醫師工作壓力及其相關因素研究

A Study on the Work Stress of Physicians Relevant Factors

黃鈺淵(YU-YUAN HUANG)

指導教授 ： 葉季森

中臺科技大學/管理學院/醫療暨健康產業管理系碩士班/碩士(2018年)

摘要

研究目的：醫師常處於高壓力的工作情境，是過勞的高危險族群，本研究參考Karasek「負荷-控制」模型，探討醫師的工作壓力現況及其相關因素，進而掌握醫師壓力高風險因子，提出改善方案與建議措施。
研究方法：以台中市執業醫師為研究對象，在相關醫學會會員活動中以便利抽樣法，尋訪自願者填答問卷，問卷內容含：社會人口學特質、職業屬性、健康狀況、工作過度投入量表、工作滿意度、工作負荷-控制量表。統計方法含描述性統計、獨立樣本t檢定、單因子變異數分析、卡方檢定、多元線性及邏輯迴歸分析。
研究結果:受訪醫師83.0%為男性，平均年齡42.03歲，40歲以下佔54%，73.0%已婚、18.0%有碩、博士學位，66.5%為主治醫師。三成(36.0%)常常或總是感到工作壓力大，近五成(44.0%)對工作感到滿意或很滿意，近四成(36.0%)自覺健康好或很好，64.0%身心狀況適應良好，36.0%有輕度以上之情緒困擾，2.5%有自殺意念，一成(10.3%)有高工作壓力，工作過度投入量表平均得分65.7(滿分100)。影響醫師工作壓力的重要因素為：心理情緒困擾、自覺健康及工作過度投入，三個變數可解釋醫師工作壓力28.1%的變異量(P<0.05)。
研究建議：醫師個人應及早察覺及接受壓力狀況，學習壓力調適及正向、幽默的因應技巧，需要時勇於尋求資源。另外，建構友善醫療環境，以提升醫療互信與醫病關係，醫療制度上建請相關單位持續推動醫療刑責合理化及醫療糾紛處理法，適切地將勞基法落實於醫師，以提升醫師身心健康，保障民眾醫療品質。

關鍵字

醫師 ； 工作壓力 ； 負荷-控制模式

並列摘要

Research Objective: Physicians often work under high-stress situations and are a high-risk group for over-fatigue. This study, with reference to Karasek’s “load-control model,” explores the work stress situations of physicians and the relevant factors, thereby gaining an insight into the high-risk factors that contribute to physicians’ stress and proposing improvement plans and recommendation measures.

Research method: Practitioners in Taichung City were adopted as the research participants. During the relevant medical association activities, convenient sampling was adopted to seek volunteers to fill out the questionnaire. The questionnaire contents include: socio-demographic characteristics, occupational attributes, health status, overly involved with work scale, work satisfaction and work load-control scale. The statistical methods include descriptive statistics, independent sampling t-test, one-way ANOVA, chi-square test and multiple linear and logistics regression analysis.

Research Results: 83% of the interviewed physicians were male, with the average age of 42.03 years old; the under 40 years old comprise 54%, 73.0% are married, 18.0% have a master’s/doctorate degree and 66.5% are attending physicians. About one third of the physicians (36.0%) often or always feel stressed at work, nearly 50% (44.0%) are satisfied or highly satisfied with their work, nearly 40% (36.0%) think they are in good health or perfect health, 64.0% are in good physical and mental conditions, 36.0% have slight to moderate emotional disturbance, 2.5% have suicidal tendencies and about one-tenth (10.3%) are under high work stress, with the average score of 65.7 (out of 100) in the overly involved with work scale group. The important factors affecting physicians’ work stress are: psychological and emotional disturbances, self-perceived health and over involvement with work. These three variables can explain 28.1% of the physicians’ work stress variance (P<0.05).
Research Recommendations: Physicians should detect and accept their stress statuses, learn stress adaption and positive and humorous response skills and have the courage to seek resources whenever needed. In addition, a friendly medical environment should be established to enhance medical mutual trust and patient-doctor relations. In terms of the medical system, the relevant units are urged to continue to promote the rationalization of medical criminal liability and medical dispute handling laws, thereby appropriately implementing the labor-related laws on physicians and continuing to improve the physicians’ physical and mental health and safeguarding people’s medical care quality.

並列關鍵字

Physicians ； Work stress ； load-control model

參考文獻

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