臨床研究護理師僱用模式與健康之相關

Associations between Employment Conditions and Health Status among Clinical Research Nurses

楊家旋(Chia-Hsuan Yang)

指導教授 ： 鄭雅文

共同指導教授 ： 胡文郁(Wen-Yu Hu)

國立臺灣大學/公共衛生學院/公共衛生碩士學位學程/碩士(2016年)

https://doi.org/10.6342/NTU201610117

摘要

一、 研究動機與目的：
在臨床研究蓬勃發展的趨勢下，越來越多護理師投入臨床研究的領域，目前臨床研究護理師的聘僱模式多數屬於「不安定僱用」。過去許多研究顯示不安定僱用對工作者的健康有負面的影響。因此本研究欲探討目的為：(1)了解台灣研究護理師的僱用型態類型；(2)了解台灣研究護理師身心健康情形；(3)探討研究護理師僱用型態與身心健康之相關；(4)與台灣整體受僱者及醫療保健服務業受僱者相較，以瞭解臨床研究護理師僱用型態與身心健康之差異程度。
二、 研究方法：
本研究為橫斷性研究，以自填式匿名問卷進行調查。結構式問卷內容包括僱用模式、職場工作特質、身心健康情形。本研究將僱用模式分為「安定僱用」與「不安定僱用」，工作契約為「長期僱用」定義為「安定僱用」，工作契約為「約聘僱」及「短期或臨時性契約」定義為「不安定僱用」。問卷並包含開放性題目收集質性資料，以了解其他可能影響職場身心健康的因素。
研究對象為現任臨床研究護理師或從事臨床研究之護理師。調查期間為104年8月26日至104年12月10日之間，由研究者至「台灣護理師臨床研究學會」所舉辦的研討會會場中進行招募與發放問卷，總共回收80份有效問卷。
三、 結果：
研究對象均為女性，年齡以30~39歲、年資5年以下、學士學位居多，73.8%由醫療機構直接聘僱，但有81.3%屬不安定僱用。
不同僱用模式之臨床研究護理師在自評健康以及身體痠痛情形方面並無顯著差異。與全國「工作環境安全衛生狀況認知調查」之女性醫療保健服務業受僱者比較，則發現臨床研究護理師之不安定僱用模式顯著偏高，且臨床研究護理師在自評健康及身體痠痛情形均顯著較全國女性醫療保健服務業受僱者差。統計分析顯示，以下職場特質與臨床研究護理師的職場身心健康有顯著相關：續聘及制度的不確定性、工作量大且雜、心理壓力大、需在試驗場所奔走、主管支持程度低、需長時間集中注意力。
四、 結論：
臨床研究護理師普遍屬不安定僱用工作者，而聘僱制度不確定性及工作量繁雜等因素，可能是臨床研究護理師職場身心健康問題的重要因素。本研究建議臨床研究之主管機關與聘僱單位應重視臨床研究護理師之聘僱模式與職場身心健康。具體建議方面，建議實習單位以實境練習強化教育培訓、對資深臨床研究護理師提供進階培訓、舉辦經驗分享工作坊、推動專業證照與進階制度。本研究並建議聘僱機構應明確定位臨床研究護理師工作範疇、規劃薪資結構與福利制度，並應將長期僱用工作者納為編制內人員。

關鍵字

臨床研究護理師 ； 不安定僱用 ； 僱用模式 ； 職場健康

並列摘要

Objectives:
A growing number of nurses have been involved in clinical trials along with the rapid growth of clinical research. Most of the clinical research nurses are precarious employees, whom might have greater health risks due to job insecurity and poor occupational safety and health protection. However, their work and health status has rarely been investigated. This study was designed to examine the employment conditions, health status and their associations among clinical research nurses in Taiwan. In addition, this study was designed to compare the employment conditions and health status between clinical research nurses and other employees.
Methods:
A cross-sectional survey was conducted anonymously using a questionnaire with closed-ended and open-ended questions. Study subjects were recruited at several workshop meetings organized by the Taiwan Academy of Clinical Research Nurses during the period from 26 August to 10 December 2015, in which clinical research were invited to participate in this survey on a voluntary basis. A total of 80 participants answered and completed questionnaires. The employment modes were classification as “precarious employment” and “permanent employment” in this study, “contract-based employment” and “short-term or seasonal employment” was defined as “precarious employment”; “long-term employment” was defined as “permanent employment”.
Results:
All of the study participants were women; most of them were in the age range of 30-39 years and were university-educated, and had been practicing in clinical research less than 5 years. Most of the study subjects (73.8%) were employed by the hospitals but a majority of them (81.3%) were employed on a short-term contract basis.
There was no significant difference in self-rated health and bodily pain in clinical research nurses across different employment modes. However, there were significant high percentage in precarious employment, poor self-rated health, and bodily pain between clinical research nurses in study and the “Survey of Perceptions of Safety and Health in the Work Environment in 2013 Taiwan”. Major factors that affected heath status of clinical research nurses included: precarious employment, workloads, stress, need to run around in hospital, fewer social support from supervisors and work requiring concentration for long time.
Conclusion:
Usually, clinical research nurses were employed on a short-term contract basis. Major occupational health concerns are burnout and bodily pain and their risk factors included precarious employment and heavy workloads.
The author suggested the TACRN to provide relevant training programs for junior clinical research nurses, to provide advance trainings for senior clinical research nurses, to organize workshops for experience sharing, and to set up guidelines for professional accreditation. The author also suggested that employing institutions to clearly define the scope of work of clinical research nurses, to guarantee appropriate salary and welfare provision, and to minimize precarious employment by adopting clinical research nurses as regular employees.

並列關鍵字

Clinical research nurse ； Precarious employment ； Employment condition ； Employee health status in workplace

參考文獻

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