醫院員工對組織文化、組織承諾及工作滿意度之分析--榮民醫療體系垂直整合模式下兩家分院為例

Hospital Employees’ Perception of Organizational Culture, Organizational Commitment, and Job Satisfaction –Two Branches of Veterans General Hospital System under Vertical Integration

徐正宜(Cheng-Yi Hsu)

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(2014年)

https://doi.org/10.6833/CJCU.2014.00117

摘要

目的 組織進行變革時，員工經常面臨變革所帶來的失敗情緒、壓力，不僅形成組織變革中無形的阻力，更會削減組織變革的動能。退除役官兵輔導委員會之某榮民總醫院垂直整合轄下之兩家分院，三方進入磨合、適應的階段。本研究旨在了解兩家分院員工在垂直整合後，對組織文化、組織承諾、工作滿意度之態度，並探討不同醫院的組織文化是否影響員工之工作滿意度對組織承諾之影響。
方法 本研究採橫斷性問卷調查法，以某榮民總醫院轄下的兩家分院全體員工為調查對象，其中一家為人力、物力資源集中且工作負擔較大的醫院（A分院），另一家則位處純樸鄉村、資源較精簡的醫院（B分院）。問卷採不記名方式，由受測者作答，共發出400份，回收有效問卷310份，回收率為77.5%。問卷經整理檢核後，以SPSS軟體進行相關性分析、階層線性迴歸分析，並驗證研究假說。
結果 本研究之受訪對象以40歲以下者居多，有185人（59.7%）；工作人員以已婚者居多，有186人（60.0%）；教育程度以大學畢業者居多，佔52.3%；工作年資以5年以下者為主，佔34.2%。差異性分析結果顯示，B分院之嚴格型文化明顯大於A分院，B分院員工較能感受到他人以嚴格、嚴厲的態度看待，而A分院雖有較多資源與人力，但需承擔較多工作與責任，仍對醫院有較高的組織承諾；另外具主管職者其組織承諾與整體工作滿意度皆比非主管者來得高；努力承諾及整體組織承諾方面顯示，醫事人員大於護理人員、已婚者比未婚者較高；51歲以上者較40歲以下的努力承諾、價值承諾、整體組織承諾、自主滿意、制度滿意、潛力滿意和整體工作滿意度高。透過迴歸分析發現，工作滿意度達顯著影響（p<0.05），亦即工作滿意度愈高時，組織承諾則愈高。另在組織文化之干擾效果部份，結果顯示兩分院及A分院僅創新型、嚴格型文化達顯著影響（p<0.05），而B分院僅嚴格型文化達顯著影響（p<0.05）。
結論 隨著醫療模式的轉變以及民眾需求的增加，醫療產業必須跟著變革以求生存。本研究發現不同分院間之組織文化、組織承諾與工作滿意度有顯著差異，具主管職者、醫事人員、已婚者均有較高的組織承諾；工作滿意度對組織承諾有顯著影響，亦即工作滿意度愈高，組織承諾就愈高。加入組織文化干擾後，僅創新型文化和嚴格型文化在兩分院及A分院對組織承諾有顯著正向解釋力，B分院僅嚴格型文化達顯著影響。
關鍵字：組織變革、組織文化、組織承諾、工作滿意度

關鍵字

組織變革 ； 組織文化 ； 組織承諾 ； 工作滿意度

並列摘要

Objectives The emotional stress in institutional reorganization not only is the resistance for the change but also decreases the energy of revolution. One General Veteran Hospital integrated 2 other local Veteran Hospitals as 2 branches, and the three institutions need to adapt to the reorganization. The aims of this study were to investigate the influence of the institutional reorganization toward organizational culture, organizational commitment and job satisfaction, and to explore whether different organizational culture would moderate the impact of job satisfaction on organizational commitment.
Method This cross-sectional study surveyed the staffs from the 2 branches of General Veteran Hospital. Branch A with heavy loading had more adequate manpower and resource, and Branch B with light loading had less resource in the countryside. Among 400 nominated questionnaires, 310 valid copies were collected with a response rate of 77.5%. The hypotheses were tested by Pearson’s correlation and hierarchical linear regression with SPSS.
Result For the whole sample, 185(59.7%) participants were under age 40, and 186(60.0%) participants were married, 52.3.% of participants graduated from college, and 34.2% of participants had under 5 year work experience. Branch B hospital had more significant strict culture than Branch A hospital, and the staffs in Branch B hospital were more sensitive to other’s harsh attitude. With adequate resource and manpower, though under more work loading and responsibility, staffs in Branch A hospital still had higher organizational commitment. Besides, leaders had higher organizational commitment and job satisfaction than non-leaders. For effort commitment and overall organizational commitment, para-medical staffs had higher scores than nursing staff, and those who married had higher scores than those who were single. Staffs above age 51 had higher scores than those below age 40 in effort commitment, value commitment, overall organizational commitment, autonomy satisfaction, system satisfaction, potential satisfaction and overall job satisfaction. In regression models, job satisfaction was significantly related with organizational commitment. In the moderating effect of organizational culture, innovative culture and strict culture were significant in both branches and Branch A hospital alone, and strict culture was significant in Branch B hospital alone.
Conclusion The health care industry needs to change for survival under the pressure of evolving health service models and the increase of public’s demand. This study found significant difference between different branch hospitals in organizational culture, organizational commitment and job satisfaction. Leaders, para-medical staff and the married staffs had higher organizational commitment, and higher job satisfaction significantly related with higher organizational commitment. Some organizational culture could moderate the effect of job satisfaction on organizational commitment. Innovative culture and strict culture were significant in both branches and Branch A hospital alone and strict culture was significant in Branch B hospital alone.
Key words：organizational change, organizational culture, organizational commitment, job satisfaction

並列關鍵字

organizational change ； organizational culture ； organizational commitment ； job satisfaction

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