護理人員工作環境感受與留任意願之相關性探討

Explore the relationship between nurses’ perceptions of their work environment and intention to stay.

郭富美(Fu-Mei Kuo)

指導教授 ： 劉怡

高雄醫學大學/護理學院/護理學系研究所/碩士(2012年)

https://doi.org/10.6832/KMU.2012.00055

摘要

背景：台灣護理人員離職率逐年上升。因此，如何留任優良護理人員，是目前醫院管理者刻不容緩需積極面對的課題。過去許多相關研究大多為探討護理人員離職率或離職意願之相關議題。然而，留任意願對於組織成員離職行為之預測較離職意願對於組織成員離職行為之預測更為有效，故探討與護理人員留任有關之主要護理工作環境因素，更能達到有效留任之改善策略。
目的：旨為瞭解護理人員對其工作環境八大要素(包含組織文化價值、主管的支持、臨床實務之管控、臨床自主性、護理人力配置、醫護關係、護理能力及教育支持之)的感受，及其與護理人員人口學變項與留任意願之間的相關性。
方法：本研究採用橫斷式問卷調查法，2010年10月20日至11月3日以南部某醫學中心執業滿一年以上(含三個月試用期)之所有臨床護理人員（不包含副護理長以上層級之主管）做為本研究資料收集的對象。結構式問卷包括護理人員人口學特質調查表、護理人員工作環境感受量表及護理人員留任意願量表等收集資料，共發出問卷220份，回收217份，有效問卷210份，有效問卷率為95.5%。以電腦統計軟體SPSS Statistics 17.0進行資料處理與分析。
結果：(1)本研究之護理人員對工作環境感受的認同程度平均分數仍屬中高程度之認同感。(2)不同的護理年資、婚姻狀態、工作單位及工作職稱的護理人員，對工作環境感受及留任意願有顯著性差異。(3) 護理人員年齡與「護理人力配置」及「醫護關係」構面呈顯著正相關。(4)「護理人力配置」、「醫護關係」、「護理能力」、「教育支持」、「工作年資」及「工作職稱」為護理人員留任意願的顯著解釋因子，可解釋護理人員之留任意願的變異量達57.1%。
討論：本研究將可協助基層主管及醫院行政管理者了解及檢視第一線護理人員對目前工作環境之自覺感受，並作為留任護理人員改善方案之參考，更進一步提昇病人之照護品質。

關鍵字

護理人員 ； 工作環境感受 ； 留任意願

並列摘要

Abstract
Background: Nurses’ turnover rate has greatly increased. Hence, to keep nurses at work has become an important issue for hospital administrators. In the past, most studies focused on nurses’ intention to leave. Compared to intention to leave, intention to stay is a better predictor for employee’s behavior. Therefore it is necessary to explore which essential factors in work environment are related to nurses’ intention to stay so that the improvement strategies might be successful.
Purpose: The purpose was to investigate nurse staffs’ perceptions regarding the eight essentials of work environment, including organizing cultural value, the manager support, control of clinical practice, clinical independence, attending to the staffing, doctors and nurses' relationship, nursing ability and support for the education, as well as the correlation between demographic data and staffs’ intention to stay.
Method: This research adopted the cross-sectional, questionnaire survey design. The survey was conducted among clinical nurse staffs (excluding administrators) with at least one year working experience (including the probation period) in a medical center at the southern Taiwan from October 20 to November 3, 2010. Thequestionnaire included demographic data, essentials of work environment, and intention to stay scale. A total of 220 questionnaires were sent out and 217 were returned. A total of 210 questionnaires (about 95.5%) were valid. The data was then analyzed using software SPSS Statistics 17.0.
Result: (1) The mean score of nurses’ perception on the agreement toward their work environment was at the moderately high level; (2) Among different demographic groups, such as work experiences, marriage status, work units, and work titles, nurses’ perceptions toward work environment and the intention to stay were significantly different;(3) Nurses’ age was positively related to the subscales of attending to the staffing and doctors with nurses' relationship; (4)Four work environment factors (attending to the staffing, doctors and nurses' relationship, nursing ability, and support for the education) and two demographic data (work experience and work title), were significant factors for explaining the variance of intention to stay, which accounted for 57.1%.
Conclusion: This research can be served as the base for hospital administrators to examine the nursing staffs perceptions regarding their work environment and then to make improvement strategies for nurses’ intention to stay so that the quality of health care can be enhanced.

並列關鍵字

nursing staff ； perceptions of work environment ； intention to stay

參考文獻

中文文獻：

于乃玲、胡瑞桃、周碧琴、賴瑞月（1999）。某區域醫院護理人員工作滿意度與留任意願相關性之探討。長庚護理：10(3)，28-37。

牛美雲（2005）．護理人員工作滿意度、組織承諾及留任意願之調查研究─以宜蘭縣護理人員為例．未發表的碩士論文，台北：國立台灣大學公共衛生學院醫療機構管理研究所。

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