Team climate, emotional labor and burnout of physicians: a multilevel model

團隊氣氛、情緒勞務與醫師職業倦怠之關係：多層次研究模式

Objectives: This study applied a multilevel analysis to verify the relationships among team climate, emotional labor, and physician burnout. Methods: We conducted a questionnaire survey for the physicians in Taiwanese hospitals. A total number of 530 physicians from 30 physician teams participated in this study. Hierarchical linear modeling (HLM) was used to test the multilevel hypotheses. Results: (1) deep acting of emotional labor was significantly associated with three components of burnout, while surface acting was only significantly associated with emotional exhaustion; (2) highly significant association between team climate and burnout for three components (emotional exhaustion, γ01=-.651, p<.001; depersonalization, γ01=-.491, p<.01; reduced personal accomplishment, γ01=-.795, p<.001); and (3) team climate only has a significant moderating effect on the relationship between surface acting of emotional labor and emotional exhaustion (γ11=-.446, p<.05). Conclusions: The results support the hypothesis that team climate and emotional labor have impacts on physician burnout. The findings remind hospital executives that climate of physician team help to mitigate physician burnout. In addition, the findings could help to clarify some aspects of the emotional dimensions of physicians with a view to improving the quality of service.

目標：本研究採用多層次分析來驗證團隊氣氛、情緒勞務和醫師職業倦怠的關係。方法：以問卷調查法針對台灣醫院的醫師團隊進行調查以蒐集研究資料。總計有30個醫師團隊共530位醫師為有效樣本。統計分析主要是採用階層獻性模式（Hierarchical linear modeling，HLM）來進行多層次研究假設的驗證。結果：（1）情緒勞務之深層行為與職業倦怠之三個面向存在顯著統計相關，但表層行為只與職業倦怠中的情緒耗竭有顯著統計相關；（2）團隊氣氛和職業倦怠的三個面向有顯著的相關（情緒耗竭，γ01=-.651，p＜.001；去人性化，γ01=-.491，p＜.01；個人成就感低落，γ01=-.795，p＜.001）；及（3）團隊氣氛只對於表層行為和情緒耗竭之間的關係有顯著調節作用（γ11=-.446，p＜.05）。結論：本研究結果顯示團隊氣氛和情緒勞務會影響醫師的職業倦怠，此發現提醒醫院管理者，醫師正向的團隊氣氛有助於減輕醫生的職業焦崩。此外，本研究結果亦有助於澄清醫師的情緒面向的影響，以提高醫療服務的品質。