從工作要求資源模式檢視公共衛生護理人員職業倦怠因素：以公共服務動機為調節變數

Factors associated with public health nurses' burnout from the perspective of job demands-resources model: public service motivation as a moderator

目標：本研究以全國的公衛護理人員為研究對象，企圖系統性分析衛生所護理人員工作負荷與疲憊之問題癥結，藉以提出對維持公衛護理人員職場健康與福利保障的改善建議。方法：以E-mail寄送網路問卷給全國提供郵件的衛生所護理人員，調查期間自2018年7月25日起，至2018年8月13日止，實際寄件總數為3,742份，問卷回收量為1,215份，回覆率為32.5%。在排除台北市與非護理人員之樣本後，本研究針對剩餘751名護理人員進行分析。結果：在工作要求部分，工作負荷、繁文縟節均會正向的影響工作與服務對象倦怠，而每週工時僅對工作倦怠有正向影響；工作資源部分，組織支持能減緩工作倦怠，同事支持能減緩服務對象倦怠；而公共服務動機（PSM）與工作和服務對象倦怠皆有負向關連，但在PSM的調節效果上，PSM卻會強化工作負荷、繁文縟節與工作倦怠的關連性。結論：建議應檢討衛生所護理人員的工作負荷，以及工作上繁文縟節的情形，並避免加班超時工作；PSM高可能是促進公衛護理人員積極投入工作的美德，有助於減緩職業倦怠，但可能會因為其投入意願更多，導致在高工作負荷與繁文縟節的工作環境下，工作倦怠的情形更嚴重。 Objectives: To analyze the relationship between the work burden and burnout of nursing staff in public health centers to propose suggestions for improving their health and welfare. Methods: An online survey of nursing staff in public health centers was conducted by contacting the said staff through email. The survey was conducted from July 25 to August 13, 2019. The authors sent out 3,742 emails and received 1,215 responses (response rate: 32.5%). After survey samples from Taipei and non-nursing staff were excluded, the sample size was 751. Results: Regarding the work demands dimension, work burden and red tape were positively correlated with work burnout and client burnout; weekly working hours were positively correlated with work burnout. In the work resources dimension, organizational support relieved work burnout, while client support alleviated client burnout. Although public service motivation (PSM) was negatively correlated with work and client burnout, it exacerbated the relationships of work burnout with work burden and red tape when it was analyzed as a moderator. Conclusions: The authors suggest that policy makers should reduce the workload, red tape, and over time working hours of nursing staff in public health centers. PSM could be an impetus for increasing work engagement and thus alleviate work burnout. However, it could also exacerbate the work burnout of the nursing staff due to increased work engagement in scenarios of a heavy workload and red tape.