| 摘要: | 本研究之目的是探討護理長具備的管理技能及其影響因素，同時比較護理長與護士對「護理長具備的管理技能」在認知上的差異。調查對象是在衛生署八十三年評鑑合格的台北市區域醫院服務，擔任護理長年資滿一年的護理長及其管轄單位的護士；研究工具為「管理技能量表」結構型問卷，共計38項，採Likert五分法計分。本研究採立意取樣，共發出問卷500份，有效回收率為87．4%(護理長108份、護士329份)。問卷回收後，以t-檢定、單因子變異數分析及皮爾森積差相關分析及逐步複迴歸等方法進行資料分析。
研究結果發現：(一)護理長與護士認知護理長具備之管理技能的平均值介於3.0?4.0分之間，屬於中上程度。(二)護理長認知自己具備的各層面管理技能之分數轉換成一百分的標準化分數為76.43?79.95分。(三)護理長認知自己最具備的十項管理技能依序是(1)熟練本科臨床技術的操作、(2)協調相關單位的能力、(3)適當授權的能力、(4)績效考核公正的能力、(5)保養維護醫療儀設備的能力、(6)處理意外事件的能力、(7)理解護理倫理原則、(8)維持工作環境安全的能力、(9)制定單位護理工作標準及(10)解決衝突的能力。護士認知護理長最具備的十項管理技能有(6)表達技巧及(10)與上司相處的技巧兩項與護理長的認知不同。(四)護理長的婚姻狀況不同在人際關係性技能上有顯著差異；護理長的工作單位性質不同在人際關係和領導統御技能上有顯著差異；護理長是否曾接受管理的訓練僅在財務管理技能上有顯著差異；護理長的年齡與其認知台已具備的管理技能僅在領導統御技能上有正相關。(五)護士的婚姻狀況不同與其認知護理長具備之管理技能在人際關係、概念性及領導統御等技能上有顯著差異；護士的工作單位性質不同對護理長管理技能認知在技術性、人際關係、概念性及領導統御等技能上有顯著差異；護士的年齡、服務年資與其認知護理長具備的管理技能之間有正相關。(六)護理長與護士認知護理長具備的管理技能有九項有顯著差異：(1)熟練本科臨床技術之操作、(2)應用護理研究結果、(3)具備護理研究概念、(4)應用病人分類系統的能力、(5)激勵士氣的能力、(6)運用成本效益分析結果、(7)與上司相處的技巧、(8)績效考核公正的能力、(9)為部屬爭取合理權益的能力。
The purpose of this study is to explore management skills considered essential to the head nurse''s management. A comparison of head nurses'' and staff nurses'' perceptions toward head nurses'' management skills was also examined. Subjects were recruited from regional hospitals in Taipei. Inclusion criterion was head nurses with more than one year''s management experience. A self-developed questionnaire (Management Skills Scale; MSS) was used for data collection. Five hundred questionnaires were sent out with a returned rate of 87.4 % (108 head nurses and 329 staff nurses). Data were analyzed using t-tests, ANOVA, Pearson''s correlation coefficient and stepwise multiple regression.
Major findings of this study were as followed:
1. The head nurses'' and staff nurses'' perceptions toward head nurses'' management skills were all above average (x=3.0-4.0).
2. The standard pereentile values for head nurses'' perception toward their own management skills were among 76.44-79.44.
3. The top ten management skills perceived by head nurses were (1) being familiar with clinical techniques, (2) competence in interdisciplinary coordination, (3) delegate appropriately, (4) fairness in performance appraisal, (5) maintenance of medical equipment, (6) management of accidents, (7) knowledgeable about nursing ethical principles, (8) maintenance of working environment safety, (9) setting up of nursing practice standards, and (10) ability in conflict resolution. Two management skills perceived by staff nurses differed from head nurses'' top-ten list were (6) skills of expression and (10) skills in getting along with superiors.
4. Head nurses'' marital status had a significant impact on their interpersonal skills. Head nurses'' interpersonal skills and leadership competency were significantly influenced by the wards they worked. Financial management skill was the only factor related whether or not head nurses having received training for management skills. Age was positively related to head nurses'' self-perception of leadership competency.
5. Staff nurses'' marital status would influence their perception of head nurses'' interpersonal skills, conceptual skills, and leadership competence. Nurses'' age and their nursing experience were also positively related to their perception of head nurses'' management skills. The characteristics of hospital wards where nurses'' worked had significant impact on their perceptions of head nurses'' technical competence, interpersonal relationship and conceptual skills.
6. There were nine items which were significant differences between head nurses and staff nurses perceptions of head nurses'' management skills: (1) familiar in clinical techniques,(2) application of nursing research findings, (3) competence in nursing research concepts, (4) application of patient classification systems, (5) competence of motivate morale, (6) utilization of cost-benefit results, (7) getting along with superiors, (8) fairness in performance appraisal, and (9) compete for members'' best interests. |
