不同班制護理人員職業疲勞與工作生活品質之相關性研究

The Correlation study in burnout and nurses′ quality of working life on nurses in different types of shifts

吳瑞珍(Jui-Chen Wu)

指導教授 ： 徐明儀

中山醫學大學/醫學院/護理學系碩士班/碩士(2017年)

摘要

護理工作是一天24小時持續不間斷的工作型態，輪班制作業便成為醫護人員最常見的工作模式，以提供必要的照護服務。輪班造成日夜節律混亂、睡眠障礙，以及身體、心理上的健康問題，而使人員感到疲勞；疲勞會產生身體上的不適、導致情緒負面的反應、睡眠障礙以及對家庭及社會適應上的衝擊，進而影響到工作生活品質或造成醫療照護疏失。
本研究主要目的為不同班制護理人員職業疲勞與工作生活品質之相關性之探討，採橫斷式相關性研究法，對象為台灣北、中、南部地區教學醫院臨床單位護理人員共590位，研究工具以結構式問卷調查，包括人口基本屬性、職場疲勞量表及護理人員工作生活品質量表。研究資料以描述性統計、單一樣本t檢定及單因子變異數分析、皮爾森相關及階層迴歸進行資料分析。研究結果發現：(一)護理人員基本屬性與班制對職業疲勞分析，描述性研究結果發現護理人員的職場疲勞整體得分為50.59分，進一步分析四個面中，以「個人疲勞」平均分數最高得分57.86分，其次依序為「工作疲勞」平均得分53.83分，「工作過度投入」平均得分45.94分，在「對服務對象疲勞」分數最低為44.71分。推論分析結果發現護理人員基本屬性在年齡、執照別、睡眠品質、自覺健康狀況、慢性疾病內科病房當天照護病人數及產科病房當天照護人數共7項與職業疲勞有顯著性差異；在班制變項皆無顯著差異。階層迴歸分析結果發現班制變項對職業疲勞無顯著差異性。(二)護理人員基本屬性與班制對工作生活品質分析，描述性研究結果顯示護理人員的整體工作生活品質為3.23分(SD=.32)，進一步分析六個面向，人際關係平均得分3.47分(SD＝.43)、自我實現得分3.40分(SD＝.46)、自我效能平均得分3.30分(SD＝.40)、職業自我概念平均得分3.15分(SD＝.38)、工作方面平均得分3.07分(SD＝.37)、組織方面平均得分3.02分(SD＝. 56)。推論分析結果發現護理人員基本屬性在婚姻、教育程度、護理工作總年資、任職區域、睡眠品質、自覺健康狀況及內科病房當天照護病人數共7項與工作生活品質有顯著差異性；班制變項在輪班方式及換班速率共2項與工作生活品質有顯著差異性。階層迴歸分析結果發現班制變項中「輪班方式」變項對工作生活品質有顯著性的影響。(三)職場疲勞與工作生活品質結果為負相關，在職業疲勞中的工作過度投入面向與工作生活品質中的職業自我概念構面結果為正相關。(四)護理人員基本屬性、班制及職業疲勞與工作生活品質相關階層迴歸分析結果發現「職業疲勞」對工作生活品質有顯著性的影響。
本研究嘗試了解班制、職業疲勞與工作生活品質三者之關係，以提供作為醫院人力部門建立正向工作安排政策的參考。

關鍵字

輪班 ； 護理人員 ； 職業疲勞 ； 工作生活品質

並列摘要

Shift causes day and night rhythm disorder, sleep disorder, physical and psychological health problems. Burnout will produce physical discomfort, leading to negative emotion, sleep disorders and the impact of family and social adaptation, thus it affects the quality of work life or causes medical care loss.
The purposes of this study were to explore the relationship among nurses′ shift, occupational burnout inventory and nurses′ quality of working life by the structured questionnaire. A total of 590 nurses were investigated, they were worked in many Community Teaching Hospitals distributed around northern, middle and southern Taiwan. The data were analyzed by descriptive statistics, single sample t test, single factor analysis, Pearson correlation coefficient and hierarchical regression.
The findings of this study were: (1) the basic attributes of the nursing staff and the work shift on the occupational burnout analysis, descriptive study found that the nursing staff of the workplace burnout overall score of 50.59 points, further analysis of the four faces to "personal burnout" average score of 57.86 points, followed by an average of 53.83 points for "work burnout" and an average score of 45.94 points for "overwork", with a score of 44.71 in the "burnout of service". The results of the descriptive showed that the basic attributes of nursing staff were significantly different from those of occupational burnout in the age, the license, the sleep quality, the self-conscious health status, the number of care patients in the chronic diseases and the number of care in the obstetric ward. The results of the hierarchical regression analysis showed that the shift variables are no significant influence on occupational burnout. (2) Nursing staff basic attributes and shift on the quality of working life analysis, descriptive research results showed that the overall quality of working life of nursing staff is 3.23 points. Further analysis of six-oriented, interpersonal average score of 3.47 points (SD = .43), self-achievement score of 3.40 points (SD = .46), self-efficacy average score of 3.30 points (SD = .40), career self-concept average score of 3.15 (SD = .38), the average score of work was 3.07 points (SD = .37), the organization average score of 3.02 points (SD = .56). The results showed that the basic attributes of nursing staff found that the basic attributes of nursing staff were significantly different from those quality of working life in marriage, education level, total age of nursing work, working area, sleep quality, self-conscious health status and medical care day. There were significant differences between the shift type and the shift rate with the quality of working life. The results of the hierarchical regression analysis revealed that one of the shifts variables "shift mode" had a significant effect on the quality of working life. (3) The workplace burnout is negatively correlated with the quality of working life, and the excessive work in the occupational burnout is positively related to the occupational self-concept of the quality of working life. (4) From the regression analysis of basic attributes of nursing staff, shift, occupational burnout and quality of working life related shift, the results found that the occupational burnout has a significant influence in quality of working life.
This study is tried to understand the relationship of shifts, burnout and nurses′ quality of working life, providing a reference for establishing a positive working arrangement which might offer better recommendations for the policy of human resources department in hospitals.

並列關鍵字

shifts work ； nurses ； burnout ； quality of working life

參考文獻

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