加護病房專責與非專責醫師制度下工作滿意度與工作績效之探討

A Study on Job Satisfaction and Job Performance for Intensivists and Non-intensivists in ICUs

黃玉娟(Yu-Chuan Huang)

指導教授 ： 陳金淵

長榮大學/健康科學學院/醫務管理學系(所)/碩士(2011年)

https://doi.org/10.6833/CJCU.2011.00065

摘要

目的 隨著人口老化及疾病嚴重度增加，加護病房之需求日益增加。加護病房醫療團隊成員中，主要以醫師為首，主導整個醫療服務之規劃及執行。國內、外在逐漸推動加護病房專責醫師制度後，有許多照護品質、資源運用與效率、病人病情的改善研究。不過，到目前為止國內有關專責醫師制度實行後醫師工作滿意度及工作績效上之相關研究，仍付之闕如。
方法 本研究以重症醫學會99年版會員名冊所列服務於加護病房之醫師207人為研究對象。利用重症醫學會年會教育訓練課程活動期間及事後至醫院進行問卷調查，共計發放194份問卷，回收有效問卷173份（回收率89.2％）。問卷內容除個人基本屬性外，還包括工作滿意度以及工作績效量表。建檔資料利用SPSS 18.0進行描述統計與研究假說檢定，並利用複迴歸模式探討工作績效之相關預測因子。
結果 專責與非專責醫師在年齡、醫院類別、職稱、臨床醫療服務年資、薪資、兼具教職等方面有明顯差別（α＝0.05）。受訪醫師之工作滿意度與工作績效得分，經過標準化後分別為64.86與75.7，進一步以專責與否區分比較，發現專責醫師在工作滿意度得分較高，非專責醫師則在工作績效得分較高，但均未達統計上顯著性差異。相關性分析則呈現，專責醫師的工作滿意度與工作績效間具有相關性（r＝0.33,p＜0.01）。透過複迴歸分析得知，工作滿意度對工作績效之預測力貢獻度達顯著（p＝0.015）。
結論 個人基本屬性對於工作滿意度並沒有顯著差別。在工作績效部分，專責醫師於職稱、醫院類別、臨床服務年資與教職身分具有顯著差異，其中具備管理階級職位、豐富的臨床服務工作經歷，除了能夠在份內工作範圍表現熟練之外，還能處理跨部門之溝通與合作協調等事務。
建議 請衛生署考慮及早規劃重症專科，藉以規範重症醫師相關適用條件，並透過專科醫學會之管理，了解全國重症醫師之人力狀態、執行教育訓練活動，進而促進專業認同及歸屬感。

關鍵字

專責醫師 ； 工作滿意度 ； 工作績效

並列摘要

Objectives With the aging of the population and the increasing severity of the disease, the need for intensive care units (ICUs) is getting higher and higher. Physicians are the core members of the ICU team, and they manage the planning and practice of the medical service from the beginning to the end. There exist many researches focusing on care quality, resource use and efficiency, and the recovery of patients’ illness about the ICU intensivist care model. However, so far there’s still little in literature about the physician’s job satisfaction and job performance. Therefore, the main purpose of this study was to examine the job satisfaction and job performance among intensivists and non-intensivists. Another aim was to explore the predicting factors related to job performance.
Methods Two hundred and seven ICU physicians, who enrolled in the Taiwan Society of Critical Care Medicine in 2010, were analyzed in this study. Out of the 194 questionnaires collected, 173 were retained for further analysis with a valid response rate of 89.2%. The questionnaire includes respondents’ demographic characteristics and survey instruments of job satisfaction and job performance. Data were analyzed by using the statistical software package SPSS 18.0 for descriptive statistics and hypotheses testing. Multiple regression models were established for the prediction of job performance.
Results There is significant difference (α=0.05) between intensivists and non-intensivists in age, hospital category, title, service seniority, salary, and part-time teaching career. The standardized scores of job satisfaction score and job performance were 64.86 and 75.7, respectively. The intensivists had higher job satisfaction and the non-intensivists demonstrated higher job performance, but the difference was not significant. For the intensivists, there is a significant relationship (r=0.33, p<0.01) between job satisfaction and job performance. The regression modeling revealed that job satisfaction is a significant predictor of job performance (p = 0.015).
Suggestion It is recommended that the Department of Health consider and plan ahead the critical care system to set suitable conditions for intensivists. Through the administration of professional associations, a better understanding of the intensivist manpower resource can be achieved and pertinent education training activities can be designed to enhance professional identity and a sense of belonging for intensivits.

並列關鍵字

Intensivist ； Non-intensivist ； Job satisfaction ； Job performance

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