| 摘要: | 本研究旨在探討居家護理師工作壓力及工作滿足感之相關性。研究目的包括：瞭解居家護理人員感受工作壓力源及壓力程度與工作滿足感的現況；探討居家護理人員背景資料的不同與其感受工作壓力源、壓力感受程度與工作滿足感之差異；分析居家護理人員工作壓力源、壓力感受程度及工作滿足感之相關性；以及找出影響居家護理人員工作壓力源、工作壓力感受程度及工作滿足感之重要因素。採量性研究之橫斷式相關性研究設計，以目前提供居家護理機構的現職居家護理人員且平均每月訪視量大於0次為研究對象，將台灣地區醫院型態194家、衛生所102家、獨立型態48家，以分層隨機抽樣方式抽出居家護理機構，共寄出200份問卷，回收187份問卷，實際有效問卷共計163份（有效回收率81.5%）。研究工具乃為自擬結構式問卷，其效度CVI值達0.94以上，Cronbach’s Alpha值介於0.80-0.94之間。研究結果以SPSS10.0套裝軟體進行分析。
結果發現，目前台灣地區居家護理人員感受自護理專業技術方面壓力最大。以工作中常覺得有很多做不完的事為最大壓力感受程度。在工作滿足感方面則以對於工作中與單位同事相處最令人滿意。研究亦發現接受居家護理訓練課程及機構提供獎金制度情形與工作情境、護理專業知識方面壓力源呈顯著微相關，且教育程度、婚姻狀況、機構屬性、職稱、長照協會訪查等級與參與居家護理成長團體情形在病人照護、工作情境、專業知識、專業技術、專業態度等壓力源皆有其差異性。機構提供獎金制度情形與機構屬性亦與壓力感受程度呈微相關。居家護理職前訓練、長照協會訪查與縣市督考結果、在職進修學制與工作滿足感亦有其差異性。此外，壓力感受程度與六大層面工作壓力源呈正相關。病人照護、工作情境與專業態度方面壓力源則與內外在、整體滿足感有顯著負相關。複迴歸分析發現專業態度與工作情境等方面工作壓力源能解釋居家護理人員壓力感受程度之40.1%的總變異量。而專業態度、居家護理職前訓練、居家個案百分比與縣市督考結果等方面工作壓力源則能解釋居家護理人員工作滿足感之21.8%的總變異量。
研究發現工作壓力與工作滿足感有其相關性。建議未來鼓勵居家護理人員參加居家護理成長團體、定期舉辦居家護理相關之在職教育以及督促護理紀錄電腦化，將有助於降低工作壓力提高工作滿足感。
The purpose of the study was to describe home care nurses’ perceptions on job stressors, job stress and job satisfaction; to explore the relationship between home care nurses’ characteristics and their perceived job stressor, job stress and job satisfaction; to examine the correlations among home care nurses’ perceived job stressors, job stress and job satisfaction; and finally to identify factors predicting their job stress and job satisfaction. The cross-sectional, correlational research design was used. Target population of this study were all qualified home care nurses who had made home visit at least once per month. Stratify sampling was used to mail 200 questionnaires to 194 home care agencies. A total of 163 valid returned (response rate: 81.5%). The research instruments were self developed with acceptable content validity (CVI > .94) and internal consistency (α ＝ .80 - .94).
The results revealed that home care nurses perceived highest on the professional technique as the job stressor. “Often oncerning that there are many things in the work can not finish” ranked highest on stressor perception. Home care nurses felt most satisfied on “geting along with unit's co-worker in the work” among job satisfaction items. Study also found stressors of working situation and professional knowledge were relate to participation of the
training program and whether home care agencies offering the bonus system situation. Home care nurses characteristics of educational degree, marital status, agencies’ attribute, professional title, accredation by Taiwan Long-Term Care Professional Association and participation of home care nurses’ self- development group also had significant associations with their job stressors in patient care, working situation, professional knowledge, professional technique and professional attitude domains. Minor correlations between perceived job stress and home care agencies attribute and with bonus policy had also been identified. Home care nurses’ characteristics on pre job training, accredation by Taiwan Long-Term Care Professional Association and governmental body, in-service schooling were significantly relate to job satisfaction. Finally, there were positive correlation between job stress and all 6 domains of job stressors; and negative correlations between patient care, working situation and professional attitude job stressors and internal, external and general domains of the job satisfaction. Results of multiple regression identified the major factors predicting perceived job stress were professional attitude and working situation stressors and these two variables can explained 40.1% of variance. The training program of the home care nurses, proportion of home care cases and results of the counties or cities’ accreditation were 4 variables that predicting job satisfaction (21.8% of variance).
In order to promote home care nurses’ job satisfaction, encourage home care nurses to attend home care nurses’ self-development group, hold a home care nurses’ related in-service training program periodically and to reinforce computerization of nursing record were recommended. |
