探討護理人員職場疲勞、同理心、壓力因應行為與離職傾向之相關性

研究背景:護理人員是助人的專業工作者，在臨床照護病患上必需具備「耐心」、「愛心」、「同理心」；然而，因護理工作特性負荷大、高壓力及長時間的累積繼而引發護理人員身心疲憊，處在高壓力工作下，無法適當調適壓力，最終選擇離職，在臨床上護理人員若能發揮同理心及適時壓力調適，影響離職傾向發生，是當前及未來會面臨的議題。研究目的:探討護理人員的職場疲勞、同理心壓力因應行為與離職傾向之相關性。研究方法:本研究採橫斷性調查法，使用結構式問卷進行資料收集，研究對象以台灣北部某區域醫院護理人員為對象，總計收案 181 名護理人員，研究問卷內容包括「護理人員的基本資料」、「職場疲勞量表(哥本哈根疲勞量表) 」、「傑佛遜同理心量表」、「壓力因應行為量表」、「離職傾向量表」五部分，經由 SPSS 22.0 for Windows 電腦統計軟體、Pearson 相關係數分析、斯皮爾曼等級相關係數、線性迴歸、複迴歸進行資料處理與分析。研究結果:護理人員在職場疲勞以自覺疲勞為最高分，同理心主要是病人治療中一項重要的因素，壓力因應策略主要是採取積極正向態度，離職傾向屬於中度離職意願。護理人員職場疲勞與離職傾向呈正相關，職場疲勞與同理心呈負相關，職場疲勞與壓力因應行為呈正相關，因此護理人員職場疲勞、同理心、壓力因應行為對離職傾向是具有影響力。進行迴歸預測分析，顯示職場疲勞、同理心、壓力因應行為可以解釋離職傾向達 13.7%，而趨近/樂觀型壓力因應行為與職場疲勞無顯著相關。結論:職場疲勞、同理心、壓力因應行為等因素會影響護理人員的離職傾向。本研究結果發現，職場疲勞中以自覺疲勞佔大部分，在臨床上擔心自己照顧疾病嚴重度高的個案無法負荷，而造成困擾導致身心疲憊，建議醫院在臨床上更應該關注年輕及護理經驗較少護理師，需進行臨床能力培訓等策略以幫助年輕和經驗不足的護理師獲得臨床知識和技能，建立穩定及更有信心去處理複雜個案。護理人員面對壓力時仍有採取自我責備及逃避，較負向及不健康的因應方式，建議多新增正向壓力調適相關課程及辦理紓壓相關活動，多參加戶外活動，抒發壓力進而減少疲勞。

關鍵字

護理人員；職場疲勞；同理心；壓力因應；離職傾向

並列摘要

Background:Nurses are professional workers who help others, and they must have "patience," "caring," and "empathy" in patient care; however, due to the heavy workload, high pressure, and long-term accumulation of nursing work, nursing care is triggered. Personnel is physically and mentally exhausted, under high-pressure job, unable to properly adjust to the pressure, and finally, choose to leave. Clinically, if nurses can show empathy and timely pressure adjustment, it will affect the occurrence of turnover tendency, which is a current and future issue. Research objective: Investigating nursing workplace correlation among fatigue, empathy, stress response behavior, and turnover intention. Research method: This research adopts a cross-sectional survey method and uses a structured questionnaire for data collection. The research objects are nurses in a regional hospital in northern Taiwan. A total of 181 nurses are accepted. The content of the research questionnaire includes "basic information of nurses," "Workplace Fatigue Scale (Copenhagen Fatigue Scale)," "Jefferson Empathy Scale," "Stress Response Behavior Scale," and "Turnover Tendency Scale" five parts, through SPSS 22.0 for Windows computer statistical software, Pearson correlation coefficient analysis, Spearman's rank correlation coefficient, linear regression, and multiple regression were used for data processing and analysis. Result: Nurses were fatigued in the workplace, with perceived fatigue as the highest score. Empathy There is general agreement to believe that empathy is an essential factor in patient care. The stress coping strategy is mainly to adopt a positive attitude, and the turnover intention is moderate. Nurses' workplace fatigue is positively correlated with turnover intention, workplace fatigue is negatively associated with empathy, and workplace fatigue is positively correlated with stress coping behavior. Therefore, nurses' workplace fatigue, empathy, and stress coping behavior influence turnover intention. Regression prediction analysis showed that workplace fatigue, empathy, and stress coping behaviors could explain 13.7% of turnover intentions while approaching/optimistic stress coping behaviors had no significant correlation with workplace fatigue. Conclusion:Workplace fatigue, empathy, and stress coping behaviors can influence nursing staff's turnover intention. The results of this study found that conscious fatigue accounts for the majority of workplace fatigue. In clinical practice, we are worried that we will be unable to take care of cases with high severity of the disease, which will cause distress and lead to physical and mental exhaustion. It is recommended that hospitals should pay more attention to young people and nursing experience in clinical practice. Strategies such as clinical competency training are needed to help young and inexperienced nurses acquire clinical knowledge and skills,build stability, and have more confidence in handling complex cases. Nurses still take self-blame and evasion when faced with stress, which is a more hostile and unhealthy coping method. It is recommended to add more positive stress adjustment-related courses, organize stress-relief-related activities, and participate in more outdoor activities to express stress and reduce fatigue.