由於在醫院過速擴張及總額預算制度壓縮下,基層診所競爭越趨激烈,除了積極爭取基層診所總額預算之合理成長外,診所的經營管理是一重要課題。 本研究主要是了解基層診所之醫師夫人在診所扮演的管理者角色及壓力。利用質性訪談與量化研究,以中部西醫基層醫療診所為對象,利用Mintzberg管理者的十個角色為問卷研究工具。採系統問卷調查法,先行編號,間隔10家抽取一家,進行施測。總計發出問卷300份,回收問卷178份,回覆涉及管理者有166份,回覆完全未涉及管理者12份,問卷回收率為59%。以下針對樣本資料作綜合析:1.醫師夫人在基層診所管理上以扮演領導者角色最多;扮演發言者的角色最少2.角色壓力程度為角色負荷最高,角色模糊最低3.不同工作狀況對參與管理者的角色上,有顯著性差異4.在診所管理所扮演的資訊及決策的角色,會因員工數的不同,有顯著性差異。5.在診所管理所扮演的關係、資訊及決策的角色,因到診天數的不同,有顯著性差異。6. 在角色模糊程度上會因工作狀況、一週到診天數、子女數目有顯著差異。角色過度負荷程度在教育狀況、工作狀況、開業年資,有顯著性差異。 根據上述之結論,本研究提出下列建議,以供基層診所醫師、基層醫師公會、醫療行政機關參考:1.設計一套診所經營管理的課程,以增進醫師夫人管理的專業,降 低角色壓力。2. 重視基層診所的管理,以提升基層診所管理品質與成長。3. 醫師夫人多參與瞭解診所經營及管理,有其正面意義。
Due to fast expansion of hospitals and global health budget compression, primary care clinics become increasingly competitive. In addition to actively striving for reasonable budget growth, clinical management is an becaming important research topic. This study is to understand the relationship between managerial role and stress of the doctor’s wife in primary care clinics. We adopted qualitative interviews and quantitative research. The primary care clinics in central Taiwan were targeted as the population. The tools used “Mintzberg managers’ questionnaire”. We sent 300 copies of questionnaire and collected 178 questionnaires. There are 166 valid questionnaires, 12 invalid questionnaires (59% retrieved rate) Based on the analyzed result, we have following conclusions 1. In the manager’s role, the doctor’s wife is the most in character as “leader” the least as “spokesperson”. 2. In the Kahn’s “stress level”, ‘role overload” is the most and “role ambiguity” the least. 3. There is significant difference in working conditions related to role of management. 4. Among the “information role” and “decision making role”, there are significant differences in numbers of employees and work days. 5. Among the “role ambiguity stress level”, there are significant differences 6. in work days and numbers of children. 7. Among the “role overload stress level”, there are significant differences in education level, work conditions and years of practice. Based on the previous conclusions, the study offers following suggesting to primary care clinics, committees and officials 1 Designing a series of courses on clinical management improves doctor’s wife management professions and lowers the stresses. 2 Emphasis on management of primary care clinics and upgrade qualities and growth. 3 Encourage doctor’s wife to involve in management and operation of clinics.