醫院員工工作壓力、憂鬱對工作滿足之影響

The impact of hospital staff work stress, depression on job satisfaction

李冠樺(Kuan-Hua Li)

指導教授 ： 蔡雅芳

中山醫學大學/健康管理學院/醫療產業科技管理學系碩士班/碩士(2016年)

摘要

背景與目的：依據2015年衛生福利部「醫療機構現況及醫院醫療服務量統計分析」，大多數的醫療從事人員必須服務較多的病患，工作壓力及心理負擔也可能相對較重，工作滿足度可能受到連動的影響。醫院行政人員的工作負擔與壓力更是隨著健保與評鑑制度啟用以來與日俱增，成為另一類不可忽略的醫療從業人員。如何使醫院員工願意對工作更投入與奉獻，降低員工的工作壓力與焦慮造成的憂鬱情形，提升工作滿足，促使員工積極地朝組織目標前進，是目前醫療機構管理者需審慎重視的議題。本研究試著將工作壓力、憂鬱和工作滿意度，進行多構面而非單構面的探討，並找出其中互相影響之相關性，期許能對醫院經營與管理者提供更全面且有益的資訊，藉以提升醫院工作環境以及提高醫院員工工作滿意度。

研究方法：本研究採橫斷面（cross-sectional）研究設計，使用結構式問卷收集資料，問卷內容分為「工作壓力」、「憂鬱程度」、「工作滿足」三個面向及受訪者背景之人口變項資料。尋找有意願填寫之醫院員工，採用紙本問卷方式發放問卷，採便利抽樣發放，以台灣中彰投鄰近地區為主之地區醫院等級以上醫院的員工為對象發放問卷。共發放350份問卷，回收有效問卷250份，有效問卷回收率為71.4%。使用SPSS for Windows 20.0中文版統計分析套裝軟體為本研究分析之工具，並利用百分比、最小值、最大值、平均值、標準差等描述性統計分析，以及信度檢測、迴歸分析、單因子變異數分析等推論性統計分析方法進行研究分析。

結果：根據本研究問卷樣本分布情形分析結果，受訪者的性別以女性居多（68.8%），教育程度八成以上（81.6%）是大學/專科學歷，工作部門以護理/照護（35.2%）及行政人員（34.0%）為主，半數以上（54.4%）受訪者都在區域醫院等級工作，七成以上（74.4%）受訪者在工作上直接接觸病人。受訪者已經有過半數的受訪者（56.0%）具有「接近憂鬱症，或輕度憂鬱症」以上的憂鬱情緒症狀。根據本研究結果發現：當受訪者的工作壓力較高時，相對其憂鬱情形也會較高；當受訪者的憂鬱程度較高的時候，相對地其工作滿足會較低；當受訪者的工作壓力較高的時候，相對地其工作滿足會較低。醫院員工的憂鬱狀態是工作壓力與工作滿足的部分中介變項。年齡、宗教信仰、工作部門會影響工作壓力的感受；個人平均月所得則會影響憂鬱情緒的認知；其他像是性別、婚姻狀況、育有子女數、工作年資、職位等，皆不影響工作壓力、憂鬱或工作滿足的感受。

結論：經本研究結果驗證，在高工作壓力與高憂鬱情緒的工作環境下，工作滿足感受會受其影響而降低。本研究希望能藉由量化的數據來呈現醫院員工身心感受的現況，以及他們所面臨的困難，提供醫療院所管理者一個全面且客觀的參考索引，希望能盡可能使醫院員工擁有好的工作情緒，也就更能提供好的醫療品質。不論任何企業乃至醫療機構，最重要的核心價值是「人」，使人的才能與專業在機構中得以展現，每種職類、每位員工擁有良好的向心力也使其提供高品質、高效率的醫療行為與服務，共同為醫療院所營運與全民健康而努力。

關鍵字

工作壓力 ； 憂鬱 ； 工作滿足 ； 職場心理健康 ； 醫務管理

並列摘要

Background and Purpose. According to the Ministry of Health and Welfare in 2015, "the status of medical institutions, hospitals and medical services amount statistical analysis", most medical personnel must serve in more patients, work stress and psychological burden may be relatively heavy, job satisfaction may be linked impact. The workload and work stress of hospital administrative staff with the National Health Insurance to enable growing, becoming another kind can not be ignored medical practitioners. For make the hospital staff are willing to put in more work and dedication, reduce depression, improve job satisfaction, and encourage staff to actively advance toward organizational goals, the hospital managers must to careful attention to medical issues. This study will try to find out how to affect between work stress, depression and job satisfaction. Hope to provide hospital operators and managers a more comprehensive and useful information, in order to improve the hospital work environment and hospital staff's job satisfaction.

Methods. This study is a cross-sectional study , using a structured questionnaire to gather information, the questionnaire is divided into "work pressure", "depression", "job satisfaction" and demographic data. Collected data by convenience sample distribution from hospital staff in the central region of Taiwan.
Were distributed 350 questionnaires and got 250 valid questionnaires, the effective response rate was 71.4%. The statistical analyzes in this study by using SPSS for Windows 20.0 . Using of descriptive statistics analysis like percentage, minimum, maximum and standard deviation, and inferential statistical analysis like regression analysis, independent-sample T Test and ANOVA.

Results. According to this study results, the respondents's sex in females is 68.8%, level of a university / college education is 81.6%, work department is based by 35.2% of nurses and 34.0% of administrative staff, 54.4% of the respondents work at metropolitan hospitals, 74.4% of the respondents work in direct contact with patients. Most of the respondents in a slight stress or excessive stress, generally have unhappy and negative emotional response, and majority of the respondents (56.0%) have a "close depression or mild depression" symptom. This study found that: When hospital staff in high work stress will be positive impact on depression, when hospital staff have a high degree of depression then their job satisfaction will be relatively low, when hospital staff in high work stress then their job satisfaction will be relatively low. Depression is a intervening variable of the work stress and job satisfaction. Age, religion and department will significantly affect the feelings of work stress. The individual average monthly income will significantly affect the feelings of depression. Others such as gender, marital status, number of children, education, department, seniority, etc. will not affect work stress, depression and job satisfaction.

Conclusion. This study hopes to quantify the data in hospital staff's physical and psychological feeling under the current situation and what difficulties they face. Providing hospital managers a comprehensive and objective reference index, hope to make the hospital staff have a good work emotion, and them able to provide more high quality of medical care. Regardless of any enterprises and medical institutions, the most important core value is "people". Trying to make each hospital category and staff able to show their professional talent, and has a good centripetal force also make high quality and high efficiency medical care. Effort to medical institutions operation and national health.

並列關鍵字

work stress ； depression ； job satisfaction ； occupational health psychology ； health care management

參考文獻

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財團法人董氏基金會心理衛生中心 http://www.jtf.org.tw/psyche/　(2016.05.01)

財團法人醫院評鑑暨醫療品質策進會Joint Commission of Taiwan.