護理人員情緒耗竭與病人安全文化關係之研究──以中部某區域教學醫院為例

Relationship Between Emotional Exhaustion and Patient Safety Culture Among Nursing Staff in a Regional Teaching Hospital in Central Taiwan

目的：透過對護理人員的病人安全文化認知及情緒狀況的關係進行探討，協助醫院管理者發現並改善病人安全管理的各項作為，以提出有效的醫療管理制度與對策，建立良好病人安全文化與促進和諧護病關係。方法：本研究採用財團法人醫院評鑑暨醫療品質策進會修改的2014年新版病人安全文化量表衡量醫療機構的病人安全文化及情緒耗竭狀況，並以中部某區域教學醫院之護理人員為對象，利用獨立樣本t檢定、變異數分析、皮爾森相關與迴歸分析等方法檢視病人安全文化各構面間之關聯程度，以提供醫院管理者提升或改善院內的病人安全文化的方向或建議。結果：團隊合作與安全風氣具有高度相關聯性，因此若要促進部門或科室能以病人安全為中心的意識，則必須持續營造合作分工的團隊氛圍。護理人員的工作滿意度分別對病人安全意識以及團隊合作氣氛具有高度的相關性存在。本研究結果亦顯示工作滿意度也直接影響護理人員工作中的情緒狀況。而醫院內的工作狀況直接影響護理人員是否願意在治療過程中關心病人的安全議題，也影響其工作滿意度、合作意願，甚至是負面情緒的復原狀況。此外，當前護理人員的復原力狀況並不良好，如何緩解護理人員的負面工作情緒，提升復原力是個必須密切留意的重要議題。結論：良好的病人安全文化是和諧護病關係的前提。醫院可透過營造良好的團隊氛圍、提升工作滿意度、提供情緒疏導管道、改善工作狀況等方式來提升院內病人安全氛圍，進而減少醫療糾紛的發生，也能落實以病人安全為中心的醫療服務理念。

Purposes By exploring the relationship between awareness of patient safety culture and emotional conditions among nursing staff, this study assisted hospital managers in discovering and improving various patient safety management activities in order to develop an effective system and countermeasures in medical care management. Methods In this study, the new version of the Taiwan Patient Safety Culture Survey (TPSCS), amended by the Taiwan Joint Commission on Hospital Accreditation (TJCHA) in 2014, was used to measure patient safety culture and emotional exhaustion. The participants were nursing staff in a teaching hospital in central Taiwan. An independent sample t-test, analysis of variance (ANOVA), Pearson's correlation, and regression analysis were used to examine the degree of correlation among various aspects of patient safety culture with the goal of providing directions for hospital managers to improve patient safety culture in hospitals. Results The results showed that teamwork climate is highly correlated with safety climate. Job satisfaction also directly affects the emotional state of nursing staff at work. Working conditions directly influence nursing staff members' willingness to care about patients' safety issues, as well as the nurses' job satisfaction, willingness to cooperate, and even recover from negative emotions. In addition, the resilience of nursing staff is not satisfactory at present. Finding ways to alleviate the negative working moods of nursing staff and improve resilience is an important issue to which close attention must be paid. Conclusions This study suggests that creating a good team atmosphere, improving job satisfaction, providing outlets for releasing emotions, improving working conditions, and other approaches can improve the patient safety atmosphere in hospitals and reduce medical disputes, thereby achieving the mission of patient safety-centered medical service.