| 摘要: | 在醫療衛生體系中，醫護人員短缺一直是全球照護產業的問題之一。證據顯示，人力資源驅動整個醫療系統的表現。更高的工作者密度和更好的工作質量改善人群健康和人類生存。台灣在醫藥分業之後，對藥師的需求增加。從1990到2010之間，藥局人力與人口的比率明顯的成長。整體來說，醫院外的就業機會正在增加（如：診所、製藥公司、藥局），並與醫院的藥劑部門競爭藥師人力，這讓醫院藥師人力資源流失增加。控制目前醫院執業藥師的人力留任將是藥師未來發展的重點。
本研究的主要目的是透過對四間醫院問卷調查的方式探討藥師工作特性與領導風格對工作滿意度和留任意願的關聯性，來瞭解影響醫院藥師留任的真正原因。找出可以再改善的部分，提供給藥師主管們參考。
本研究設計為橫斷式研究。以SPSS 22版軟體作為資料處理與統計分析工具。資料分析方法包含信效度分析、描述性統計分析、雙變項分析與多變項分析。
在受訪者中，72％是女性。受訪者年齡介於20-29歲為居多（69.4％）。在門診調劑組、住院調組、無菌調配室、臨床藥學組和藥品管理組工作的受訪者分別為45％、26％、8.8％、8.2％和6.4％。受訪者平均年資為4.2（±4.7）年。以醫院藥師的工作分組來看，臨床藥學組的自主性分數為最高（4.71±1.27），門診調劑組的自主性分數為最低（3.52±1.13）。藥品管理組的鼓舞性激勵分數為最高（5.23±0.94），門診調劑組的鼓舞性激勵分數為最低（4.10±1.30）。激勵潛能分數（MPS）與藥師工作滿意度呈正相關（β=0.63, p < 0.001）。轉型領導與藥師工作滿意度呈正相關（β=0.64, p < 0.001）。藥師工作滿意度與留任意願呈正相關（β=0.67, p < 0.001）。工作滿意度為一完全中介變項，會影響工作特性及領導風格與留任意願的關係。
研究結果指出，工作滿意度本身可以成為留任意願的良好預測指標。醫院藥師的工作特性或轉型領導需透過工作滿意度，才能影響留任意願。工作特性與工作滿意度有正相關，其中有顯著影響的工作特性為技能多樣性、自主性、工作回饋性。轉型領導與工作滿意度有正相關，其中有顯著影響的轉型領導為理想化影響力及智力激發。最後建議醫院藥師的人事行政主管，可以持續往豐富工作內容、轉型領導邁進。
There are significant problems of shortage of health care workers while health care industry heavily depends on good competency of health professionals. Pharmacy departments in hospitals are no exceptional, and suffer serious competition with other entities, such as clinics, pharmaceutical companies, and chain drugstores. From 1990 to 2010, the ratio of pharmacist to total population has grown significantly; anyhow, job opportunities outside hospitals increase as well. Pharmacy department in hospitals are mostly understaffed in Taiwan. Therefore, it is crucial to conclude the key variables to predict pharmacists’ retention in hospitals.
The main purpose of this study is to explore the association of job characteristics, supervisor’s leadership, job satisfaction, and retention by survey on pharmacists working in four hospitals. Moreover, the result will give lights of most significant variables to determine retention. . Lastly, policy suggestions will be fostered according to the findings.
The study design is a cross - sectional survey study. The study uses SPSS version 22 software for data analysis, including reliability and validity analysis, descriptive statistics, bivariate analysis, and multivariate analysis.
Among respondents, 72% of them were women. Most respondents are aged between 20 and 29 (69.4%). There were 45%, 26%, 8.8%, 8.2%, and 6.4% of respondents working at the Outpatient Pharmacy, Inpatient Pharmacy, Aseptic Preparation Service, Clinical Pharmacy, and Inventory Management. The mean seniority was 4.2 (±4.7) years. According to the work division of the hospital pharmacists, the autonomy score of the clinical pharmacy was the highest (4.71±1.27), and the autonomy score of the outpatient Pharmacy was the lowest (3.52±1.13). The inspirational motivation score of the Inventory Management was the highest (5.23±0.94), and the inspirational motivation score of the Outpatient Pharmacy was the lowest (4.10±1.30). The Motivating Potential Score (MPS) were positively correlated with pharmacist job satisfaction (β=0.63, p < 0.001). Transformational leadership was positively correlated with pharmacist job satisfaction (β=0.64, p < 0.001). The pharmacist''s job satisfaction was positively related to retention (β=0.67, p < 0.001). Job satisfaction is a full mediation variable that will affect the relationship between job characteristics and retention and the relationship between transformational leadership and retention.
The research results indicate that job satisfaction itself can be a good predictor of retention. The job characteristics of the hospital pharmacists or the transformational leadership need to influence their retention through job satisfaction. There is a positive correlation between job characteristics and job satisfaction. Among the job characteristics that have significant impact are skill variety, autonomy, and feedback form job itself. There is a positive correlation between transformational leadership and job satisfaction. Among the transformational leaderships that have significant influence are idealized influence and intellectual stimulation. Last, it is suggested that the manager of the hospital pharmacist keeps enriching job design and better leads in the transformational leaderships. |
