護理人員工作輪調、工作壓力與組織承諾相關性探討-以南部某區域教學醫院為例

A Study on Relationships among Nursing Staff Job Rotation, Job Stress, and Organizational Commitment： A Case of a Southern Regional Teaching Hospital

陳小芳(Hsiao-Fang Chen)

指導教授 ： 陳金淵

長榮大學/健康科學學院/醫務管理學系(所)/碩士(2012年)

https://doi.org/10.6833/CJCU.2012.00064

摘要

目的 護理職業是一高壓力的服務專業，護理人員常因工作壓力而影響從業意願。工作輪調旨在強化護理多功能的專業能力，醫院面對護理人力不足的困境，工作輪調形同任務支援，本研究意在探討，護理人員在人力短缺下的工作輪調，是否淪為填補人力的變相作法，成為護理人員的工作壓力，進而影響護理人員的組織承諾，以及工作壓力是否影響工作輪調與組織承諾間之關係。
方法 本研究採用結構式問卷，以南部某區域教學醫院全體護理人員為研究對象，發出300份，回收有效問卷267份(89.9%)。回收問卷經整理後，以SPSS進行差異性、相關性、複迴歸等統計分析，並檢測工作壓力之中介效果。
結果 年齡、能力進階層級、雇用類別、班別、薪資、輪調接受度對工作輪調及組織承諾具顯著差異，整體工作輪調與工作壓力達顯著負相關（r＝-0.144, p＜0.05）。其中，輪調意願與工作壓力有顯著負相關（r＝-0.400, p＜0.01），而輪調技能獲得與工作壓力有顯著正相關（r＝0.724, p＜0.01）。整體工作輪調與組織承諾達顯著正相關（r=0.569, p＜0.01）。而工作壓力與組織承諾有顯著負相關（r＝-0.405, p＜0.01）。透過複迴歸分析顯示，工作輪調分別可以解釋工作壓力及組織承諾29.2%及40.6%之變異量，其中輪調意願對工作壓力有負向預測力(β=-0.292)，而對組織承諾有正向預測力(β=0.469)，輪調技能獲得對工作壓力有正向預測力(β=0.235)。工作壓力中以行政管理構面對組織承諾有負向預測力(β=-0.508)；工作輪調與工作壓力對組織承諾具解釋力，經交互探索，工作壓力對工作輪調及組織承諾具部份中介影響力。
結論 醫院聘用正職護理師，避免同工不同酬，可提昇護理人員工作輪調及組織承諾的正向思維，而工作輪調影響整體工作壓力，透過工作壓力，將影響組織承諾；故，管理者應尊重護理人員的輪調意願，確認工作輪調真正意義和目的，了解其壓力感受；公平地進行輪調，輪調過程中，適當規劃學習的技能，可促進護理師人員的專業技能，進而接受醫院的目標與價值，也願為醫院付出更多努力。

關鍵字

工作輪調 ； 工作壓力 ； 組織承諾 ； 護理人員

並列摘要

Objectives Nursing is a profession with high stress, which influences nurses’ willingness to practice. Therefore, job rotation has been implemented to diversify nursing staff skills and strengthen mutual support function. However, job rotation sometimes becomes alternatives to manpower shortage and results in increased workload. This study was thus aimed to examine the impact of job rotationon on job stress and the mediating effect of job stress between job rotation and organizational commitment.
Methods A structured questionnaire was developed and 300 copies were distributed to nursing staff in a southern regional hospital. 267 valid questionnaires were collected with a response rate of 89.9%. With the aid of SPSS for Windows, difference analysis, correlation analysis, and regression modeling were conducted and the mediating effect of job stress was examined.
Results The results show that there were significant differences in job rotation and organizational commitment for age, clinical ladder level, type of employment, working shift, amount of salary, and acceptance of job rotation. There existed significant negative associations between overall job rotation and job stress (r＝-0.144, p＜0.05) and the willingness of job rotation and job stress (r＝-0.400, p＜0.01), and a significant positive correlation between skills acquired during job rotation and job stress (r＝0.724, p＜0.01). In addition, the overall job rotation had a positive correlation with organizational commitment (r=0.569, p＜0.01). while the job stress had a negative correlation with organizational commitment (r＝-0.405, p＜0.01).
The multiple regression models show that job rotation could explain 29.2% and 40.6% of variances for job stress and organizational commitment, respectively. Meanwhile, the willingness of job rotation had a negative regression coefficient in predicting work pressure (β=-0.292) but had a positive regression coefficient in predicting organizational commitment (β=0.469). Skills acquired during job rotation had a positive regression coefficient in predicting job stress (β=0.235).
The administrative management dimension had a negative regression coefficient in predicting organizational commitment (β=-0.508). The job rotation and job stress each had an explanatory power for organizational commitment. A further exploration shows that job stresshad a partial mediating effect between job rotation and organizational commitment.
Conclusions Hospitals should hire formal nurses to avoid different wages for the same job on the one hand, and to improve positive thoughts of job rotation and organizational commitment for nursing staff on the other hand. Job rotoation can influence job stress, which in turn will affect organizational commitment. Therefore, the manager should respect nurses’ willingness of job rotation, ensure the meaningfulness and goals of job rotation, and understand nurses’ feelings about job stress. With a fair scheme of job rotation and proper learning schedule, nurses could enhance their professional skills, recognize the organization’s goals and values, and be willing to devote more efforts to work for the hospital.

並列關鍵字

job rotation ； job stress ； organizational commitment ； nursing staff

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