職場暴力與工作壓力對護理人員離職傾向之關聯性研究

Associations of Workplace Violence and Job Stress with Nursing Staff Turnover Intention

目的：護理人員為醫療體系中最容易受到職場暴力事件影響的對象，職場暴力事件容易導致人員身心理傷害的主要因素，除身體傷害外可能導致工作壓力增加，甚至產生離職意圖。本研究旨在探討護理人員職場暴力現況以及職場暴力、工作壓力及離職傾向三者間之關聯性。方法：以中部某區域級教學醫院基層臨床護理人員為對象，共發出268 份問卷，回收有效問卷198 份。問卷內容包含個人基本資料、工作特質量表、職場暴力量表與離職傾向等。統計分析包括卡方檢定、獨立樣本t 檢定、單因子變異數分析、皮爾森相關係數與複迴歸。結果：職場暴力型態最常見為語言暴力，外部暴力源以家屬最多，內部暴力源則以醫師為最多。護理年資2-5 年、固定小夜班者與任職單位為急診室者，遭受職場暴力之比率最高。護理人員曾遭受職場霸凌者，工作心理負荷越高，職場正義認知越低，離職傾向越高。結論：醫院應制定有效的暴力事件防範及處理機制，以及職場暴力預防之教育訓練，持續加強臨床護理人員面對暴力事件的處理能力，建立主管支持與雙向的溝通管道，即時在暴力事件發生時第一時間給予支持與關心，必要時給予心理輔導與法律協助。

Objectives: Nursing staff members typically experience workplace violence. Workplaceviolence endangers nurses’ physical health and affects job stress and turnover intention. This studydetermined the prevalence of workplace violence and identified the association of workplaceviolence and job stress with turnover intention in nursing staff.Method: The participants comprised clinical nursing staff working in central regionalhospitals. In total, 268 questionnaires were distributed, and 198 valid responses were returned.The questionnaire included items on basic personal information, a job content scale, a workplaceviolence scale, and a turnover intention scale. The t value obtained from an independent t test, chisquaredtest, and one-way analysis of variance were adopted to examine correlations among thequestionnaire data. The Pearson correlation coefficient and multiple regression analysis were alsoused to evaluate relationships between the variables.Results: Of all types of workplace violence encountered by nurses, verbal abuse was mostprevalent. Families constituted the most prevalent source of external violence, and doctorsconstituted the most prevalent source of internal violence. Nurses working swing shifts, nurseswith 2–5 years of nursing experience, and those working in the emergency unit experienced thehighest prevalence of workplace violence. Nurses who experienced workplace violence alsoexperienced increased psychological demands and tended to have lower perceptions of justice inthe workplace, which increased their turnover intention.Conclusions: Hospitals should formulate effective management mechanisms for preventingworkplace violence and provide education and training for workplace violence prevention tostrengthen the ability. Hospitals should also provide communication channels between supervisorsand subordinates, support and care when a violent incident occurs for the first time, and providenecessary counseling and legal assistance for reducing the harm caused by workplace violence.