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  • 學位論文

以Maslow需求理論比較急診護理人員需求與滿足度之差異

Apply Maslow’s need hierarchy theory to compare the difference between needs and satisfaction among Emergency department nurses

指導教授 : 鄭綺

摘要


由於護理人力短缺、醫院縮床以及病人的增加,以致急診壅塞,因而造成醫療照護品質和病人滿意度下降。本研究目的為運用Maslow需求理論比較急診室護理人員需求與滿足度之差異。本研究為三角交叉研究(Triangulation),第一階段採用質性研究法,依相關文獻及研究目的擬定訪談指引,以焦點團體式座談進行資料收集。第二階段以研究者發展的結構式問卷收集資料。研究樣本為某醫學大學三家附屬醫院及中部某醫院急診工作之護理人員,自103年3月1日至103年8月31日止,問卷發出151份,回收問卷143份,回收率94.7%,研究工具包括「基本資料表」及自擬之「急診護理人員需求量表」,自擬之急診護理人員需求量表共34題,分為五大類,經專家效度檢定,取內容重要性CVI達.86之項目,信度檢定採內在一致性Cronbach’s Alpha值為.951。個案需依據問卷中每一題,以四分量表分別勾選其需求和滿意程度。 所收集之資料以SPSS 22.0統計軟體進行資料建檔,所採用描述性統計方式包括次數分配、百分比、平均值、標準差;推論統計部分則採用t檢定、ANOVA檢驗、Multiple regression with stepwise procedure。 研究結果顯示: 一、以馬斯洛需求理論來看,急診護理人員最需要的是安全需求,其他依序為愛和歸屬感、生理需求、自尊,最後則為自我實現,而最滿足的依序為愛和歸屬感、自我實現、自尊、生理滿足度,最後則是安全。 二、急診護理人員各項需求及滿足度之間均達顯著差異(p<0.0001),,代表急診護理人員所有的滿足度均顯著低於其需求度。 三、影響急診護理人員需求度之因素有:性別、學歷、婚姻、月收入、年齡。『婚姻狀況』、『收入』為生理需求度的顯著預測因子(F=6.041,p<.0001),而『常上班別』為安全需求度的顯著預測因子(F=4.352,p<.0001),『醫院別』、『收入』、『最高學歷』為自尊需求度的顯著預測因子(F=7.467,p<.0001)。影響急診護理人員滿足度之因素有:學歷、婚姻、能力進階、月收入、單位排班等,也與年齡、工作年資及急診工作年資呈現顯著負相關。而『年齡』、『醫院別』則為生理滿足度之顯著預測因子(F=9.948,p<.0001),『急診工作年資』、『常上班別』為安全滿足度之顯著預測因子(F=6.335,p<.0001),『醫院別』為愛和歸屬感滿足度的顯著預測因子(F=5.910,p<.0001),『醫院別』是自尊滿足度的顯著預測因子(F=6.941,p<.0001)及『醫院別』為自我實現滿足度的顯著預測因子(F=4.190,p<.0001)。 本研究結果可提供給護理主管瞭解到急診護理人員的需求為何,針對護理人員最關注的安全需求,進行制度面的革新,進而制定相關政策來增加護理人員安全滿足度,並著手改善護理工作環境,讓護理人員能夠安心地上班,讓她們有更多的時間去照護病人,提升護理品質,減少異常事件的發生率。

並列摘要


Because of lack of nurse manpower and hospital beds and increased patients, emergency rooms are always overcrowded with patients that resulted in decreasing the quality of medical care and patient satisfaction. The purpose of this study was to apply Maslow’s need hierarchy theory and to compare the difference between needs and satisfaction among emergency department nurses. A triangulation research method was used in this study. A qualitative research method was adopted at the first stage of this study. According to the relevant literature and research purposes, we developed interview guidelines to collect data by conducting focused group discussion. A structured questionnaire developed by the researcher was used for data collection at the second stage of this study. The study sample from the emergency room nurses in the three affiliated hospital of a medical college and a hospital in the middle part of Taiwan. since March 1 103 to 103 on August 31, issued 151 questionnaires were returned 143 questionnaires, 94.7% response rate. The research tool includes 34 questions which can be sorted into five main categories. The CVI of the tool was .86 and the internal consistency Cronbach's Alpha value was .951. The subjects reported the degree of needs and satisfactions for each item with a 4-point Likert scale. SPSS 22.0 statistical software was used for data analysis. The descriptive statistical methods include the number of distribution, percentage, mean, standard deviation and the inferential statistical methods include t test, ANOVA test and multiple regressions with stepwise procedure. The research results are shown below: 1. From Maslow's theory, the most necessary from emergency nurses is security needs, other sequences are love, sense of belonging, physical needs, self-esteem, and self-actualization. However, the most satisfying sequences are love, sense of belonging, self-actualization, self-esteem, physical satisfaction, and the last one is safe. 2. A significant difference between needs and satisfactions from emergency nurses was observed (p <0.0001). The result revealed that the satisfaction of emergency nurses were significantly lower than the degree of their needs. 3. The impact factors of needs from emergency nurses were gender, education, marital status, income, age. The marital status and income are significant predictors of physical needs (F = 6.041, p<.0001). "more often work shift" is a significant predictor of security needs (F=4.352, p<.0001 ). "different hospitals", "income", and "educational level" were significant predictors of needs of self-esteem (F=7.467, p<.0001). The main influence factors for satisfaction among emergency nurses were education, marriage, advanced capability, monthly income, unit scheduling, etc. Also, a negative relationship between satisfactions and age, job seniority and years of emergency work was observed. The "age" and "different hospitals" were significant predictors of physiological satisfactions (F= 9.948, p<.0001). "Emergency work seniority" and "more often work shift" were significant predictors of satisfaction of safety (F=6.335, p<.0001). "Different hospitals" as a significant predictor of satisfaction of both love and belonging (F=5.910, p<.0001). "Different hospitals" was a significant predictor of satisfaction of self-esteem (F=6.941, p<.0001) and "different hospitals" was a significant predictor of self- actualization of satisfaction (F= 4.190, p <.0001). The results of this study can provide the useful data to the nurse supervisors. Let them understand the needs of emergency nurses and pay attention on the security needs of nurses. Moreover, the policy can be modified and more nurse friendly law should be established. Based on the complete policy or laws, nurse will have safety working environment and give the better health care for patients. Therefore, the quality of health care can be improved and reduce the opportunity of adverse events.

並列關鍵字

emergency nurses need satisfaction

參考文獻


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