護理職場霸凌與離職傾向及其相關因素探討－－以南部某醫學中心為例

Nursing Workplace Bullying and Turnover Intention: An Exploration of Associated Factors at a Medical Center in Southern Taiwan

背景：近年護理人力短缺問題已使醫療系統營運及病人安全問題拉高警報，而職場霸凌會讓護理人力短缺問題加劇。目的：探討國內南部某醫學中心護理人員職場霸凌與離職傾向之關係及其相關因素。方法：本研究採橫斷式、相關性研究設計，利用負向行為量表—修正版（Negative Acts Questionnaire-Revises, NAQ-R）、離職傾向量表等結構式問卷收集資料；方便取樣具護理師執照、國台語可溝通且臨床工作年資大於六個月、NAQ-R得分大於23分（排除未受到職場霸凌者）的護理人員708位；資料以SPSS 19.0 for Windows套裝軟體進行統計分析。結果：85%的護理人員在過去六個月中曾遭受過不同程度的職場霸凌，且整體離職傾向偏右、傾向高程度，離職傾向與霸凌總分呈中度正相關（r = .39, p < .05）。逐步複迴歸顯示霸凌相較於其他因子，為離職傾向最重要的預測因子（15.10%）。結論：建議應提升護理人員對職場霸凌的知覺，且應全力推展磁性醫院，提供正向的工作環境，改善職場霸凌現象，降低離職傾向，以提升護理人員的留任率。

Background: The chronic shortage of nursing staffs in hospitals continues to increasingly and negatively impact the ability of medical care systems to deliver effective care and ensure the safety of patients. Bullying is one factor known to exacerbate turnover in the nursing workplace. Purpose: This study explores workplace bullying and turnover intention among nurses working at a medical center in Southern Taiwan. Methods: A cross-sectional and correlation research design was conducted using the Negative Acts Questionnaire-Revised (NAQ-R) and the Turnover Intention Questionnaire. A convenience, purposive sample of 708 nurses was recruited. Inclusion criteria included: holding an RN license, able to communicate in both Mandarin and Hokkienese, ＞ 6 months of clinical experience, and an NAQ-R score higher than 23. Data were analyzed using SPSS19.0 software. Results: Approximately 85% of participants had experienced some degree of workplace bullying during the previous 6-month period. The trend of the turnover intention tended to the right at a high degree. A moderate, positive, and significant correlation was found between turnover intention and bullying total scores (r = .39, p ＜ .05). Multiple regression showed bullying as the most important predicator of turnover intention (15.10%). Conclusions /Implications for Practice: Based on our findings, we suggest that nurses should enhance their awareness of the negative consequences of workplace bullying. Furthermore, hospitals should implement appropriate mechanisms to decrease the phenomenon of inter-staff bullying, improve the nursing workplace environment, and reduce the rate of turnover intention.