臨床心理師的工作壓力、專業認同及對心理健康、離職意圖及轉業意圖之影響

Work Stress and Professional Identity in Clinical Psychologist and the Effects on Mental Health, Intentions of Turnover and Profession Change

張錚如(Cheng-Ju Chang)

指導教授 ： 黃淑玲

中山醫學大學/醫學科技學院/心理學系暨臨床心理學碩士班/碩士(2010年)

https://doi.org/10.6834/CSMU.2010.00075

摘要

臨床心理工作是專業度高、充滿挑戰性的專業。過去研究發現專業人員的工作壓力、專業認同可能影響其工作品質、身心健康狀態及留任意願。然而，在台灣有關臨床心理師的工作壓力、專業認同的研究很少。若能藉由系統性的研究來了解國內臨床心理師的實務工作現況及可能面臨的困境，研究結果可提供學會、公會及教學單位參考，作為未來訂定改善機制或預防之基礎。故本研究旨在瞭解台灣臨床心理師之工作壓力、專業認同的現況，分析影響臨床心理師之工作壓力、專業認同的相關因素，並嘗試探討工作壓力、專業認同對臨床心理師的心理健康狀態、離職與轉業意圖的影響。

本研究採用橫斷式研究方法，以電子問卷方式進行方便取樣調查。透過各地方臨床心理師公會協助轉寄電子郵件與網頁公告等方式，邀請全台灣具臨床心理師專業證照且執業中之臨床心理師參與調查。至2009年7月為止，台灣完成職業登記的臨床心理師共計有678人，本研究共回收有效問卷139份，問卷回收率20.5%。資料以SPSS for windows 12.0版套裝軟體進行分析，以平均數描述臨床心理師的工作壓力、專業認同程度；採用t檢定、變異數分析來檢驗個人屬性與組織屬性在工作壓力與專業認同的差異；以皮爾森相關分析（Pearson Correlation）檢視臨床心理師工作壓力、專業認同、心理健康狀態、離職意圖以及轉業意圖之相關情形；以多元線性迴歸分析（Multiple Linear Regression Analysis）檢驗工作壓力、專業認同及心理健康狀態的相關因子；以邏輯迴歸分析（Logistic Regression Analysis）檢驗工作壓力、專業認同等等變項對臨床心理師離職意圖與轉業意圖的影響程度。

研究結果顯示臨床心理師的工作壓力屬於中等程度；「工作負荷」、「資源缺乏」及「組織與行政」是主要工作壓力源。臨床工作年資短及全職工作的臨床心理師工作壓力較年資長及兼職工作者大。任職於不同機構種類的臨床心理師其壓力源有所差異，相較於「他類」機構者，精神專科醫院的臨床心理師「專業衝突與人際關係」壓力較高；而任職於綜合醫院者在「資源缺乏」與「自我專業懷疑」向度的壓力較高。

臨床心理師的整體專業認同在中上程度；工作相關變項對於臨床心理師專業認同的高低並沒有顯著性的影響。此外，工作壓力與專業認同能有效的預測臨床心理師的心理健康狀態，工作壓力較高、專業認同程度較低者心理困擾程度越高。工作壓力與專業認同程度會影響臨床心理師的離職意圖；但只有專業認同程度對臨床心理師轉業意圖有顯著性的影響。

臨床心理師的工作壓力與專業認同不僅影響其心理困擾程度，對於臨床心理師是否考慮離職亦有決定性的影響。管理階層應注意臨床心理師的工作負荷情形，以維護其心理健康與維持機構內臨床心理師人力的穩定性。臨床心理師的專業認同是決定繼續留任臨床工作與否的重要因素，未來值得投入更多研究以釐清臨床心理師專業認同的形成及影響因子。

關鍵字

臨床心理師 ； 工作壓力 ； 專業認同 ； 心理健康 ； 離職意圖 ； 轉行意圖

並列摘要

It has been evidenced that work stress and professional identity are associated with work performance, mental health and intentions of turnover and profession change. However, there has been a dearth of research on work stress and professional identity among clinical psychologists in Taiwan. The purposes of this study were to investigate work stress and professional identity among clinical psychologist and to explore their effects on mental health, intentions of turnover and profession change.

A cross-sectional research method was employed. An E-questionnaire was used to collect data. The email for participant recruiting was sent to all clinical psychologists by local clinical psychologist associations. The related message was posted on the website of Association of Taiwan Clinical Psychologist (ATCP) as well. A total of 139 questionnaires were successfully collected, deriving a response rate of 20.5%. Data were analyzed by the SPSS for Window 12.0 system.

The results showed the average of clinical psychologists’ work stress was at a moderate level. The main stressors were “workload”, “lack of resources” and “organizational structure and processes”. Clinical psychologists who were with less working years and full-time workers reported more stress than those with higher working years and part-time workers. Institutional type showed differences on work stressors. Clinical psychologists working in “psychiatric hospital” reported higher stress on “relationships and conflicts with other professionals” than those who work in “other institutions”. Those who worked in “general hospital” perceived more stress on “lack of resources” and “professional self-doubt”. The average of clinical psychologists’ professional identity was above moderate level. Work-related variables (e.g. working year, institutional type, employed type) did not have any significant effect on the level of professional identity. The results showed that work stress and professional identity had significant relations with mental health. Those indicated higher work stress and lower level of professional identity reported poorer mental health. Both work stress and professional identity had significant effects on intention of turnover, but only professional identity had a significant effect on intention of profession change.

Work stress and professional identity are not only associated with clinical psychologists’ mental health, but also linked with their intention of turnover. Administrators should pay attention on the workload of clinical psychologists to maintain clinical psychologists’ mental health and stabilize clinical psychologists’ workforces. Professional identity is an important factor associated with clinical psychologists’ intention of profession change; further studies are recommended to clarify the forming process and the related factors of professional identity in clinical psychologist.

並列關鍵字

Clinical Psychologist ； Work Stress ； Professional Identity ； Mental Health ； Intention of Turnover ； Intention of Profession Change

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