照顧服務員工作壓力及因應方式之研究

A Study on the Job Stress and the Coping Behaviors of the Health Care Aides

林鈺軒(Yu-Hsuang Lin)

指導教授 ： 朱僑麗

亞洲大學/健康學院/長期照護研究所/碩士(2005年)

摘要

長期照護機構為一個忙碌、辛苦且充滿挑戰的工作場所。而照顧服務員人員在長期照護機構中，更佔了照顧人力很大的一部份。照顧服務員除了需要面對其他專業照顧人員之外，還需要負擔住民家屬的情緒反應以及不同的需求，處於多種狀況下承擔了很多的壓力。
本研究目的為探討照顧服務員之工作壓力與因應行為。研究工具是以結構式問卷調查法進行調查，包括：個人屬性、工作壓力源、以及工作壓力因應方式等，使用SPSS for Windows version 10.0進行資料處理與分析。研究對象以中部地區的照顧服務員為研究對象。使用立意取樣的方式，徵求機構負責人同意後發放問卷，由研究者親訪機構進行問卷調查研究。研究機構包含：人力派遣中心2家、社會福利金基金會2家、醫院附設護理之家5家、私立護理之家1家、非營利組織機構1家，共發出477份問卷，取得有效樣本432份，總回收率為90.6％。
研究將個人屬性為自變項，工作壓力與因應行為為依變項，進行強制進入迴歸分析法（Enter Multiple Regression Analysis）。工作壓力迴歸調整後的R Square為22％。結果顯示照顧服務員為年紀較小者、需要輪值夜班者、工作時數為10小時者、常常會想離開工作者，以及在長期照護機構工作者，其整體工作壓力較大，而從不會想離開目前工作者，其工作壓力較小。在因應行為方面，以在居家照護（社區）工作者及有丙級執照的照顧服務員較常採用問題取向因應方式來解決工作壓力問題。而薪水四萬以上者、需要輪值夜班者、常常想離開目前工作者、在長期照護機構工作者，較常採用情緒取向的因應方式。，而從不會及很少會想離開目前工作者，也較不會採取情緒取向的反應。

建議：
（一）未來做照顧服務員教育訓練時，增加臨床實習時數及內容，加強臨床照護知識技術訓練，使照顧服務員進機構時不會感到技術缺乏。
（二）工作後，亦要增加在職教育時數及內容，包含臨床知識技術及壓力抒解訓練，使其情緒得以抒發。
（三）建立照顧服務員與督導者之溝通管道，瞭解其壓力來源，以適時降低工作壓力，提供住民更完善的照顧服務。
（四）增加照顧服務員薪資、工作津貼及員工福利，使其有基本保障。
（五）練習身心鬆弛運動與技巧，除了對身體壓力之舒緩有幫助之外，亦可以幫助個人控制不安的情緒。
（六）充分安排休閒時間與培養興趣，適時的安排休閒時間及培養興趣是維持身心健康重要的方法，對工作壓力的解除是有幫助的，進一步可以提高工作效率。

關鍵字

照顧服務員 ； 工作壓力 ； 工作壓力因應

並列摘要

Long-term caring organization is a busy, hard and full of challenge work field. In addition, health care aides occupy a very large portion of caring manpower in the long-term caring organization. Apart from facing other professional caring persons, health care aides are required to bear the emotional reaction and different requirements of the residents’ family. Health care aides have to bear a lot of pressure under various kinds of situations.
The purpose of the research is to explore the work pressure and responsive behavior of health care aides. The research tool is based on structural questionnaire research method to conduct investigation, including: personal attribute, work pressure and responsive method of work pressure etc. SPSS for Windows version 10.0 is utilized to conduct data processing and analysis. Research targets are based on health care aides in the central district. The purposive sampling method is utilized to issue questionnaire upon consent by the person in-charge of the organization. The researcher went to the organization to issue questionnaire to conduct investigation. These facilities, including 2 Human Resource Services, 2 social welfare foundations, 5 hospital-based nursing homes, 1 privately nursing home and 1 none-profit-organization. We has sent 477 copies of the questionnaire, of these, 432 were replied and effective, the response rate is 90.6％.
The independent variable is personal attributes and the dependent variables are work pressure and responsive behavior utilized to conduct enforced Enter Multiple Regression Analysis method. The Adjusted R square of work pressure regression is 22%. The result shows that when the health care aids’ age younger, rotational night shift, the work hours over10 hours, for person who often thinks of leaving the job, and for workers in long-term caring work, their overall work pressure is larger. For person who does not think of leaving the present job, his/her work pressure is less. In respective of responsive behavior, comparatively the live in caring (community) worker and caring service person with Class C license will often adopt question response method to solve work pressure. For person whose salary is more than forty thousand and rotational night shift is required and worker who often wishes to leave the present work and workers in the long-term caring organization, comparatively they will adopt emotional response method. Comparatively, for worker who rarely wishes to leave the present job will not adopt emotional response.

Suggestion:
1. In the future, when conducting educational training for health care aides, increase the clinical practice hours and the content. Enhance clinical caring knowledge technique training so that when health care aide enters the organization, he/she will no longer feel shortage of technique.
2. After work, it is necessary to increase the on-the-job education hours and content including clinical knowledge technique and pressure release training so that their emotion can be relieved.
3. Increase the health care aide’s salary, work subsidy and the employee welfare so that they can have basic guarantee.
4. Practice the body and mind relaxation exercise and technique. Besides providing help to relaxation of body pressure, it can also help individual to control discomforting mood.
5. Sufficiently arrange leisure time and cultivate interest. At appropriate time, arranging leisure time and cultivating interest is the important way to maintain healthy body and mind. It is helpful for eliminating work pressure thereby further enhancing work efficiency.

並列關鍵字

Health Care Aides ； Job Stress ； Coping Behaviors

參考文獻

吳淑瓊、張明正（民85），功能評估在估計臺灣社區老人長期照護需要之應用，中華公共衛生雜誌，15（6），533-545。

巫慧芳、蕭淑貞（民84），護理人員面對病患家屬時的工作壓力之探討，中華衛誌，14（5），417-423。

曾瑞譙（民93），私立高級中等學校校長工作壓力與其因應策略之研究，嘉義：國立嘉義大學國民教育研究所。

舒曼姝、王琪珍（民82），護理人員照顧癌症患者臨床工作壓力之探討，護理研究，1（4），351-358。

葉兆祺（民89），國民小學實習教師工作壓力與因應方式之研究，彰化師大教育學報，1，61-92。