研究生: |
詹閔雅 Chan, Min-Ya |
---|---|
論文名稱: |
醫學中心護理人員離職傾向的預測與中介效果:從組織氣候到壓力因應行為 The Predicting and Mediating Effects of Nurses’ Turnover Intention in a Medical Center: From Organizational Climate to Coping Behaviors |
指導教授: |
林坤誼
Lin, Kuen-Yi |
學位類別: |
碩士 Master |
系所名稱: |
科技應用與人力資源發展學系 Department of Technology Application and Human Resource Development |
論文出版年: | 2019 |
畢業學年度: | 107 |
語文別: | 中文 |
論文頁數: | 91 |
中文關鍵詞: | 護理人員 、組織氣候 、壓力因應行為 、離職傾向 、工作壓力 |
英文關鍵詞: | coping behaviors, nurse, organizational climate, turnover intention, work stress |
DOI URL: | http://doi.org/10.6345/NTNU201900181 |
論文種類: | 學術論文 |
相關次數: | 點閱:287 下載:18 |
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員工是組織最重要的資產,一旦員工離職將使組織人力、財力和專業知識流失。護理人員佔醫院中員工比例最高的一群,人力的質與量將決定組織的表現,但其惡劣的工作環境與高離職率卻是時有所聞,處於競爭且動態的工作環境下,如何降低離職率是人資人員需面對的急迫性挑戰。有鑑於此,本研究使用問卷調查法,針對人力問題最急迫的手術室相關單位護理人員施測,探討組織氣候、工作壓力、壓力因應行為與離職傾向之間的影響差異。本研究共發放317份問卷,回收285份,有效樣本為271份,研究結果顯示改善組織氣候、工作壓力及壓力因應行為使用頻率能降低離職傾向,壓力因應行為不受組織氣候及工作壓力的影響,變項之間沒有中介效果。本研究結果可作為醫學中心護理人員擬定改善方案的參據,以利後續組織發展與改革。
Employees are the most important assets of an organization. Once an employee leaves, it will lead to labor wastage, higher cost and professional knowledge loss of the organization. Nurses account for the highest proportion of employees in the hospital, and their quantity and quality will determine the organizational performance. However, the poor work environment and high turnover rate are well known. In a competitive and dynamic work environment, how to reduce the turnover rate is an urgent challenge for human resource specialists. In view of that, this study used questionnaire survey method and 317 nurses working in the operating rooms and related units where the most urgent manpower problem happens participated in the study. In order to investigate the relationships among organizational climate, work stress, coping behaviors and turnover intention, an analysis of structural equation modeling was conducted and showed that (1) improving the organizational climate, work stress and coping behaviors could reduce the turnover intention; (2) coping behaviors would not be affected by organizational and work stress; (3) there was no mediating effects between dimensions. The result of this study can be used as a reference for medical center to plan an improvement strategy and provide an overview for the development and change of organization.
一、中文部分
中華民國護理師護士公會全國聯合會(2018)。106年醫療機構人力現況調查統計。取自http://www.nurse.org.tw/publicUI/H/H10201.aspx?arg=8D5B1B0EBBF9675062
內政部戶政司(2018)。人口統計資料報告。取自https://www.ris.gov.tw/app/portal/346
王金蓮、邱淑媞、簡莉盈、黃心苑(2018)。探討台灣臨床護理人員工作待遇滿意度與離職及轉業意念之相關因素。澄清醫護管理雜誌,14,27-39。
行政院性別平等會(2018)。各類醫事人員性別統計。取自https://www.gender.ey.gov.tw/GecDB/Stat_Statistics_Field.aspx
吳安綺、彭台珠、彭少貞、黃寒裕、李茹萍(2009)。加護病房護理人員對職業危害的擔心程度與因應策略之探討。志為護理,8,70-80。
吳明隆、涂金堂(2012)。SPSS與統計應用分析(第二版)。台北市:五南出版社。
李茂能(2006)。結構方程模式軟體Amos之簡介及其在測驗編製上之應用。台北:心理。
李逸(2004)。公共衛生護理人員工作壓力感受、因應策略與壓力結果之探討—以互動型工作壓力模式為架構。台灣公共衛生雜誌,23(5), 398-405。
李詩應(2017)。醫務糾紛處理之醫事人員心力交瘁的問題與對策(三):護理過勞問題。月旦醫事法報告,7,131。
林子祺(2016)。護理人員工作環境、異常管理、工作壓力與離職意願之探討(未出版之碩士論文)。高雄醫學大學,高雄市。
林佳慧、周思源、蔡雅芳(2017)。醫院員工工作壓力對職場疲勞的影響-以台中區醫院護理人員為例。澄清醫護管理雜誌,13,20-32。
邱皓政(2011)。結構方程模式:LISREL的理論、技術與應用(第二版)。台北:雙葉書廊。
洪淑芬(2014)。護理人員工作壓力、工作滿意度、組織承諾與離職傾向之相關性研究(未出版之碩士論文)。國立成功大學,臺南市。
洪鈺娟(2005)。加護病房護理人員工作壓力、壓力反應與因應策略關係之研究(未出版之碩士論文)。國立高雄師範大學,高雄市。
張婷婷、陸洛、林惠彥、高旭繁、陳瑩珊(2015)。職家衝突因應策略與適應後果之關聯。組織與管理,8(1),77-111。
張翠芬、陳重光、陳敏加(2016)。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。澄清醫護管理雜誌,12(2),28-38。
張慧蘭、盧美秀、林秋芬(2010)。應屆畢業新進護理人員離職相關因素之探討。醫護科技期刊,12,161-172。
張瓈方、陳淑貞、尹玓、李易靜、蔡育倫、廖珍娟(2017)。探討北區不同等級醫院加護病房護理人員自覺職業危害、工作壓力與護理人員留任意願之相關性。中華職業醫學雜誌,24,9-21。
許士軍(1972)。有關黎史(Litwin and Stringer)二氏「組織氣候」尺度在我國企業機構之適用性之探討。國立政治大學學報,26, 103-138。
陳宥蓁、徐明儀、尹裕君、林麗英、張淑真(2012)。醫院護理管理者工作壓力源與工作壓力因應策略之研究。護理暨健康照護研究,8(2),94-105。
陳盈穎、李維綸、蔡享翰、蔡照文(2013)。護理人員工作壓力、因應策略與幸福感相關性之探討。美和學報,32(2),83-97。
陳國瑚、陳麗如、蘇喜(2006)。護理人員對護理工作認知與離職傾向之探討。台灣公共衛生雜誌,25(3),177-188。
陳綺霞(2014)。護理人員工作壓力及因應行為之影響因素-以臺北市某醫院婦兒專科區為例(未出版之碩士論文)。淡江大學,臺北市。
黃芳銘(2007)。結構方程模式理論與應用(第五版)。台北:五南。
黃慧文(2017)。某區域教學醫院護理人員離職意向之相關因素。台灣醫學,21,335-342。
葉崇杰(2013)。台北市護理人員工作輪調對離職傾向之影響研究-以工作壓力和工作適應為中介變項(未出版之碩士論文)。國立臺灣師範大學:臺北市。
劉雅惠、劉偉文(2009)。護理人員情緒勞務、工作壓力與因應行為之相關性研究。醫護科技期刊,11(2),98-115。
蔡明修、劉孟芬、陳鈺如、汪正青(2002)。門診護理人員工作壓力與專業承諾的探討。護理雜誌,59,61-69。
衛生福利部統計處(2018)105年醫療機構現況及醫院醫療服務量統計電子書。取自https://dep.mohw.gov.tw/DOS/lp-3555-113.html
鄭任程(2017)。情緒勒索、工作壓力、情緒勞務與工作倦怠之關聯性研究─以護理人員為例(未出版之碩士論文)。國立高雄應用科技大學,高雄市。
藍天雄、崔家豪(2018)。組織氣候影響組織文化與工作滿意度之研究。 管理資訊計算,7(2),44-56。
二、外文部分
Abid, G., & Butt, T. (2017). Expressed turnover intention: Alternate method for knowing turnover intention and eradicating common method bias. International Letters of Social and Humanistic Sciences, 78, 18-26.
Al-Hussami, M., Darawad, M., Saleh, A., & Hayajneh, F. A. (2014). Predicting nurses' turnover intentions by demographic characteristics, perception of health, quality of work attitudes. International Journal of Nursing Practice, 20(1), 79-88.
Alameddine, M., Bauer, J. M., Richter, M., & Sousa-Poza, A. (2017). The paradox of falling job satisfaction with rising job stickiness in the German nursing workforce between 1990 and 2013. Human Resources for Health, 15(1), 55-65.
Almalki, M. J., FitzGerald, G., & Clark, M. (2012). The relationship between quality of work life and turnover intention of primary health care nurses in Saudi Arabia. BMC Health Services Research, 12(1), 314-324.
Arnetz, B. B., Lucas, T., & Arnetz, J. E. (2011). Organizational climate, occupational stress, and Employee mental health: Mediating effects of organizational efficiency. Journal of Occupational and Environmental Medicine, 53(1), 34-42.
Arnold, H. J., & Feldman, D. C. (1982). A multivariate analysis of the determinants of job turnover. Journal of Applied Psychology, 67(3), 350-360.
Bentler, P. M., & Speckart, G. (1981). Attitudes "cause" behaviors: A structural equation analysis. Journal of Personality and Social Psychology, 40(2), 226-238.
Cammann, C., Fichman, M., Jenkins, D., & Klesh, J. (2007). The Michigan organizational assessment questionnaire: Intention to turnover scale. Kalamazoo, MI: School of Public Affairs and Administration, Western Michigan University.
Cascio, W. (1991). Costing human resources: The financial impact of behavior in organizations (3d ed.). Boston, MA: PWS-Kent.
Cattell, R. B. (1978). The scientific use of factor analysis in behavioral and life sciences. New York, NY: Plenum Press.
Chan, C. A., McBey, K., Basset, M., O’Donnell, M., & Winter, R. (2004). Nursing crisis: Retention strategies for hospital administrators. Research and Practice in Human Resource Management, 12(2), 31-56.
Chang, E. M., Hancock, K. M., Johnson, A., Daly, J., & Jackson, D. (2005). Role stress in nurses: Review of related factors and strategies for moving forward. Nursing & Health Sciences, 7(1), 57-65.
Chang, H. Y., Friesner, D., Chu, T. L., Huang, T. L., Liao, Y. N., & Teng, C. I. (2018). The impact of burnout on self-efficacy, outcome expectations, career interest, and nurse turnover. Journal of Advanced Nursing, 74(11), 2555-2565.
Chen, C. K., Lin, C., Wang, S. H., & Hou, T. H. (2009). A study of job stress, stress coping strategies, and job satisfaction for nurses working in middle-level hospital operating rooms. Journal of Nursing Research, 17(3), 199-211.
Clegg, A. (2001). Occupational stress in nursing: A review of the literature. Journal of Nursing Management, 9(2), 101-106.
Cohen, A. (2000). The relationship between commitment forms and work outcomes: A comparison of three models. Human Relations, 53(3), 387-417.
Conner, M., Sheeran, P., Norman, P., & Armitage, C. J. (2000). Temporal stability as a moderator of relationships in the Theory of Planned Behaviour. British Journal of Social Psychology, 39(4), 469-493.
Davenport, D. L., Henderson, W. G., Mosca, C. L., Khuri, S. F., & Mentzer, R. J. (2007). Risk-adjusted morbidity in teaching hospitals correlates with reported levels of communication and collaboration on surgical teams but not with scale measures of teamwork climate, safety climate, or working conditions. Journal of the American College of Surgeons, 205(6), 778-784.
Doll, W. J., Xia, W., & Torkzadeh, G. (1994). A confirmatory factor analysis of the end-user computing satisfaction Instrument. MIS Quarterly, 18(4), 453-461.
Dorgham, S. R. (2012). Relationship between organization work climate & staff nurses organizational commitment. Nature and Science, 10(5), 80-91.
Galletta, M., Portoghese, I., Carta, M. G., D'Aloja, E., & Campagna, M. (2016). The effect of nurse-physician collaboration on job satisfaction, team commitment, and turnover intention in nurses. Research in Nursing & Health, 39(5), 375-385.
Gamero, N., González-Romá, V., & Peiró, J. M. (2008). The influence of intra-team conflict on work teams' affective climate: A longitudinal study. Journal of Occupational and Organizational Psychology, 81(1), 47-69.
George, J. M., & Jones, G. R. (1996). The experience of work and turnover intentions: Interactive effects of value attainment, job satisfaction, and positive mood. Journal of Applied Psychology, 81(3), 318-325.
Gershon, R., Stone, P. W., Bakken, S., & Larson, E. (2004). Measurement of organizational culture and climate in health care. The Journal of Nursing Administration, 34(1), 33-40.
González-Romá, V., Peiró, J. M., & Tordera, N. (2002). An examination of the antecedents and moderator influences of climate strength. Journal of Applied Psychology, 87(3), 465-473.
Gormley, D. K. (2011). Are we on the same page? Staff nurse and manager perceptions of work environment, quality of care and anticipated nurse turnover. Journal of Nursing Management, 19(1), 33-40.
Gorsuch, R. L. (1983). Factor analysis. Hillsdale, NJ: Lawrence Erlbaum.
Guieford, J. P. (1965). Fundamental statistics in psychology and education (4th ed.). New York, NY: McGraw-Hill.
Hair, J. F., Black, W. C., Babin, B. J., Anderson, R. E., & Tatham, R. L. (2006). Multivariate data analysis. New Jersey, NJ: Prentice-Hall.
Hayes, L. J., O’Brien-Pallas, L., Duffield, C., Shamian, J., Buchan, J., Hughes, F., . . . North, N. (2012). Nurse turnover: a literature review – an update. International Journal of Nursing Studies, 49(7), 887-905.
Health and Safety Executive. (2005). Health and safety executive: Taking stress: the management standard approach. London: Health and Safety Executive.
Hemingway, M. A., & Smith, C. S. (1999). Organizational climate and occupational stressors as predictors of withdrawal behaviours and injuries in nurses. Journal of Occupational and Organizational Psychology, 72(3), 285-299.
Jha, S. (2009). Determinants of employee turnove intentions: A review. Management Today, 9(2), 26-33.
Kangas, S., Kee, C. C., & McKee-Waddle, R. (1999). Organizational factors, nurses’ job satisfaction, and patient satisfaction with nursing care. The Journal of Nursing Administration, 29(1), 32-42.
Kaplan, H. C., Provost, L. P., Froehle, C. M., & Margolis, P. A. (2012). The model for understanding success in quality (MUSIQ): Building a theory of context in healthcare quality improvement. BMJ Quality & Safety, 21(1), 13-20.
Kline, R. B. (2005). Principles and practice of structural equation modeling (2nd ed.). New York, NY: Guilford.
Kyriacou, C. (2001). Teacher stress: Directions for future research. Educational Review, 53(1), 27-35.
Lazarus, R. S. (1993). From psychological stress to the emotions: A history of changing outlooks. Annual Review of Psychology, 44(1), 1-22.
Lazarus, R. S., & Folkman, S. (1984a). Stress, appraisal and coping. New York, NY: Springer Publishing Company.
Lazarus, R. S., & Folkman, S. (1984b). Coping and adaptation. In W. D. Gentry (Ed.), The handbook of behavioral medicine (pp. 282-325). New York, NY: Guilford.
Lee, W. L., Tsai, S. H., Tsai, C. W., & Lee, C. Y. (2011). A study on work stress, stress coping strategies and health promoting lifestyle among district hospital nurses in Taiwan. Journal of Occupational Health, 53, 377-383.
Liou, S. R., & Cheng, C. Y. (2010). Organisational climate, organisational commitment and intention to leave amongst hospital nurses in Taiwan. Journal of Clinical Nursing, 19(11‐12), 1635-1644.
Litwin, G. H., & Stringer, R. A. (1968). Motivation and organizational climate. Boston, MA: Harvard University Press.
Litwin, G. H., & Stringer, R. A. (1996). The influence of organizational climate. Boston, MD: Harvard University Press.
Lo, W. Y, Chien, L. Y, Hwang, F. M, Huang, N., & Chiou, S. T. (2018). From job stress to intention to leave among hospital nurses: A structural equation modelling approach. Journal of Advanced Nursing, 74(3): 677– 688
Lu, L., Lee, H. M., & Shieh, T. Y. (2005). Occupation stress, health and occupational burnout among dentists: A study of clinical dentists in Kaohsiung. Research in Applied Psychology, 27, 59-80.
MacNeil, K. H. (1981). The relationship of occupational stress to burnout. In J. W. Jones (Ed.), The burnout syndrome. Park Ridge, IL: London House Management Press.
Mahmoudi, G. (2013). Introduction to understanding organizational climate. Tehran: Vania Publication.
Malloy, D. C., Hadjistavropoulos, T., McCarthy, E. F., Evans, R. J., Zakus, D. H., Park, I., . . . Williams, J. (2009). Culture and organizational climate: Nurses’ insights into their relationship with physicians. Nursing Ethics, 16(6), 719-733.
Mobley, W. H., Horner, S. O., & Hollingsworth, A. T. (1978). An evaluation of precursors of hospital employee turnover. Journal of Applied Psychology, 63(4), 408-414.
Oyeleye, O., Hanson, P., O’Connor, N., & Dunn, D. (2013). Relationship of workplace incivility, stress, and burnout on nurses’ turnover intentions and psychological empowerment. Journal of Nursing Administration, 43(10), 536-542.
Patrician, P. A., Shang, J., & Lake, E. T. (2010). Organizational determinants of work outcomes and quality care ratings among Army Medical Department registered nurses. Research in Nursing & Health, 33(2), 99-110.
Portoghese, I., Galletta, M., Battistelli, A., & Leiter, M. P. (2015). A multilevel investigation on nursing turnover intention: The cross-level role of leader–member exchange. Journal of Nursing Management, 23(6), 754-764.
Roth, S., & Cohen, L. J. (1986). Approach, avoidance, and coping with stress. American Psychologist, 41(7), 813-819.
Seybolt, J. W. (1983). Dealing with premature employee turnover. California Management Review, 25(3), 107-117.
Sleutel, M. R. (2000). Climate, culture, context, or work environment? Organizational factors that influence nursing practice. The Journal of Nursing Administration, 30(2), 53-58.
Snow, J. L. (2002). Enhancing work climate to improve performance and retain valued employees. Journal of Nursing Administration, 32(7), 393-397.
Sousa-Poza, A., & Henneberger, F. (2004). Analyzing job mobility with job turnover intentions: An international comparative study. Journal of Economic Issues, 38(1), 113-137.
Srivastav, A. K. (2006). Organizational climate as a dependent variable: Relationship with role stress, coping strategy and personal variables. Journal of Management Research, 6(3), 125-136.
Steers, R. M., & Mowday, R. T. (1981). Employee turnover and post decision accommodation processes. In B. M. Staw & L. L. Cummings (Eds.), Research in organizational behavior (Vol. 3, pp. 325-381). Greenwich, CT: JAI Press.
Tourangeau, A. E., Cummings, G., Cranley, L. A., Ferron, E. M., & Harvey, S. (2010). Determinants of hospital nurse intention to remain employed: Broadening our understanding. Journal of Advanced Nursing, 66(1), 22-32.
Winwood, P. C., Winefield, A. H., & Lushington, K. (2006). Work‐related fatigue and recovery: The contribution of age, domestic responsibilities and shiftwork. Journal of Advanced Nursing, 56(4), 438-449.
Xie, Z., Wang, A., & Chen, B. (2011). Nurse burnout and its association with occupational stress in a cross-sectional study in Shanghai. Journal of Advanced Nursing, 67(7), 1537-1546.
Yin, J. C., & Yang, K. P. (2002). Nursing turnover in Taiwan: A meta-analysis of related factors. International Journal of Nursing Studies, 39(6), 573-581.