組織氣候和領導型態對護理人員專業能力進階意願影響之研究

Influence of Organizational Climate and Leadership on Nurses' Willingness to Participate in the Nursing Clinical Ladder System

陳姵君(Pei-Chun Chen) ； 龔建吉(Chien-Chi Kung) ； 許哲瀚(Che-Han Hsu) ； 黃薏媛(Yi-Yuan Huang) ； 葉麗月(Li-Yueh Yeh) ； 洪弘昌(Hung-Chang Hung)

《榮總護理》 38卷2期 (2021/06) Pp. 165-174

https://doi.org/10.6142/VGHN.202106_38(2).0007

摘要

護理人員專業能力進階制度，可以提升護理專業發展及留任意願，雖推行長久，但護理人員參與意願並不高，此現象值得探究。護理主管有效的領導型態可以引領護理人員意向創造和諧組織氣候，進而提高護理人員參與專業能力進階動機，因此本研究從組織氣候及領導型態的角度探討護理人員專業能力進階意願。本研究為橫斷式研究，採方便取樣，研究對象以某區域教學醫院有職業登記之297位護理人員來進行普查，共發放297份問卷，回收277份。結果顯示：一、有進階經驗、最高級階年資淺，較有意願參加能力進階；二、組織氣候與專業能力進階意願呈顯著正相關（r=.60, p＜.001）、領導型態與專業能力進階意願呈顯著正相關（r=.50, p＜.001）、組織氣候與領導型態呈顯著正相關（r=.77, p＜.001）；三、與護理人員專業能力進階意願有顯著相關者為績效標準（β=.32, p＜.001）、轉換型領導（β=.19, p＜.01）、獎酬（β=.25, p＜.001），且績效標準、轉換型領導與獎酬，共可以解釋40.6%的變異量。由此可證實組織氣候與領導型態對於能力進階意願之影響性，建議護理主管除了積極向醫院建言將進階與績效制度結合外，也可以彈性應用不同管理型態營造正向組織氣候，以提升基層護理人員參與進階申請之意願。

關鍵字

組織氣候 ； 領導型態 ； 專業能力進階意願

並列摘要

The Nursing Clinical Ladder (NCL) system can enhance the development of nursing profession and nurse retention. Although this system has been implemented for a long time, the willingness of nurses to participate has been low. Effective leadership by nursing supervisors can result in a harmonious organizational climate that can, in turn, make nursing staff more willing to participate in the NCL system. Therefore, this study explored the relationships between the willingness of nursing staff to participate in the NCL, organizational climate, and leadership style. This cross-sectional study used purposive sampling to recruit 297 nurses with occupational registration in a regional teaching hospital; the valid questionnaires of 277 of them were analyzed. The study made three findings. First, those with advanced experience in the NCL system (i.e., the most advanced level with junior seniority) were more willing to participate in the NCL system. Second, the organizational climate was significantly related to nurses' willingness to participate in the NCL (r= .60, p＜ .001). In addition, leadership style and willingness to participate in the NCL were significantly positively related (r= .50, p＜ .001) and so were leadership style and organizational climate (r= .77, p＜ .001). Third, the factors significantly related to the willingness to participate in the NCL system were performance standards (β= .32, p＜ .001), transformational leadership (β= .19, p＜ .01), and rewards (β= .25, p＜ .001), which could explain 40.6% of the variation in nurses' willingness to participate in the NCL system. These findings indicate the influence of organizational climate and leadership on nurses' willingness to participate in the NCL system. Therefore, to enhance nurses' willingness to participate in the NCL system, we recommend for nursing supervisors to undergo management courses regarding organizational leadership. Furthermore, we recommend for nursing supervisors to not only actively advise the hospital manager to combine NCL and performance systems but also flexibly apply different management strategies to create a positive organizational climate to enhance the willingness of primary care nurses to participate in the NCL system.

並列關鍵字

organizational climate ； leadership ； willingness to nursing clinical ladder

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