醫院護理主管領導行為、團隊健康氣候及護理人員職場幸福感之多層次研究：護理人員健康行為之仲介效果驗證

Multilevel research on leadership behaviors of nursing supervisors, healthy team climate, and workplace well-being of nurses: mediating effect of nurse health behavior

本研究旨在針對護理團隊主管領導行為、團隊健康氣候、護理人員健康行為及職場 幸福感之關聯性進行多層次分析。方法：採用橫斷性研究設計，以便利取樣方式選取願意參 與研究之護理團隊及其護理人員，共選取43組護理團隊，共計663人。本研究問卷包括魅力領 導、組織健康文化、健康促進生活及職場幸福感量表，以及背景變項。結果：單一層次關係的 驗證結果顯示，護理團隊主管領導之形塑文化行為對團隊健康氣候三構面都有顯著正向影響， 護理人員健康行為對護理團隊主管領導之形塑部屬行為影響護理人員之職場幸福感三構面都具 有部分中介效果。跨層次關係的驗證結果顯示，團隊健康氣候會影響護理人員的職場幸福感三 構面，團隊健康氣候對職場幸福感三構面的影響乃透過健康行為的部分中介作用而產生。結 論：研究發現護理團隊主管領導行為對於團隊的健康氣候、護理人員的健康行為與職場幸福 感構面間存在一定的影響性，更突顯護理團隊主管領導的重要性。（台灣衛誌 2020；39（5）： 565-577）

Objectives: This study was a multilevel analysis on the relationship between leadership behavior of nursing supervisors (including culture shaping behaviors and subordinate shaping behaviors), healthy team climate, nurses' health behavior, and nurses' workplace well-being. Methods: This cross-sectional study was conducted using the questionnaires include Charismatic Leadership Scale, Organizational Health Culture Scale, Health Promotion Lifestyle Scale, Workplace Well-being Scale, and background variables. Convenience sampling was used to select nurses from each of 43 nursing teams, and the questionnaire was distributed to 663 nurses. Following the calculation of descriptive statistics, hierarchical regression analysis was conducted to assess the relationships among single-level constructs. Subsequently, hierarchical linear modeling was used to assess the relationships among cross-level constructs. Results: Regarding single-level relationships, culture shaping behaviors of leadership significantly affected all three dimensions of the healthy team climate. In addition, the effects of culture shaping behaviors of leadership on three dimensions of the workplace well-being of nurses were partially mediated by nurses' health behavior. Regarding cross-level relationships, the healthy team climate affected three dimensions of workplace well-being of nurses, and this effect was partially mediated by nurses' health behavior. Conclusions: By using a multilevel model, this study demonstrated that the leadership behavior of the nurse leader affects the team climate, nurses' health behavior, and nurses' workplace well-being. The findings highlight the importance of leadership in the nursing team. (Taiwan J Public Health. 2020;39(5):565-577)