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  • 學位論文

行政院衛生署所屬醫院新進護理人員工作壓力及其相關因素之調查研究

A Study on the Work Stress of the New Nurses in General Hospital, Department of Health, Executive Yuan,Twaiwan,R.O.C.

指導教授 : 盧美秀
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摘要


論文名稱:行政院衛生署所屬醫院新進護理人員工作壓力及其相關因素之調查研究 研究所名稱:臺北醫學大學護理學研究所 研究生姓名:黃千惠 畢業時間:93學年度第2學期 指導教授:盧美秀 臺北醫學大學護理學研究所教授 本研究旨在探討行政院衛生署所屬醫院臨床新進護理人員的自覺工作壓力感受情形及其相關因素,先以訪談方式,收集12位新進護理人員之工作壓力感受情形,將訪談結果整理分類後,配合文獻查證及護理實務之現況,應用「需求─控制─支持」模式,自擬新進護理人員工作壓力調查問卷,並經專家內容效度、再測信度之檢測。 研究對象為從護理學校畢業後,第一次進入臨床擔任護理工作,且服務滿一個月至半年之內的新進護理人員。抽樣範圍包含行政院衛生署所屬綜合醫院共十六家,共發出問卷109份,回收105份,回收率為96%。回收之問卷以次數分配、平均值、標準差、變異數分析、t-test、相關分析、複迴歸等方法進行資料的分析處理。 研究結果顯示: 受訪者的年齡、教育程度、到職天數、受雇狀態、證書別及工作單位與自覺工作壓力的感受程度無統計學上的顯著相關。新進護理人員自覺工作壓力感受的平均得分2.2分,顯示新進護理人員的工作壓力介於中低程度,較許多研究提出的結果為低。對工作壓力的情緒反應為:上班時心理很緊張、覺得常遭遇挫折、容易感到煩躁;生理反應為:精疲力竭、很疲憊、腰酸背痛及抵抗力降低容易生病。 工作需求的得分越高則自覺工作壓力感受的得分越高(回歸係數=0.42,p<0.0001),工作負荷大,工作時間的緊迫、藥物的認識及應用、常見檢查及治療的執行、延遲下班、交班及書寫記錄都是工作需求中會增加自覺工作壓力感受程度的因素。工作控制的得分越高則自覺工作壓力感受的程度越低(回歸係數= -0.16,p=0.04),新進護理人員覺得較難掌控的情形依序為:病人病情變化醫師遲遲不來、輪上夜班、處理危急的病人、無法掌握病情及工作時間的控制。社會支持的得分越高則自覺工作壓力感受的得分越低(回歸係數= -0.23,p= -0.04)社會支持總平值為3分,顯示新進護理人員感受到很多的支持,可緩衝新進護理人員自覺工作壓力的感受。 本研究的結果顯示行政院衛生署所屬醫院雖然工作需求高,但因提供新進人員高度的自主權及支持度,所以新進人員對於工作壓力呈中低程度,屬於高需求、高控制、高支持的情境下所產生的壓力,為積極主動型的正向壓力,是一個適合新進護理人員的工作場所。

並列摘要


Title of thesis: A Study on the Work Stress of the New Nurses in General Hospital, Department of Health, Executive Yuan, Taiwan, R. O. C. Institution: Graduate Institute of Nursing , Taipei Medical University Author: Huang, Chien-Hui Thesis directed by:Lu, Meei-Shiow, Professor The subject of this research is to discuss the actual status about how clinical nurses, who are newly recruited by the hospitals under Department of Health(DOH), Executive Yuan, Taiwan, R.O.C., feel about their self-perceived level of work stress and related factors. Firstly, we interviewed 12 newly recruited nurses to collect data of their perception of work stress. Then we categorize the data according to records, tests and status of nursing work in designing the questionnaires, using "Demand-Control-Support" modle. since the method has been tested and approved by experts for content validity and test-retest reliability. The research sample group was nursing school graduates who have nursing work experience of more than 1 month, but less than 6 months. Samples included 16 consolidated hospitals under the DOH, Executive Yuan. A total of 109 questionnaires were issued with 105 returned. The survey’s return rate was 96%. The questionnaire data was analyzed by the following methods: times of distribution, average score, standard errors, ANOVA analysis, t-test, correlation analysis and multi-regression analysis. The conclusion of this research showed "the self-perceived level of work stress" of sample group had no obvious correlation with their age, education level, days of working record, employee status, diploma differences or different work division. The average coefficient score of work stress for newly recruited nurses is 2.2, which means they rate their job pressure level as between medium to low. This is lower than many other research results. Their emotional responses to work stress are: feeling very tensed mentally while on duty, feeling frustrated frequently, and feeling anxious easily. Their physical reactions are: feeling exhausted, feeling very tired, getting sore and aching back, feeling their immunity decreasing and falling sick easily. The higher job demands seems to always cause a higher score on the self-perceived levels of work stress (regression coefficient= .42, p< .0001). Factors such as having heavy job load, having tight working schedule, retaining knowledge and application of medication, performing regular checkup and executing therapy, having to work extra hours regularly, changing shifts and writing work journals, all contribute to the increased feeling of work stress. The higher score on having job control seems to always lower the score on work stress perception (regression coefficient= -.16, p= .04). Newly recruited nurses feel not in control when: doctors do not show up in time for patients' emergencies, working on night shifts with limited support, handling critical patients, unable to handle patients' status and having no control over working hours. The higher score of support from manager and colleague seems to lower work stress scores (regression coefficient= -.23, p= -.04). The total average social support coefficient score is 3, which means newly recruited nurses feel that they are receiving high level of support, which helped relieve some feeling of work stress. This research also showed the high job demands in hospitals under the DOH, Executive Yuan. However, they are allowed to work with "high self-determination and support" in their job field, thus easing new comers' perception of their work stress to a medium-low level. A positive & self-imposed pressure from a high-demand, highly-controlled and highly-supported work environment could be most suitable for newly recruited nurses.

並列關鍵字

work stress newly nurses

參考文獻


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被引用紀錄


曾淑倩(2014)。新進護理人員的生活經驗〔碩士論文,長榮大學〕。華藝線上圖書館。https://doi.org/10.6833%2fCJCU.2014.00109
李玉媚(2010)。三個月內離職之新進護理人員職場經驗初探〔碩士論文,長榮大學〕。華藝線上圖書館。https://doi.org/10.6833%2fCJCU.2010.00028
張慧蘭(2008)。應屆畢業新進護理人員離職相關因素之探討〔碩士論文,臺北醫學大學〕。華藝線上圖書館。https://doi.org/10.6831%2fTMU.2008.00046
黃寶華(2007)。團體座談會對應屆畢業新進護理人員工作壓力調適之成效探討〔碩士論文,臺北醫學大學〕。華藝線上圖書館。https://doi.org/10.6831%2fTMU.2007.00098
曾淑倩、周傳姜(2016)。新進護理人員的學習經驗榮總護理33(2),186-195。https://doi.org/10.6142%2fVGHN.33.2.186

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