| 摘要: | 本研究目的在探討臨床基層護理人員的向上影響行為使用頻率與有效性,並探討不同基本屬性的護理人員向上影響行為的使用頻率與有效性的差異及相關性,同時比較不同層級醫療機構的臨床護理人員其向上影響行為頻率與有效性的差異性。本研究採橫斷式的調查法,以分層隨機取樣的方式,針對衛生署85-87年醫院評鑑結果,北部地區公私立醫學中心、區域醫院、地區教學醫院等共十所醫院的臨床基層護理人員,以自擬結構式問卷"護理人員向上影響行為及其有效性問卷調查表"來收集資料。收案日期為88年9月中旬至同年11月上旬,共發出問卷360份,回收346份,回收率96.11%,其中有效問卷332份,回收問卷有效率為92.22%。資料以描述性統計、單因子變異數分析、Pearson*s 積差相關係數分析等統計方法進行處理與分析。
研究結果發現:1.護理人員向上影響行為使用頻率平均得分為1.62分(標準差0.33),介於從不使用到很少使用之間，六種向上影響行為中，以理性說服平均得分最高，為2.64(標準差0.65)；以非理性施壓得分最低為1.21(標準差0.24) 2.護理人員向上影響有效性平均得分為1.77分(標準差0.46),介於毫無效果到很少效果之間。在六種向上影響行為有效性中，以理性說服平均得分最高，為2.80(標準差0.63)；以非理性施壓得分最低為1.32(標準差0.42)。3.護理人員的基本屬性方面:護理人員所屬的病房科別、醫院層級、公私立醫院間與護理人員向上影響行為使用頻率有統計學上的顯著差異;護理人員的年齡、工作年資、在病房年資等因素在理性說服的影響行為中有顯著的相關性;病房護理人員數愈多,在各種向上影響行為的使用頻率皆愈低。4.護理人員的病房科別與向上影響行為有效性呈統計上的顯著差異,病房護理人員數愈多,在各種向上影響行為有效性皆愈低。5.護理人員向上影響行為使用頻率與有效性間達統計學上的顯著相關,且各種向上影響行為頻率與有效性間呈現顯著的正相關,顯示護理人員愈常使用的向上影響行為,其影響的有效性愈高。
由本研究結果可以了解,護理人員向上影響行為使用最多的是正向影響行為，其影響的有效性也最高，而負向的影響行為則較少使用，其影響的有效性也較低。護理人員若對於向上影響行為能有更多瞭解與正確使用,則向上影響行為將更有效,且能增加工作的成就感;護理長若能知曉護理人員的向上影響行為,則在管理與督導護理人員時更能達到有效性;醫院在作在職訓練時,加入護理人員向上影響行為的知識,將可促進護理管理者與其部屬之間的溝通。本研究結果應可以提供未來的研究方向、護理人員在職教育課程的設計及護理管理的參考。
The objective of this thesis was to explore the frequency and the effectiveness of the clinical nurses* upward influence behaviors .While trying to find out the frequency and the effectiveness of upward influence behaviors initiated by nurses of different attributes, comparisons and contrasts among different levels of medical institutions were included as well.
Were posted out in mid-September 1999 to randomly selected clinical nurses and 346 were returned (response rate 96.11%) within two months, in which 332 of them were valid (valid rate 92.22%).All raw data were processed and analysed by using descriptive statistics, one way ANOVA ,and Pearson*s correlation.
Several Phenomena were presented in the analysed data:
1. The mean of the nurses* upward influence behaviors frequency was 1.62(SD=0.33) and much below moderate. Among the six upward influence behaviors ,the logic persuade method had the highest score (mean=2.64,SD=0.65) and the non-reasonable pressure method had the lowest score (mean=1.21,SD=0.24).
2.The mean of the nurses* upward influence behaviors effectiveness was 1.77(SD=0.46) and much below moderate. Among the six upward influence behaviors ,the logic persuade method had the highest score (mean=2.80,SD=0.63) and the non-reasonable pressure method had the lowest score (mean=1.32,SD=0.42).
3.It suggested that the frequencies of upward influence behaviors were significantly different among nurses of various attributes with which their ages and their tenures were highly associated. The more nurses in the unit,the lower the frequency.
4. As to the effectiveness of the nurses* upward influence behaviors, the results also disclosed that there were significant differences among different unit. The more nurses in the unit , the lower the effectiveness.
5. The overall results showed in contrast that the effectiveness of the nurses* upward influence behaviors was positively relatived to the frequency. The more often nurses exercise upward influence, the higher effectiveness they can achieve.
Therefore ,the results showed the most frequently used upward influence behaviors by nurses* were the positive behaviors and their effectiveness of the upward influence behaviors were high .The least frequently used upward influence behaviors were the negative behaviors and their effectiveness were low. The research had a tendency to suggest that clinical nurses enhance the effectiveness of upward influence behaviors and meanwhile increase their sense of fulfilment by better understanding how to exercise upward influence behaviors. This can furthermore help the head nurses to manage and supervise their follow nurses. In addition , medical institutions should provide correct knowledge about upward influence behaviors in their in-work training programs so as to attain more harmonious relationship between management staffs and their follows .In a nutshell, the results of this study offered possible directions for future researches, suggested course designing for hospital in-work training programs, and at the same time provided references to nursing management. |
