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  • 學位論文

女性受暴護理人員人格特質、社會支持、心理韌力與憂鬱症狀之相關性

The Relationship among Personality, Social Support, Psychological Resilience and Depressive Symptoms in Abused Female Nurses

指導教授 : 王秀紅

摘要


研究背景:職場暴力已經成為全球各國關注的議題,醫療工作人員都是職場遭受暴力的高危險群,尤其是對專業的護理人員而言。因為任何形式的暴力對護理人員都會造成身體或心理的傷害。因此,護理界專家、醫院管理者以及社會大眾都應該關注此議題。經由了解影響女性受暴護理人員的心理健康因素,不僅可維護女性護理人員的心理健康,也可促進醫療照護機構營造友善的工作環境,進而提升護理人員的職場留任率。 研究目的:本研究主要以心理韌力理論(resilience theory)為基礎,(1)探討女性受暴護理人員的受暴型態、人格特質、社會支持、心理韌力與憂鬱症狀的現況;(2)檢視女性受暴護理人員人格特質、社會支持、心理韌力以及憂鬱症狀之相關性;(3)分析女性受暴護理人員之中介效果;(4)建構女性受暴護理人員人格特質、社會支持、心理韌力與憂鬱症狀的結構方程模型(Structural Equation Model, SEM)。 研究方法:本研究採橫斷式相關性研究法,以結構式問卷收集資料。研究對象採台灣北部、中部以及南部共11家醫院之急診或精神科病房護理人員為研究對象。收案條件為一年內曾遭受過語言或肢體暴力之急診室或精神科護理人員。本研究資料除以SPSS19版統計軟體進行描述性及推論性統計分析外,並以AMOS 19.0版軟體進行結構方程模型之假設模式驗證。 研究結果:研究結果顯示,有75% (n= 488)研究對象在過去一年內曾經遭受語言或肢體暴力。在相關性分析方面,憂鬱症狀與神經質人格特質(r= 0.450, p<0.01)呈現正相關、與外向性人格特質(r= -0.207, p<0.01)、社會支持(r= -0.144, p<0.01)以及心理韌力(r= -0.394, p<0.01)皆呈現負相關。經由SEM驗證顯示,心理韌力在受暴型態與憂鬱症狀之間具有完全中介效果。心理韌力在神經質人格特質與憂鬱症狀之間具有部份中介效果。最後,驗證女性受暴護理人員憂鬱症狀因果模式顯示,神經質人格對心理韌力(β=-0.17, p=0.002)與憂鬱症狀(β=0.31, p<0.001)達顯著、心理韌力對憂鬱症狀(β=-0.38, p<0.001)達顯著。 研究討論:神經質人格特質於本研究中是影響憂鬱症狀的主要危險因子;相對的,心理韌力對受暴護理人員是一項重要的保護因子,可以調節其個人對外在環境與壓力之因應,避免受到憂鬱症狀的困擾;因此,醫院管理者應該針對這群神經質人格特質傾向較高者提早給予介入措施,以及提供加強個人心理韌力的方法,以避免或是降低憂鬱症狀的產生。

並列摘要


Background: Workplace violence (WPV) is now a serious and global issue indisputably, and all healthcare providers, especially nurses, are particularly at high risk of WPV worldwide. All forms of violence can lead to physical and mental injuries, and attention to this issue should be paid by nursing professionals, hospital managers and all of the public. We can maintain abused nurses’ mental health with retaining their job by understanding associated factors and setting up a safe and friendly working environment. Purpose: This study is based on the theory of resilience and the purpose of this study is to (a) explore the types of the violence, personality traits, social support, resilience and depressive symptoms in abused nurses; (b) examine the association among personality traits, social support, resilience and depressive symptoms; (c) analyze the mediating effects and (d) construct a structural equation model (SEM) of personality traits, social support, resilience and depressive symptoms in abused nurses. Methods: Using a cross-sectional correlational study with convenience sampling, abused nurses will be recruited from 11 hospitals distributed over northern, central and southern Taiwan. Inclusion criteria for the participants are nurses who (1) have worked for at least three months in the emergency room or psychiatric ward, and (2) have been abused at workplace in the past 12 months. Data were analyzed using SPSS 19.0 for descriptive and inferential statistical analyses. Structural equation modeling was employed by using AMOS 19.0 for verifying the relational impact model and hypothesis. Results: Results showed that 75% (n= 488) of the participants suffered from verbal or physical workplace violence in the past one year. Analysis of correlation revealed that depressive symptoms was positively associated with neuroticism (r= 0.450, p<0.01), but negatively associated with extraversion (r= -0.207, p<0.01), social support (r= -0.144, p<0.01) and resilience (r= -0.394, p<0.01). SEM demonstrated that resilience has complete mediating effect between types of violence and depressive symptoms and resilience has partial mediating effect between neuroticism and depressive symptoms. Finally, the verification of depressive symptoms causal model showed neuroticism has significant effect on resilience (β=-0.17, p=0.002) and depressive symptoms (β=0.31, p<0.001) and resilience has significant effect on depressive symptoms (β=-0.38, p<0.001). Discussion: Neuroticism is the major risk factor for developing depressive symptoms among abused nurses in this study, whereas resilience is an essentially protective factor which regulates and enhances their ability to cope with stress. Thus, the healthcare managers should provide nurses with neuroticism preventive intervention on ways to enhance personal resilience and prevent the development of depressive symptoms when workplace violence occurs.

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