行政院衛生署所屬醫院新進護理人員工作壓力及其相關因素之調查研究
論文名稱：行政院衛生署所屬醫院新進護理人員工作壓力及其相關因素之調查研究
研究所名稱：臺北醫學大學護理學研究所
研究生姓名：黃千惠
畢業時間： 93 學年度第 2 學期
指導教授：盧美秀 臺北醫學大學護理學研究所教授
本研究旨在探討行政院衛生署所屬醫院臨床新進護理人員的自覺工作壓力感受情形及其相關因素，先以訪談方式，
收集 12 位新進護理人員之工作壓力感受情形，將訪談結果整理分類後，配合文獻查證及護理實務之現況，應用「需 求─控制─支持」模式，自擬新進護理人員工作壓力調查問卷，並經專家內容效度、再測信度之檢測。
研究對象為從護理學校畢業後，第一次進入臨床擔任護理工作，且服務滿一個月至半年之內的新進護理人員。抽樣 範圍包含行政院衛生署所屬綜合醫院共十六家，共發出問卷 109 份，回收 105 份，回收率為 96% 。回收之問卷以次 數分配、平均值、標準差、變異數分析、 t-test 、相關分析、複迴歸等方法進行資料的分析處理。
研究結果顯示 : 受訪者的年齡、教育程度、到職天數、受雇狀態、證書別及工作單位與自覺工作壓力的感受程度無 統計學上的顯著相關。新進護理人員自覺工作壓力感受的平均得分 2.2 分，顯示新進護理人員的工作壓力介於中低 程度，較許多研究提出的結果為低。對工作壓力的情緒反應為：上班時心理很緊張、覺得常遭遇挫折、容易感到煩 躁；生理反應為：精疲力竭、很疲憊、腰酸背痛及抵抗力降低容易生病。
工作需求的得分越高則自覺工作壓力感受的得分越高（回歸係數 =0.42 ， p<0.0001 ），工作負荷大，工作時間的緊 迫、藥物的認識及應用、常見檢查及治療的執行、延遲下班、交班及書寫記錄都是工作需求中會增加自覺工作壓力 感受程度的因素。工作控制的得分越高則自覺工作壓力感受的程度越低（回歸係數 = -0.16 ， p=0.04 ），新進護理 人員覺得較難掌控的情形依序為：病人病情變化醫師遲遲不來、輪上夜班、處理危急的病人、無法掌握病情及工作 時間的控制。社會支持的得分越高則自覺工作壓力感受的得分越低 ( 回歸係數 = -0.23 ， p= -0.04) 社會支持總平值為 3 分，顯示新進護理人員感受到很多的支持，可緩衝新進護理人員自覺工作壓力的感受。
本研究的結果顯示行政院衛生署所屬醫院雖然工作需求高，但因提供新進人員高度的自主權及支持度，所以新進人 員對於工作壓力呈中低程度，屬於高需求、高控制、高支持的情境下所產生的壓力，為積極主動型的正向壓力，是 一個適合新進護理人員的工作場所。
A Study on the Work Stress of the New Nurses in General Hospital, Department of Health, Executive Yuan,Twaiwan,R.O.C.
Title of thesis: A Study on the Work Stress of the New Nurses in General Hospital, Department of Health, Executive Yuan, Taiwan,
R. O. C.
Institution: Graduate Institute of Nursing , Taipei Medical University
Author: Huang, Chien-Hui
Thesis directed by:Lu, Meei-Shiow, Professor
The subject of this research is to discuss the actual status about how clinical nurses, who are newly recruited by the hospitals under Department of Hea lth(DOH), Executive Yuan, Taiwan, R.O.C., feel about their self-perceived level of work stress and related factors. Firstly, we interviewed 12 newly re cruited nurses to collect data of their perception of work stress. Then we categorize the data according to records, tests and status of nursing work in de signing the questionnaires, using "Demand-Control-Support" modle. since the method has been tested and approved by experts for content validity and test-retest reliability.
The research sample group was nursing school graduates who have nursing work experience of more than 1 month, but less than 6 months. Samples in cluded 16 consolidated hospitals under the DOH, Executive Yuan. A total of 109 questionnaires were issued with 105 returned. The survey’s return rat e was 96%. The questionnaire data was analyzed by the following methods: times of distribution, average score, standard errors, ANOVA analysis, t-te st, correlation analysis and multi-regression analysis.
The conclusion of this research showed "the self-perceived level of work stress" of sample group had no obvious correlation with their age, education l evel, days of working record, employee status, diploma differences or different work division. The average coefficient score of work stress for newly r ecruited nurses is 2.2, which means they rate their job pressure level as between medium to low. This is lower than many other research results. Their e motional responses to work stress are: feeling very tensed mentally while on duty, feeling frustrated frequently, and feeling anxious easily. Their physi cal reactions are: feeling exhausted, feeling very tired, getting sore and aching back, feeling their immunity decreasing and falling sick easily.
The higher job demands seems to always cause a higher score on the self-perceived levels of work stress (regression coefficient= .42, p< .0001). Facto rs such as having heavy job load, having tight working schedule, retaining knowledge and application of medication, performing regular checkup and executing therapy, having to work extra hours regularly, changing shifts and writing work journals, all contribute to the increased feeling of work stres s. The higher score on having job control seems to always lower the score on work stress perception (regression coefficient= -.16, p= .04). Newly recr uited nurses feel not in control when: doctors do not show up in time for patients' emergencies, working on night shifts with limited support, ha ndling critical patients, unable to handle patients' status and having no control over working hours. The higher score of support from manager a nd colleague seems to lower work stress scores (regression coefficient= -.23, p= -.04). The total average social support coefficient score is 3, which me ans newly recruited nurses feel that they are receiving high level of support, which helped relieve some feeling of work stress.
