不同類型醫院護理人員特質、工作壓力、工作滿意度與離職傾向之相關性研究──以六家地區醫院及四家區域醫院為例

A Study of Demographic Traits, Job Stress, Job Satisfaction, and Turnover Intention Among Nurses Working in Different Types of Hospital – The Case of Six Local Community Hospitals and Four Metropolitan Hospitals

目的：本研究旨在探討護理人員的個人屬性與工作壓力、工作滿意度對其離職傾向的影響，並比較資深、新進護理人員離職傾向及不同層級醫院間護理人員離職傾向，提出提高護理人員執業率與留任意願的建議。方法：以彰化、南投、雲林、嘉義之6家地區醫院與4家區域醫院的護理人員為對象，共收案新進護理人員84位、資深護理人員109位。問卷包含：人口統計特性量表、工作滿意度量表、工作壓力量表、離職傾向量表。結果：（1）護理人員對病患安全的壓力感受度最高。（2）護理人員對工作酬勞及醫院管理制度的滿意度最低。（3）服務於不同類型的醫院會影響護理人員的工作壓力感受度及感受頻率。（4）護理人員的離職傾向與工作壓力類別之感受度、感受頻率均呈顯著正相關。（5）護理人員的離職傾向與工作滿意度呈顯著負相關。結論：建議醫院針對資深護理人員建立單位輪調制度；提供新進護理人員足夠的壓力因應訓練及資源；加強對資深護理人員管理的人性化及合理化的檢討；提供更具激勵性的誘因鼓勵新進的高職及專科學歷的護理人員進修學位；在護理照護品質前題下，儘可能滿足護理人員在排班方面的個人需要；提供護理人員面對醫療糾紛、病患及家屬暴力事件的支持。

Purposes: The aim of this study was to evaluate the influence of demographic characteristics, job satisfaction, and job stress on nursing staff’s turnover intention, to compare the difference of turnover intention between new and senior nursing staffs, and to compare the difference of turnover intention between nurses working among different types hospitals. The suggestions of this study may be used as a reference for improvement the insufficiency of nursing staffs. Methods: This study was conducted by a survey design with the 84 new nursing staff and 109 senior nursing staff who worked in 6 local community hospitals and 4 metropolitan hospitals of Chung-Hua, Nan-Tou, Yun-Lin, and Chia-Yi counties. The questionnaire used in this study covering: demographic scale, job satisfaction scale, job stresses scale, and turnover intention scale. Results: Major findings were as follows: 1. the most intense stressor perceived by OR nurses was patient safety; 2. work rewards and administrative management were the lowest scoring job satisfaction subscales; 3. stress level and frequency perception of nursing staff were significantly related to type of hospital; 4. turnover intention was positively related to the intenseness and frequency of stressor perceived; 5. turnover intention was inversely related to job satisfaction. Conclusions: Major suggestions include: 1. hospitals should design the rules of jobs rotation for senior nursing staffs; 2. hospitals should provide adequate training and resources of stress coping for new nursing staffs; 3. hospital should improve human-based and rationalization for the management system of senior nursing staffs; 4. hospitals should provide more excite attractions to encourage the new nursing staffs whose education background are senior vocational high school or junior college to pursue further education; 5. In scheduling, hospitals should satisfy nursing staff’s need as much as possible; 6. hospitals should offer related resource to assist nursing staff to coping with patient safety job stress.