在職進修護理人員壓力因應、健康促進生活型態與幸福感之相關性研究

A Study on the Relationship between Stress Coping Strategies, Health Promoting Lifestyles and Well-being among on-the-job Learning Nurses

背景：面臨瞬息萬變的醫療環境，護理人員必須持續進修精進醫療知識與提升照護品質以因應專業需求，過程中面對職場、學校、家庭多重角色的衝突與壓力，而衍生健康生活型態的改變，可能影響在職進修護理人員整體幸福感受。
目的：研究目的為了解在職進修護理人員壓力因應、健康促進生活型態與幸福感之現況；檢視基本屬性與壓力因應、健康促進生活型態與幸福感之差異；探討壓力因應、健康促進生活型態與整體幸福感之相關性，最後分析在職進修護理人員幸福感的影響因子。
方法：研究採橫斷式相關研究設計，以結構式問卷進行資料收集；以立意取樣招募北區護理相關系所在職進修碩士及學士班之學生；研究工具包含社會人口基本資料、壓力因應量表、健康促進生活型態量表及人幸福感量表；統計分析以獨立樣本t檢定、單因子變異數分析、皮爾森相關分析及多元複迴歸進行資料分析。
結果：招募85位研究對象，回收有效問卷76份，有效問卷回收率95. %。研究對象平均年齡36（SD =8.49）歲，年資3.8（SD =7.94）年，50.6%已婚，進修學制以碩士班居多，「獲得學歷文憑」為主要進修動機，最重要的支持因素以「家人支持」為主。研究發現：一、整體壓力因應為中等以上程度，與整體幸福感呈顯著正相關。二、整體健康促進生活型態達中等以上，與整體幸福感呈顯著正相關。三、幸福程度屬中等幸福感受。四、整體幸福感之重要影響因子有健康促進生活型態、職稱「行政主管」及整體壓力因應，解釋總變異量為28.4%。五、健康促進生活型態中之自我實現及整體壓力因應中之紓解壓力，對整體幸福感解釋總變異量達42.8%。
結論與建議：健康促進生活型態、職稱「行政主管」及整體壓力因應為影響在職護理人員整體幸福感之重要預測因子。期望研究結果，可作為在職進修護理人員面臨多重壓力因應之參考，並可喚起對自身健康促進生活型態的重視與實踐，協助能在健康的生活型態下，正向的因應壓力，順利完成學業，達成人生目標與自我實現，增進整體幸福感，也能提供職場與校園管理者參考，以營造健康、友善的在職進修環境。

Background: In the ever-changing healthcare environment, nurses must continue to improve their medical knowledge and quality of care to meet the demands of the profession. The fact was that nurses faced multiple conflict roles from working place, family, and school during the learning process, their healthy lifestyles and the subjective well-being may be affected.
Objectives: The purposes of this study were to explore the distribution of stress coping strategies, health promotion lifestyle and well-being in on-the-job nurses learning. In addition, to examine the relationships among stress coping strategies, health promotion lifestyle and well-being in on-the-job nurses learning.
Methods: A cross-sectional with correlational study design was adopted, and full-time nurses on-the- job learning were recruited from master and bachelor classes in Nursing School of the Northern Taiwan by purposive sampling. Data were collected using a structured questionnaire including '' Basic Sociodemographic Information '', ''Stress coping strategies Profile '', '' Health Promotion Lifestyle Profile '' and '' Chinese Happiness Inventory ''. Data analysis was performed by independent t-test, single factor variance analysis (ANOVA), Pearson’s correlation coefficient and multiple linear regression.
Results: 185 participants were recruited, a total of 176 valid questionnaires were retrieved, and the return rate was 95.1%. The results showed that the mean age of the participants was 36 (SD=8.49) years, and the seniority was 13.8 (SD=7.94) years. 50.6% were married and most of participants were studying in master's degree. Obtaining a diploma was the main motivation for continuing education. ''family support'' was the most important supporting factor. The study found that the overall stress coping strategies was above medium level, and the overall stress coping strategies was significantly positively correlated with overall well-being; additionally, the overall health promotion lifestyle was above medium level, and the health promotion lifestyle was significantly positively correlated with overall well-being; moreover, the level of well-being was moderate. 28.4% of the total variation in overall well-being could be explained by the health promotion lifestyle, the title of ''administrator'' and the overall stress coping strategies. Finally, self-actualization in health promotion lifestyle and relieve stress in the overall stress coping strategies accounted for 42.8% of the total variation in overall well-being.
Conclusions and suggestions: In conclusion, the health promotion lifestyle, the title of ''administrator'' , and the overall stress coping strategies were the important predictors for overall wellbeing. Hopefully, the findings of this study can be provided as a reference for the on-the-joblearning nurses as faceing multiple stresses and help them to successfully cope the stress and complete their studies in a healthy life state, and then achieve ideal goals.