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| 題名: | 支持團體對腫瘤病房護理人員工作壓力及職業疲潰之成效 |
| 作者: | 林惠蘭 |
| 貢獻者: | 護理學研究所 |
| 關鍵詞: | 腫瘤病房護理人員 工作壓力 職業疲潰 支持團體 |
| 日期: | 2010 |
| 上傳時間: | 2010-10-20 13:05:03 (UTC+8) |
| 摘要: | 護理工作是醫療照護體系中具高度壓力的工作之ㄧ，而照護腫瘤疾病患者對護理人員而言更是極富挑戰性的工作，因為惡性腫瘤是威脅生命的疾病，病人及家屬面對身心健康、事業及家庭生活巨大的衝擊，腫瘤病房護理人員則須面對長期受疾病折磨的病人與身心俱疲的家屬、日新月異的治療方式、繁瑣多變的化學藥物療程，更要經常面對照護末期及瀕死病人的無力感，使得腫瘤病房護理人員承受相當程度的工作壓力。當長期工作壓力無法有效因應時，即可能經驗到生理、情緒及心智耗竭等職業疲潰現象，甚而降低留任的意願及影響病人照護品質，因此，非常値得賦予深切的關注。
本研究目的在瞭解腫瘤病房護理人員工作壓力與職業疲潰感受程度及其相關因素，並探討支持團體介入對工作壓力及職業疲潰之成效。研究設計採兩組前後測之類實驗研究法，以台灣北部某醫學中心腫瘤科病房護理人員為母群體，招募60名護理人員，隨機分派為實驗組或對照組各30人，再將實驗組護理人員分為兩組，每組成員15人。研究者針對實驗組護理人員施予每週一次，每次2小時，共8次之支持團體介入措施，對照組則未給予任何介入措施。研究工具包括護理工作壓力量表、職業疲潰量表及支持團體計畫。於進行支持團體前及完成8次支持團體後，分別進行兩組護理人員之問卷測量。研究資料以SPSS 17.0中文版統計軟體處理，以描述性統計、卡方檢定、獨立樣本t檢定、相依樣本t檢定、單因子變異數分析、皮爾森積差相關、迴歸分析、及重複測量變異數分析等統計方法進行資料分析，統計顯著水準訂為α=.05。
研究結果顯示：(1)腫瘤病房護理人員之工作壓力總分平均值為156.1分，單項平均值為3.6分；職業疲潰總分平均值為54.8分，單項平均值為2.5分，顯示工作壓力及職業疲潰均屬中等程度。(2)腫瘤病房護理人員之工作壓力與職業疲潰有顯著正相關，即工作壓力感受程度愈高者其職業疲潰程度愈高，工作壓力可顯著預測職業疲潰程度，其預測力達36.8％。(3)年齡、腫瘤護理年資及護理工作年資與工作壓力有顯著負相關，即年齡愈小、腫瘤護理年資及護理工作年資愈資淺者，其工作壓力程度愈高；不同僱用職別其工作壓力及職業疲潰程度均有顯著差異，契約護理師顯著高於公職護理師。(4)腫瘤病房護理人員接受支持團體介入後，其工作壓力及職業疲潰程度均顯著低於支持團體介入前；接受支持團體介入的腫瘤病房護理人員，其工作壓力及職業疲潰程度均顯著低於未接受支持團體介入者，驗證支持團體介入對於改善腫瘤病房護理人員之工作壓力及職業疲潰確實具有成效。
本研究結果可提供護理主管於安排工作場所相關支持計畫之參考，以營造優質的護理工作環境，減少工作壓力及預防職業疲潰，進而提升護理照護品質。
Oncology nurses have been seen as a group at risk for job stress and burnout. In general, they are exposed to patients’ and their relatives’ suffering, an increase in the complexity of cases and available treatment options for patients, being unable to control the results of efforts, the need to cope with death, and a high level of physical exhaustion without psychological support to their need. Moreover, job stress and burnout may consequently negative impact on the retention of oncology nurses and quality of patient care. Therefore, it will be beneficial for oncology nurses, if administrator can be sensitive to potential factors that lead to job stress and burnout, and construct an effective psychological support mechanism.
The aim of this study was to understand the job stress and burnout level in oncology nurses, and to explore the effectiveness of support group on job stress and burnout among oncology nurses. The two-group Quasi-experimental design was use in this study. Sixty nurses working in oncology ward of a medical center were invited. Thirty nurses were random assigned to an experimental group, in which they received a 8-weeks support group serve as intervention, and thirty nurses were random assigned to a control group without intervention. The questionnaires included the Nurse Stress Checklist and the Maslach Burnout Inventory. Data were collected before and after the 8-weeks support group. The SPSS 17.0 for windows statistic software was apply as the tools for statistic analysis. The statistic methods are as follow: descriptive statistics, Chi-Square, t-test, ANOVA, Pearson correlation, regression, and repeated measure ANOVA. α=.05 was considered as statistically significant.
The important findings were as the following: (1) the mean score of the subjects’ total job stress and burnout were 156.1 and 54.8, respectively. the mean score of the subjects’ each item of job stress and burnout were 3.6 and 2.5, respectively; (2) there was a significant positive correlation between job stress and burnout; (3) it was determined that variables influencing job stress were age, years in oncology nursing, years in nursing, and employment status. oncology nurses who were younger and junior suffered significantly higher level of job stress; (4) by affiliation support group can reduce the level of job stress and burnout among oncology nurses. These results might provide ideas for nursing administrator to develop effective support group, in order to release job stress and burnout effectively, and then work effectively. |
| 關聯: | 139頁 |
| 描述: | 目 錄
頁數
致 謝 I
中文摘要 III
英文摘要 V
目 錄 VII
圖表目次 X
第一章 緒論 1
第一節 研究背景與動機 1
第二節 研究目的 4
第三節 研究假設 5
第四節 名詞界定 6
第二章 文獻查證 8
第一節 壓力與工作壓力之概念 8
第二節 腫瘤病房護理人員工作壓力 11
第三節 腫瘤病房護理人員職業疲潰 16
第四節 支持團體 22
第五節 概念架構 28
第三章 研究方法 30
第一節 研究設計 30
第二節 研究對象 32
第三節 倫理考量 33
第四節 研究工具 34
第五節 研究步驟 39
第六節 資料分析計畫 42
第四章 研究結果 46
第一節 研究對象個人屬性 46
第二節 腫瘤病房護理人員工作壓力與職業疲潰感受程度 54
第三節 工作壓力與職業疲潰之關係 61
第四節 個人屬性與工作壓力之關係 65
第五節 個人屬性與職業疲潰之關係 72
第六節 支持團體介入之成效 76
第五章 討論 83
第一節 個人屬性及前測工作壓力與職業疲潰之差異性 83
第二節 工作壓力與職業疲潰感受程度 84
第三節 工作壓力與職業疲潰之相關性 87
第四節 個人屬性與工作壓力及職業疲潰之相關性 88
第五節 支持團體介入之成效 93
第六章 結論與建議 97
第一節 結論 97
第二節 研究貢獻 99
第三節 研究限制與建議 100
參考資料 102
中文部分 102
英文部分 105
附 錄 112
附錄一 招募海報 112
附錄二 實驗組受試者同意書 113
附錄三 對照組受試者同意書 116
附錄四 護理人員壓力量表 119
附錄五 「護理人員壓力量表」使用同意函 121
附錄六 職業疲潰量表 122
附錄七 「職業疲潰量表」使用同意函 123
附錄八 支持團體活動進度表 124
附錄九 焦點團體座談 125
附錄十 「支持團體活動進度表」修訂版 127
附錄十一 專家內容效度之專家名單 129
附錄十二 致專家信函及評分表 130
附錄十三 專家內容效度評分結果 135
附錄十四 專家內容效度及建議 136
附錄十五 「支持團體活動進度表」最終版 138
圖表目次
頁數
圖一 支持團體介入對腫瘤病房護理人員工作壓力及職業
疲潰成效之概念架構圖 29
圖二 支持團體對腫瘤病房護理人員工作壓力及職業疲潰
成效之研究流程圖 41
表一 類實驗研究法之實驗組與對照組前測及後測設計 31
表二 描述性統計分析 44
表三 推論性統計分析 45
表四 腫瘤病房護理人員個人屬性之類別變項分布 47
表五 腫瘤病房護理人員個人屬性之連續變項分布 48
表六 兩組腫瘤病房護理人員個人屬性類別變項之比較 50
表七 兩組腫瘤病房護理人員個人屬性連續變項之比較 51
表八 腫瘤病房護理人員支持團體成員出席率 53
表九 腫瘤病房護理人員工作壓力感受程度 55
表十 腫瘤病房護理人員工作壓力感受程度各項目排序 56
表十一 腫瘤病房護理人員職業疲潰感受程度 59
表十二 腫瘤病房護理人員職業疲潰感受程度各項目排序 60
表十三 兩組腫瘤病房護理人員工作壓力與職業疲潰之比較 62
表十四 腫瘤病房護理人員工作壓力與職業疲潰之皮爾森積
差相關分析 63
表十五 腫瘤病房護理人員工作壓力與職業疲潰之迴歸分析 64
表十六 腫瘤病房護理人員個人屬性與工作壓力之差異性
比較 67
表十七 腫瘤病房護理人員個人屬性與工作壓力之單因子
變異數分析 68
表十八 腫瘤病房護理人員個人屬性與工作壓力之皮爾森
積差相關分析 69
表十九 腫瘤病房護理人員個人屬性與工作壓力之迴歸分析 70
表二十 腫瘤病房護理人員個人屬性與工作壓力之逐步複迴
歸分析 71
表二十一 腫瘤病房護理人員個人屬性與職業疲潰之差異
性比較 73
表二十二 腫瘤病房護理人員個人屬性與職業疲潰之單因
子變異數分析 74
表二十三 腫瘤病房護理人員個人屬性與職業疲潰之皮爾
森積差相關分析 75
表二十四 實驗組腫瘤病房護理人員前後測工作壓力與職
業疲潰之比較 78
表二十五 對照組腫瘤病房護理人員前後測工作壓力與職
業疲潰之比較 79
表二十六 兩組腫瘤病房護理人員工作壓力與職業疲潰前
後測差異之比較 80
表二十七 兩組腫瘤病房護理人員工作壓力之重複測量變
異數分析 81
表二十八 兩組腫瘤病房護理人員職業疲潰之重複測量變
異數分析 82
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