護理長管理自我效能與管理成效之相關研究
A study of the relationship between perceptions of self-efficacy and performance in management by head nurses
中文摘要
本研究目的在探討臨床護理長管理自我效能的影響因素、及其管理自我效能與管 理成效間之關係。係採橫斷式相關性之研究設計。以方便取樣，針對大台北地區 三家分屬公、私、軍不同屬性的準醫學中心以上機構，和六家分別為市立和私人 的區域級醫院的護理長，以自擬“護理長管理自我效能與管理成效問卷調查表
”和訪談方式收集資料。收案日期為88 年 1 月至 5 月，共發出 289 份問卷，回 收277 份，回收率 95.8%；其中有效卷為 268 份，回收問卷有效率 96.8%。資料 以t 檢定、配對 t 檢定、單因子變異數分析、卡方檢定、直線迴歸和 Partial F test 等 統計方法進行處理和分析。
研究結果發現:1.護理長管理自我效能平均得分 8.48 分(滿分 10 分)；各分量表平
均介於8.29~8.93 分，顯示受測護理長對執行任務具八成自信和把握；而自評實
際表現平均8.06 分(滿分 10 分)；各分量表則介於 7.83 ~8.65 分，雖低於自我效
能，但仍自認有80%左右的執行力；對整體工作滿意度平均為 7.57 分(滿分 10
分)，表示護理長對自己工作表現有 75%的滿意度。2.受測護理長管理自我效能 會因年齡、婚姻狀況、工作年資、護理長年資、行政訓練、工作場所屬性、醫院評鑑 等級等不同，而有顯著的不同。3.護理長在履行任務過程中，知覺到被口語支持 和鼓勵、以及感受到不錯經驗的頻率越多，而身心不適較少者，其管理自我效能
的得分也越高。4.工作年資、行政訓練、就讀護理相關科系和知覺不錯經驗的頻率
可用來預測護理長管理自我效能的得分，其共同預測力為22.01%。5.護理長管
理自我效能會顯著影響自評實際表現的得分，其預測力高達79%。而且管理自
我效能與實際表現得分越高者，其工作滿意度也越高；其中自評實際表現可以
用來預測工作滿意度，其預測力為44%。6.護理長管理自我效能與自評實際表現
間也呈顯著的差異。工作年資、行政訓練是影響兩者間有差異的重要變項；而且 不同差異程度其工作滿意度也有顯著不同。7.會影響護理長管理自我效能與實際 表現間有差異的因素，經訪談所得包括:外在環境:如機構的政策和要求、授權程 度及職掌的明確性、單位和護理工作的特性；相關人員方面:則有主管和部屬目 標、價值觀、理念與護理長的一致性，和對護理長的支持和肯定程度；以及護理 長本身人格特質、對護理和管理的興趣和認同、以及工作意願和投入程度等。
由本研究結果了解，工作經驗和行政訓練是影響自我效能的重要因素。在選擇護 理長時須考慮工作年資，不可單以學歷為取捨。另外護理長的管理自我效能，會 顯著影響臨床實際表現，因此訓練護理長時，不可忽略信心的培養。期待這個結 果可以提供未來護理行政者在選拔和培訓人才，以及行政管理課程設計上之參 考。
英文摘要
The purpose of the thesis was to study factors associated with perceptions of self- efficacy, and the relationship between these perceptions and of performance
management by head nurses. A cross-sectional research design was conducted using convenience sampling. The sample included head nurses from three medical centers, and from six local hospitals in Taipei. A "Relationship between Perceptions of Self- efficacy and Performance in Management by Head Nurses Questionnaire" was developed to collect data between January and May 1999. From a total of 289 questionnaires distributed, 277 were returned, a return rate of 95.8%. Of these, 268 were valid for purposes of the study, a validity rate of 96.8%. Data were analyzed by t-test, paired t-test, one way ANOVA, chi-square, linear regression and partial F test.
Research results were shown as following: 1) Head nurses obtained an average of 8.48 points (total 10 points) for self-efficacy of management, with score of sub-scales were between 8.29~8.93, indicated an 80% level of self-confidence in the discharge of their responsibilities by head nurses. In self-appraisal of actual performance, head nurses achieved 8.06 points (total 10 points), with score of sub-scales were between 7.83~8.65. Although self-appraisal of actual performance was slightly lower than their perception of self-efficacy, their belief in their performance was around 80%.
Their overall satisfaction with their work was 7.57 points (total 10 points) indicated a 75% satisfaction level among head nurses of their performance. 2) The perception of self-efficacy of head nurses was associated with age, marital status, seniority of work, seniority of head nurse, administrative training, type of work environment, and hospital assessment level.3) Head nurses who had high frequency of verbal
encouragement and support, high frequency of positive experiences, and who had low frequency of sickness tended to have a higher self-efficacy of management. 4)
Finding was indicated that 22.01% of the variance in estimating perception of self- efficacy of management among head nurses can be predicated by seniority of work, administrative training, graduation in nursing and perceptions of positive experiences.
5) Head nurse''s self-efficacy of management influenced self-appraisal of actual performance at a level of 79%. The higher the self-efficacy of management or self-appraisal of actual performance, the level of job satisfaction was elevated.
Especially, finding was shown that 44% of the variance in job satisfaction can be predicated by self-appraisal of actual performance. 6) Seniority of work and
administrative training were associated with the significant discrepancy between self- efficacy of management and self-appraisal of actual performance. 7) Based on interview data, the discrepancy between self-efficacy of management and self- appraised of actual performance may be associated with external environment : organization''s policy and demands, level of delegation of authority and
clarity of job descriptions, the nature of the ward and type of nursing work, other staff: the level of correspondence between the goals, values, and belief of the head nurse and those of her superiors and subordinates, the level of support and
encouragement given the head nurse by superiors and subordinates, the character of the head nurse: interest in nursing and management and level of enthusiasm and Involvement.
This study was shown that the most important factors associated with a head nurse''s self-efficacy of management were job experience and administrative training. It is not only to consider educational background, but also consider job experience while hiring a head nurse. In addition, the perception of self- efficacy may relate with a head nurse''s actual clinical performance, so building up self-confidence is clearly significant in the training of a head nurse. It is hoped that this study will be able to provide reference material for the recruitment and training of head nurses by nursing administrators and for the planning of
administrative management classes.
