臺灣博碩士論文加值系統

全球護理人員嚴重短缺，不只增加了護理人員照護時的工作負荷量，更可能影響病患的照護品質，因此，本研究的目的在探討護理人員足量性、時間壓力、工作倦怠與照護品質間關係。本研究係採用問卷調查法收集資料，樣本對象為台灣北部二間醫學中心的護理人員及病患，透過一位護理人員及其照護的三位病患成對收樣，共回收有效樣本412對(包含護理人員樣本412份、病患樣本1236份)，並使用結構方程式進行分析。結果發現護理人員不足，會增加護理人員的時間壓力，間接降低照護品質中的回應性與保證性。其次，時間壓力會增加工作倦怠中的情緒耗竭，間接增加去個人化，再間接降低其個人成就感。最後，人員的不足，除了會增加時間壓力外，也會透過情緒耗竭、去個人化與個人成就感間接影響照護品質中的回應性、關懷性與有形性。建議管理者透過降低護理人員時間壓力及提高其個人成就感皆能有助於照護品質的提升。

With the worldwide nursing shortage, it increases the nurse workloads and leads to lower patients’ care quality. The purpose of current study is to determine the impact of nurses’ staffing adequacy on time pressure, burnout and care quality. This study utilized a cross-sectional design, analyzed with structural equation modeling (SEM). The sample consisted of 213 pairs of nurses and patients (included 213 nurses and 1236 patients).The findings of this study found staffing adequacy directly affected nurses’ time pressure, then affected the responsiveness and assurance of care quality. In addition, time pressure increased emotional exhaustion of burnout, then affected depersonalization and personal accomplishment. Finally, inadequacy of staffing levels not only increased nursing time pressure, also affected the responsiveness, empathy and tangibles of care quality. The findings also provided implication of hospital managers that reduce nurses’ time pressure and improve their accomplishment may enhance care quality effectively.

目 錄
指導教授推薦書……………………………………………………
口試委員會審定書…………………………………………………
長庚大學授權書…………………………………………………… iii
致謝………………………………………………………………… iv
中文摘要…………………………………………………………… v
英文摘要…………………………………………………………… vi
目錄………………………………………………………………… vii
圖表目錄…………………………………………………………… ix
第一章 前言……………………………………………………………1
第二章 文獻回顧………………………………………………………2
2.1照護品質………………………………………………………2
2.2人員足量性……………………………………………………5
2.3時間壓力………………………………………………………7
2.4工作倦怠………………………………………………………9
第三章 假說推論………………………………………………………12
3.1人員足量性與時間壓力間關係………………………………12
3.2時間壓力與照護品質間關係…………………………………12
3.3時間壓力與情緒耗竭間關係…………………………………14
3.4情緒耗竭與去個人化間關係…………………………………15
3.5去個人化與個人成就感間關係………………………………15
3.6個人成就感與照護品質間關係………………………………15
第四章 研究方法………………………………………………………20
4.1樣本與流程……………………………………………………20
4.2衡量工具………………………………………………………23
4.3衡量工具的信度與效度………………………………………28
第五章 分析……………………………………………………………30
5.1各構念相關……………………………………………………30
5.2假說檢定………………………………………………………31
第六章 結論……………………………………………………………34
6.1研究發現………………………………………………………34
6.2理論意涵………………………………………………………34
6.3管理意涵………………………………………………………35
6.4研究限制與未來研究…………………………………………36
參考文獻 ………………………………………………………………39

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