居家服務照顧服務員工作壓力現況之研究－以高雄市為例

A Study on the Status Quo of the Work-related Stress of Home Care Nursing Aides –Case Study in Kaohsiung City.

許玉珍(Yu-Chen Hu)

指導教授 ： 李聲吼

國立屏東科技大學/人文暨社會科學院/社會工作系/碩士(2014年)

https://doi.org/10.6346/NPUST.2014.00319

摘要

研究動機及背景：人口結構高齡化、平均壽命延長，以及疾病型態轉變，失能者人數大幅增加，照顧需求相對增高，國內外許多研究指出工作壓力影響照護品質及個案地照護結果均有正向的關係。本研究之目的係針對居家服務照顧服務員，探討其工作壓力之現況，以使照顧服務政策之擬定者及業主瞭解這些照顧服務人員的工作壓力狀況，作為人力資源管理及提升照護品質的參考。研究方法採橫斷式調查研究法，以立意取樣方式，對高雄市29家居家服務機構，工作三個月，具有照顧服務員訓練合格證書，且同意參與本研究之照顧服務員，以問卷調查進行研究。發出600份，回收507份，回收率84.5%。
本研究工具係依文獻探討設計結構式問卷，問卷分為二大部份，為個人基本資料、工作壓力，採Liker5點評分法。將回收問卷之有效問卷進行資料分類、編碼、整理、劃記、列表，再利用SPSS17.0統計軟體進行資料處理與統計分析。研究結果：研究有效樣本中女性478位佔94.3%；年齡層分佈以51歲以上最多232位佔45.8%；婚姻狀況絕大多數已婚325位佔64.1%；學歷以高中以上最多353位佔69.6%；工作地點以財團(社團)為最多371人佔73.2%；照服經驗已無經驗者佔多數498為佔98.2%；目前工作服務年資在4年以上最多123人佔24.3%；自覺健康狀況以274位覺得普通佔54.2%；壓力課程訓練以未皆受過訓練者162位為最佔32.0%；定期在職教育感受覺得有成長者最多444位佔87.6%；薪資以2萬至3萬元為最多數306位佔60.4%。研究資料統計分析，顯示照服員整體工作壓力為介於「輕度」至「中度」之間，偏向「中度」，以女性(平均值為60.15,標準差為14.93)、未婚婚姻狀況(平均值為61.63,標準差為14.89)、自覺健康狀況差者(平均值為74.79,標準差為18.29)、機構定期舉辦在職教育感受(平均值為59.02,標準差為14.72)四個項目最為顯著。在壓力類別四個構面上以知識技巧方面最高，依序工作本質、人際關係、行政管理最低。在壓力最高為『我需要照顧不合作、易怒或常常抱怨的個案，讓我覺得壓力很大』。在壓力最低項目為『我和其他工作人員相處不好（例：同事..）』。結論與建議：照服員政策擬定者及業者應積極研擬居服員之減輕壓力之措施，進行實際與學理並重的在職教育及友善之勞動環境，以提升有效之工作績效能力，加強工作能力的提升以因應挑戰力，及給予獎勵，讓他們感受居服員式有意義的工作，以提升工作的向心力及滿意度。

關鍵字

居家照顧服務 ； 居家照顧服務員 ； 工作壓力

並列摘要

Motivation and Background:
The demand for nursing care was relatively stronger than before while the population was getting older, the life expectancy was rising and the number of the disable was considerably increasing amid the shift of the disease patterns. Many researches at home and abroad indicated that work-related stress had a positive relationship with the influence on the care quality and the outcome of case care. The purpose of this study was to investigate the status quo of the work-related stress on home caregivers. The study findings may help their stress be better understood and serve as a reference for policy makers and employers in human resource management and care quality enhancement.
Methods：
With a cross-sectional study design, the caregivers were recruited by purposive sampling, who hold home care qualification certificate, have been employed over three months by 29 home care institutions in Kaohsiung and agreed to join this project. The research was done by means of questionnaire survey. 600 questionnaires were sent out and 507 responses were received. The response rate was 84.5%. The research tool used was the structured questionnaire designed for literature review. The questionnaire was divided into two parts: basic personal information and work-related stress. Based on 5-point Likert Scale, the valid of the recovered questionnaire went through data classification, coding, sorting, tallying and listing. And then, quantitative data processing and analysis was performed with IBM SPSS17.0.
Results：
Of the valid samples, the number of females was the biggest with 478 persons accounting for 94.3%. The major age range was over 51, totaling 232 persons which amounted to 45.8%. The marriage status was mostly married. There were 325 persons amounting to 64.1%. The majority of education background was above senior high school. It totaled 353 persons and accounted for 69.6%. The workplace at most was the consortium (the association), with 371 persons, and the percentage was 73.2%. In terms of caregiving experience, most were inexperience, the number of which was 498 persons and the rate was 98.2%. As far as work experience was concerned, most had above 4 years, totaling 123 persons which were equivalent to 24.3%. On the part of self-perceived physical fitness, 274 persons felt acceptable, whose rate was 54.2%. In terms of stress management training, 162 persons hadn’t taken any training course, the number of which was at most and accounted for 32%. Of the subjects receiving regular in-service education, 87.6% (444 persons) had felt enlightened, which was the largest part. The salary level at most was NT$20,000 to NT$30,000. 306 persons were in this salary range and the rate was 60.4%.
The results revealed the work-related stress level of the home caregiver ranged between light and moderate and was closer to moderate. 4 categories stood out the most as followed: 1. Female (The average value was 60.15 and standard deviation 14.93.) 2. Unmarried (The average value was 61.63 and standard deviation 14.89.) 3. Self-perceived poor physical fitness (The average value was 74.79 and standard deviation 18.29.) 4. Thoughts about in-service education organized by the institute (The average value was 59.02 and standard deviation 14.72.) Of the 4 sections of the stress categories, knowledge and technique were on the top. The others listed in sequence were work nature, interpersonal relationship and administration. The highest stress was: “I have to deal with incorporate, irritable and whiny case. It makes me feel pretty stressful.” The lowest stress was: “I don’t get along well with the other personnel, for example coworkers.”
Conclusion and Suggestion：
The principal conclusion was as followed: the home caregiver policy maker as well as the employer should proactively work on measures to relieve the stress on the home caregiver. Work environment that was friendly and offered on-job education both theoretical and practical, was supposed to be established so that work performance could be improved effectively. Besides, strengthening the work ability to address challenge and giving rewards helped make them feel their job as home caregivers makes sense. By doing so, the cohesion and satisfaction in work could be elevated.

並列關鍵字

home care service ； home caregiver ； work-related stress

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