臺灣博碩士論文加值系統

急診醫師為醫療的最前線，當社會發生重大的災難時，急診室就是救死扶傷的第一線且是社會安全網中不可或缺的一環。但在台灣急診醫師的人力資源一直不足，因此本研究以調查急診醫師工作滿意度及離職意向為主軸，探討各研究構面及細部因素對於工作滿意度及離職意願的影響，找出其決定性因素，可做為衛生主管機關及醫院經營者對於急診經營管理政策的參考。
本研究主要參考 Lloyd, Streiner, Shannon於1994年於加拿大發展之急診醫師工作滿意度量表及整體工作滿意度量表，發展出本研究的研究架構與研究假設。問卷包含行政管理、臨床自主、醫療資源、工作關係、生活型態、工作挑戰、整體工作滿意度等構面共91項問題。
本問卷調查針對全體台灣急診醫學會會員醫師發放電子問卷共1480人，填答者176份，回覆比率11.89%。資料收集後，運用SPSS統計軟體進行因素分析、信效度檢定、敘述性統計、T檢定、ANOVA、線性迴歸、線性機率模型（Linear Probability Model, LPM）等相關檢定。
本問卷經因素分析後，七大構面共歸納出二十項因素，並精簡為65題。台灣急診醫師工作滿意度平均2.905分，低於滿意3分。填答者中有57.4% 表達不滿意，且51.7% 具三年內離職意向。本研究結果符合赫茨伯格雙因素理論。主要影響台灣急診醫師工作滿意度及離職意向的保健性因素為東部縣市、環境因素，物質生活，家庭生活。促進性因素則為年資增長，時數降低，職務提升，臨床限制，團隊關係，醫病關係，個人生活。而薪資管理及人力因素為雙向性因素中的保健性因素。政策管理，臨床協調，健康生活，工作挑戰為雙向性因素中的促進性因素。問題管理，排班管理為雙向性因素中的中性因素。最後，健保給付，設備因素，性別，婚姻狀況，醫院層級，薪資水準等對於急診醫師工作滿意度及離職意向均無顯著影響。

The primary objective of this study was to develop a valid and reliable instrument to measure the job satisfaction of the Taiwan emergency physician (EP). The secondary objective was to investiagte factors associated with EP’s job satisfaction and intention to leave. The Canadian Emergency Physician Job Satisfaction Instrument (EPJS) was applied into this study. A total of 176 questionnaires were analyzed. We developed a reliable instrument with 65 items for further emergency physician job satisfaction investigation. The results of this study indicate that east county, environment, material life, and family life are hygiene factors (significantly effected the intention to leave). Furthermore, seniority, working hours, job position, clinical limitation, team relationship, patient relationship and personal life are motivator factors (had significantly influence on the job satisfaction). Compensation management and human resources management are bidirectional hygiene factors (had significantly influence both on the job satisfaction and the intention to leave and major effected the intention to leave). In addition, health life and challenge are bidirectional motivator factors (had significantly both on the job satisfaction and the intention to leave and major effected the job satisfaction). The results are in conformity with Herzberg’s two factor theory.

摘要 I
Abstract II
誌謝 V
目錄 VI
表目錄 VIII
圖目錄 X
第壹章 緒論 1
第一節 研究背景與動機 1
第二節 研究目的 2
第三節 研究範圍 2
第四節 研究流程 3
第貳章 文獻回顧與探討 4
第一節 工作滿意度與離職意向的重要性 4
第二節 影響工作滿意度之因素 6
第三節 歷年來對於急診醫師工作滿意度的研究 7
第四節 本研究之努力方向 11
第參章 研究方法 12
第一節 研究架構與假說 13
第二節 操作性定義與研究問項 14
第三節 抽樣設計與研究對象 22
第四節 資料分析方法 23
第肆章 實證結果分析 25
第一節 因素分析、信效度分析 25
第二節 敘述性統計分析 41
第三節 差異性分析 49
第四節 線性迴歸分析 56
第五節 線性機率模式分析 61
第六節 總結各因素之整理 64
第伍章 結論與建議 66
第一節 問卷發展結論 66
第二節 整體問卷回覆結論 66
第三節 綜合結論 72
第四節 實務心得與感想 76
第陸章 研究限制 79
參考文獻 80
附錄一、台灣急診醫師工作滿意度及離職意向調查 85

中文參考文獻
台灣急診醫學會 ( http://www.sem.org.tw/tsem/?doActionValueID= 1454＆menuID 1179069063＆doAction=detail )
吳萬益 (2011)。企業研究方法。台北：華泰文化。
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