of staff nurses in long term care facilities; third, to explore the difference of work stress suffered by different characteristics of staff nurses in long term care facilities; fourth, to find the relationship between workload and work stress of staff nurses in long term care facilities.
Materials and Methods
A cross-sectional survey was conducted in this study and a structured questionnaire method was used to collect data. Questions in the questionnaire can be categorized into characteristics of person and occupation, workload, work stress, and the training and work experiences of the certified nursing assistant. The study object is the staff nurses employed in regional care facilities, hospital affiliated nursing homes, and private nursing homes in Kaohsiung-Pingtung area for at least 6 months. Convenience sampling was conducted to select interviewees. There are 200 valid questionnaires in total. Collected data were analyzed and verified with SPSS version 18.0. Statistical methods include descriptive statistics, t-test, one way ANOVA, the Scheffe's test, and Pearson correlation.
Results
The results show as follows. First, the average score for the overall feelings of workload is 90.07, which falls in the medium range. Staff nurses in private facilities have higher scores than those in public facilities in terms of the feelings toward the difficulties to communicate with care attendants. Also, staff nurses from care facilities and private nursing homes also have higher scores than those from affiliated facilities in terms of the feeling toward the communication difficulties. Second, the score of overall stress is 164.39, which falls in the medium range.The work stress is mainly from communicating with certified nursing assistants. Female, employees with lower education levels, and staff nurses who do not hold administrative positions tend to feel higher stress. In terms of facility characteristics, staff nurses employed in private facilities and care facilities feel higher pressure on interaction. Third, both "education and training of certified nursing assistants" and "work experiences of certified nursing assistants" are correlated to the overall workload, administrative workload, and difficulties on work assignment, monitoring, and communication. The less the education, training, and work experiences are, the heavier of the stress feelings of the interviewees are about their workload.
Recommendations
Following are proposed suggestions based on the results in this study. First, facilities could provide group resources and eduction plans, increasing opportunities to improve situations of workload and work stress of their staffs. Second, the training and quality of staff nurses and certified nursing assistants should be improved. Third, communication mechanism and training of both staff nurses and certified nursing assistants should be strengthened. Fourth, a work environment which could help healthy team communication should be built.

並列關鍵字

long term care facilities ； staff nurse ； workload ； work stress

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