緊急救護技術員工作壓力、社會支持與專業承諾關係之研究－以臺北市專責救護隊為例

A Study of the Relationships among the Emergency Medical Technicians’ Job Stress, Social Support and Professional Commitment in Designated Ambulance Crews of Taipei City

林威(Wei Lin)

指導教授 ： 高美英

臺北醫學大學/醫學院/醫學人文研究所/碩士(2009年)

https://doi.org/10.6831/TMU.2009.00008

摘要

緊急醫療救護系統，包括到院前緊急救護及到院後緊急醫療，提供民眾平日及災害時，緊急傷病完整之緊急醫療救護服務，到院前緊急醫療救護對於整個醫療體系而言，就等同於醫院急診的院外延伸。緊急救護技術員是受過專業急救訓練，在遇有緊急傷病患或大量傷病患之事故時，於現場對傷病患施予急救，快速將傷病患運送至醫院，使其能儘早接受妥善醫療照護，並於運送途中、傷病患到院前，持續給予必要救護處置之專業技術人員，可說是到院前緊急醫療救護的執行者。救護技術員已成為到院前緊急救護的專業象徵，關注救護技術員的工作壓力、社會支持及專業承諾，並釐清其間之影響關係，將有助於瞭解救護技術員對緊急救護之專業承諾，使緊急醫療救護系統之水準更能提升。

　　本研究假設救護技術員個人屬性、工作壓力、社會支持及專業承諾呈顯著相關，且不同個人屬性之救護技術員在工作壓力、社會支持及專業承諾上呈顯著差異，不同工作壓力型態之救護技術員在專業承諾亦有顯著差異。研究假設之理論模型為救護技術員個人屬性變項會影響救護技術員社會支持，而個人屬性變項及社會支持會影響救護技術員工作壓力，最後個人屬性變項、社會支持及工作壓力皆為影響救護技術員專業承諾之因素。本研究採用問卷調查法，研究工具包含「工作壓力」、「社會支持」及「專業承諾」之結構式問卷，以台北市消防局所有在各消防分隊專門擔負緊急救護勤務之「金鳳凰專責救護隊」隊員為研究對象，有效問卷回收數目共353份，有效問卷回收率94.1%。

　　研究結果顯示，救護技術員之工作型態為較低之工作控制及中等偏高之工作心理負荷量，社會支持呈中高程度，專業承諾則呈中等程度。救護技術員之緊急救護工作年資愈長，生活中得到之社會支持愈高；生活或工作社會支持愈高，則工作控制愈高，工作心理負荷量愈低，對於專業承諾之確定性也就愈高。不同的緊急救護教育程度或工作單位，在工作控制及專業承諾上有顯著差異，高級救護技術員之工作控制及專業承諾皆明顯高於中級救護技術員。如同研究架構，緊急救護工作年資與緊急救護教育程度或工作單位會影響救護技術員在生活中或工作上所感受到之社會支持；緊急救護教育程度或工作單位及社會支持對工作壓力（工作控制、工作心理負荷量）有顯著影響力；而緊急救護教育程度或工作單位、社會支持、工作壓力皆是影響救護技術員專業承諾之重要因素。

關鍵字

緊急救護技術員 ； 工作壓力 ； 社會支持 ； 專業承諾

並列摘要

Emergency Medical Services System (EMSS), including pre-hospital emergency medical services and in-hospital emergency medical care, offers people Emergency Medical Services (EMS) in daily lives or disasters. For the medical system, pre-hospital emergency medical services extend the emergency room to out of the hospital. Emergency Medical Technician (EMT), the performer of pre-hospital emergency medical services and trained by professional emergency medical courses, can offer emergency medical treatments to emergency patients and take them to hospitals for more medical care when accidents happened. EMT now is the professional symbol of pre-hospital emergency medical services. Concerning about their job stress, social support and professional commitment and confirming the relationships among them could help us understand EMT more and improve the quality of the EMSS.

The purpose of this study was to explore the relationships among the Emergency Medical Technicians’ job stress, social support and professional commitment. This study employed the structured questionnaire to collect the related data. Finally, total 353 Emergency Medical Technicians of Designated Ambulance Crews in Taipei City completed and returned the questionnaires, and the response rate was 94.1%.

The result of this study indicated that the major work type of EMT was lower job control and higher psychological demands. The social support of EMT was at the middle-high level, and the professional commitment was at the moderate level. EMT with more working experiences perceived higher social support, and the higher social support related to the higher job control, lower psychological demands and higher professional commitment. There were significant differences on job control and professional commitment across different emergency medical education levels (equal to the working units in this study). EMT-P (Paramedic) had higher job control and professional commitment than EMT-II. As the study proposed, working experiences and emergency medical education levels of EMT were both important factors to influence the social support. Emergency medical education levels and social support of EMT also significantly influence the job stress (including job control and psychological demands). In Summary, the emergency medical education levels, social support, and job stress all had strongly impact on the factors significantly influence the professional commitment.

並列關鍵字

Emergency Medical Technician ； job stress ； social support ； professional commitment

參考文獻

49.曾瀞瑤，（2004），醫學中心護理人員工作壓力與身心健康之相關探討。國立台灣大學醫療機構管理研究所碩士論文。

13.巫慧芳、蕭淑貞，（1995），護理人員面對病患家屬時的工作壓力與因應方式之探討。中華公共衛生雜誌，14(5)：417-425。

24.林碧莉、何美瑤、曾麗琦、呂桂雲，（2005），衛生所護理人員工作壓力與專業承諾之研究。實證護理，1(2)：132-139。

28.施嫈瑜、李明濱、李世代、郭聖達，（2004），壓力與健康：生理病理反應。北市醫學雜誌，1(1)：17-24。

39.陳石池、林芳郁，（2000），創傷急診醫學。台灣醫學，4(2)：143-149。