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研究生:黃芳婷
研究生(外文):Fang-Ting Huang
論文名稱:探討醫院合併前後各合併醫院護理人員工作態度之差異—以高雄市立聯合醫院為例
論文名稱(外文):The differences of nursing staff’s working attitudes before and after hospital merger — A study of Kaohsiung Municipal United Hospital
指導教授:趙必孝趙必孝引用關係
指導教授(外文):Bih-Shiaw Jaw
學位類別:碩士
校院名稱:國立中山大學
系所名稱:醫務管理研究所
學門:商業及管理學門
學類:醫管學類
論文種類:學術論文
論文出版年:2004
畢業學年度:92
語文別:中文
論文頁數:116
中文關鍵詞:工作滿足護理人員組織承諾工作不安全感工作投入離職傾向
外文關鍵詞:organizational commitmentjob satisfactionjob involvementjob insecuritynurse staffingand intention to quit.
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台灣地區之公立醫院,一方面因為曾所肩負的社會責任及角色的改變、另一方面因為全民健保制度下醫療產業的激烈競爭,在經營型態上亟需調整,例如以合併的方式整合核心能力、降低行政成本。而組織的改變對於組織員工普遍會引起工作不安全感,並進一步造成工作態度上的影響;在醫院當中,佔員工最大比例的人員即為護理人員。
本研究之研究對象為高雄市立聯合醫院,合併前分別為高雄市立大同醫院與高雄市立婦幼綜合醫院,兩院於2003年初合併。本研究於合併前夕2002年底發放第一次問卷,合併後一年,即2003年底再次發放問卷,以問卷調查護理人員工作不安全感及各工作態度之狀況。針對兩次所得之問卷,一方面探討醫院合併之工作不安全感對於護理人員工作態度的影響,另一方面也比較了兩個不同醫院之護理人員工作態度之差異。研究結果發現:
1. 護理人員之工作不安感愈高,則工作滿足愈差。
2. 護理人員之工作不安全感及各工作態度,在不同個人特徵(所屬醫院、年齡、婚姻狀況、教育程度、服務年資、職階、編制)之情況下有不同之表現。
3. 護理人員之工作不安全感對於工作滿足、組織承諾及離職傾向之影響,在不同醫院之間有顯著差異;亦即護理人員之工作不安全感對工作滿足,受到所屬醫院的干擾效果之影響。
4. 護理人員之工作不安全感對於工作滿足之影響,在合併前或合併後也存在顯著差異;亦即護理人員之工作不安全感對工作滿足,受到合併前後的干擾效果之影響。
The public hospitals in Taiwan are facing the change of public responsibilities that they used to have and on the other hand encountering the fierce competition caused by National Health Insurance. As a consequence of this, public hospitals need to adjust their managerial model, like mergers for example, in order to coordinate their core competence and lower their cost in administration. However, the changes of organizations will cause the job insecurity of employees and further to affect their working attitudes. In hospitals, nursing staff forms the biggest proportion of employees.
In this study, we examined the merger of Kaohsiung Municipal United Hospital in 2003. We investigated the job insecurity and working attitudes of nursing staff by questionnaires in the end of 2002 (before the merger) and in the end of 2003 (one year later of the merger) separately. By analyzing those questionnaires we explored the influences of job insecurity on working attitudes, and we also compared the differences of nursing staff’s working attitudes in two hospitals. The findings are:
1. The more job insecurity that nurses got, the worse their job satisfaction will be.
2. The job insecurity and working attitudes of nursing staff will be different based on their different personal characteristics, including the hospital they belonged to, the ages, marriage status, education, levels of position, and their contract types.
3. The influences of job insecurity on job satisfaction, organizational commitment, and intention to quit will be different based on different hospitals.
4. The influences of job insecurity on job satisfaction will be different before and after merger.
第一章 緒論……………………………………………………………1
第一節 研究背景與動機…………………………………………………………1
第二節 研究目的……………………………………………………………………3
第二章 文獻探討……………………………………………………….5
第一節 合併之意義與醫院合併…………………………………………………….5
第二節 工作不安全感……………………………………………………………….6
第三節 工作態度……………………………………………………………………11
第四節 台灣地區護理人員之現況…………………………………………………22
第五節 醫院背景……………………………………………………………………23
第三章 研究方法………………………………………………………26
第一節 研究架構與假設……………………………………………………………26
第二節 研究變項的操作型定義與衡量……………………………………………31
第三節 資料蒐集方法及樣本特性分析……………………………………………40
第四節 資料分析方法………………………………………………………………46
第五節 研究限制……………………………………………………………………47
第四章 研究結果………………………………………………………49
第一節 各研究變項之描述性統計結果……………………………………………49
第二節 工作不安全感、工作態度與個人變項的變異數分析……………………53
第三節 工作不安全感與各項工作態度的相關性及迴歸分析……………………66
第四節 不同醫院與合併前後對各項工作態度之影響……………………………68
第五章 結論與建議……………………………………………………93
第一節 結論…………………………………………………………………………93
第二節 建議………………………………………………………………………103
參考文獻………………………………………………………………107
附錄……………………………………………………………………114
參考文獻
一、中文部分
Robbins, S.P. (1994)。組織行為學。(李青芬、李雅婷、趙慕芬譯)。台北市:華泰。
中華民國護理師護士公會全國聯合會(2004)。「護理危機」病人安全在哪裡?—護士節記者會。台北市。
行政院衛生署(2002)。民國九十一年醫療機構現況及醫療服務統計量統計摘要。上網日期:93年2月15日。網址:http:// www.doh.gov.tw/statistic/醫療服務量/91.htm
行政院衛生署(2003)。中華民國公共衛生年報。台北市:國家書坊。
吳靜吉、潘養源、丁興祥(1980)。內外控取向與工作滿足及績效之關係,國立政治大學學報,第41期,61-74。
林辰彥、梁開天、鄭炎生(1993)。醫藥衛生類法規,台北縣:名拓。
林碉力、車鵬程、康才�隉B陳俊堅、蔡麗玲、邱民芳(1995)。金融機構合併之研究。台北:中央存款保險局。
莊逸洲(2001)。醫療機構人力資源管理。台北市:華杏。
許士軍(1990)。管理學。台北市:東華。
陳永興(2004),高雄市立聯合醫院醫院簡介。上網日期:93年2月19日。網址: http://w4.kcg.gov.tw/~kmwcgh/0/051h000f.htm
陳楚杰(2001)。醫院組織與管理。台北市:宏翰。
黃文棧(2002)。公務制度對醫院人力成本與生產效率影響之探討—以高雄市立醫院為例。國立高雄醫學大學公共衛生研究所碩士論文。
黃國隆(1986)。中學教師的組織承諾與專業承諾,國立政治大學學報,第53期,55-84。

二、英文部分
Adkins, C.L., Werbel, J.D., & Farh, J.L. (2001). A field study of job insecurity during a financial crisis. Group & Organization Management, 26(4), 463-483.
Ameen, E.C., Jackson, C., Pasewark, W.R., & Strawser, J.R. (1995). An empirical investigation of the antecedents and consequences of job insecurity on the turnover intentions of academic accountants. Issues in Accounting Education, 10(1), 65-
Angle, H.L. & Perry, J.L. (1981). An empirical assessment of organizational commitment and organizational effectiveness. Administrative Science Quarterly, 26, 1-13.
Appelbaum, S.H., Gandell, J., Yortis, H., Proper, S., & Jobin, F. (2000). Anatomy of a merger: Behavior of organizational factors and processes throughout the pre- during- post-stage. Management Decision, 38(9), 649.
Armstrong-Stassen, M., Cameron, S.J., & Horsburgh, M.E. (2001). Downsizing -initiated job transfer of hospital nurses: How do the job transferees fare. Journal of Health and Human Services Administration, 23(4), 470-489.
Armstrong-Stassen, M., Cameron, S.J., Mantler, J., & Horsburgh, M.E. (2001). The impact of hospital amalgamation on the job attitudes of nurses. Canadian Journal of Administrative Sciences, 18(3), 149-162.
Ashford, S.J., Lee, C., & Bobko, P. (1989). Content, causes, and consequences of job insecurity: a theory-based measure and substantive test. Academy of Management Journal, 32(4), 803-829.
Austrin, S.M. (Ed.) (1999). Managed health care simplified – A glossary of terms. Canada: Delmar.
Blaufuss, J., Maynard, J., & Schollars, G. (1992). Methods of evaluating turnover costs. Nursing Management, 23(5), 52-59.
Burk, R.J. & Greenglass, E.R. (2000). Effects of hospital restructuring on full time and part time nursing staff in Ontario. International Journal of Nursing Studies, 37(2), 163-171.
Burke, R.J. & Greenglass, E.R. (2001). Hospital Restructuring and nursing staff well-being: The role of personal resources. Journal of Health and Human Service Administration, 24(1), 3-26.
Burke, R.J. (2003). Nursing staff attitudes following restructuring: The role of perceived organizational support, restructuring processes and stressors. The International Journal of Sociology and Social Policy, 23(8/9), 129-157.


Caplan, R.D., Cobb, S., French, J.R., Jr., Van Harrison, R., & Pinneau, S.R., Jr. (1975). Job demand and worker health, Washington, D.C.: U.S. Department of Health, Education, and Welfare, National Institute for Occupational Safety and Health.
Casal, J.C. (1996). Shoot for the ‘star’. Journal of Health Care Marketing, 16(2), 22-26.
Davy, J.A., Kinicki, A., Kilroy, J., & Sheck, C. (1988). After the merger: Dealing with People’s Uncertainty. Training & Development Journal, November, 57-61.
Frone, M.R. & Major, B. (1988). Communication quality and job satisfaction among managerial nurses. Group & Organizational Studies, 13(3), 332-347.
Greenhalgh, L. & Rosenblatt, Z. (1984). Job insecurity: Toward conceptual clarity. Academy of Management Review, 9(3), 438-448.
Greenhalgh, L. (1983). Managing the job insecurity crisis. Human Resource Management. 22(4), 431-444.
Hartmann, L.C. & Bambacas, M. (2000). Organizational commitment: A multi method scale analysis and test of effects. International Journal of Organizational Analysis, 8(1), 89-108.
Holmås, T.H. (2002). Keeping nurses at work: A duration analysis. Health Econ, 11, 493-503.
Jamal, M. & Baba, V.V. (1992). Shiftwork and department-type related to job stress, work attitudes and behavioral intentions: A study of nurses. Journal of Organizational Behavior, 13(5), 449-464.
Kanungo, R.N. (1982). Measurement of job and work involvement. Journal of Applied Psychology, 67, 341-349.
King, J.E. (2000). White-collar reactions to job insecurity and the role of the psychology contract: Implications for human resources management. Human Resource Management, 39(1), 79-92.
Kinnunen, U., Mauno, S., Nätti, J., & Happonen, M. (2000). Organizatoinal antecedents and outcomes of job insecurity: A longitudinal study in three organizations in Finland. Journal of Organizational Behavior, 21(4), 443-459.
Leiter, M.P. & Maslach, C. (1988). The impact of interpersonal environment on burnout and organizational commitment. Journal of Organizational Behavior, 9 (4), 297-308.
Lok, P. & Crawford, J. (2001). Antecedents of organizational commitment and the mediating role of job satisfaction. Journal of Management Psychology, 16(8), 594-613.


Lopopolo, R.B. (2002). The relationship of role-related variables to job satisfaction and commitment to the organization in a restructured hospital environment. Physical Therapy, 82(10), 984-999.
McCue, M., Mark, B.A., & Harless, D.W. (2003). Nurse Staffing, Quality, and Financial Performance. Journal of Health Care Finance, 29(4), 54-76.
McNeese-Smith, D. (1996). Increasing employee productivity, job satisfaction, and organizational commitment. Hospital & Health Service Administration, 41(2), 160-175.
McNeese-Smith, D.K. (2000). Job stages of entry, mastery, and disengagement among nurses. Journal of Nursing Administration, 30(3), 140-147.
McNeese-Smith, D.K. (2001). A nursing shortage: Building organizational commitment among nurses. Journal of Healthcare Management, 46(3), 173-187.
Mobley, W.H. (1977). Intermediate linkage in the relationship between job satisfaction and employee turnover. Journal of Applied Psychology, 62(2), 237-240.
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.
Moore, K.A. (2001). Hospital restructuring: Impact on nurses mediated by social support and a perception of challenge. Journal of Health and Human Service Administration, 23(4), 490-515.
Mowday, R.T., Steers, R.M., & Porter, L.W. (1979). The measurement of organizational commitment. Journal of Vocational Behavior, 14, 224-247.
Newman, K. (2002). The nurse satisfaction, service quality and nurse retention chain. Journal of Management in Medicine, 16(4), 271-291.
Porter, L.W., Steers, R.M., Mowday, R.T., & Boulian, P.V. (1974). Organizational commitment, job satisfaction, and turnover among psychiatric technicians. Journal of Applied Psychology, 59(5), 603-609.
Price, J.L. & Mueller, C.W. (1981). A casual model of turnover for nurse. Academy of Management Journal, 24(3), 543-565.
Sager, J.K. (1990). Reducing sales manager job stress. The Journal of Consumer Marketing, 7(4), 5-14.
Samuel, A. (1994). Job involvement: An analysis of its determinants among male and female teachers. Revue Canadienne des Sciences de l’Administration, 11(4), 320-330.
Savery, L.K. & Syme, P.D. (1996). Organizational commitment and hospital pharmacists. The Journal of Management, 15(1), 14

Shaw, D.V. (2003). Mergers and health care organizations. Journal of Health Care Finance, 29(3), 28-37.
Tyson, P.D. & Pongruengphant, R. (2004). Five-year follow-up study of stress among nurses in public and private hospital in Thailand. International Journal of Nursing Studies, 41, 247-254.
Tzeng, H.M. & Ketefian, S. (2002). The relationship between nurses’ job satisfaction and inpatient satisfaction: An exploratory study in a Taiwan teaching hospital. Journal of Nursing Care Quality, 16(2), 39-49.
Wanous, J.P. & Lawler, E.E. (1972). Measurement and meaning of job satisfaction. Journal of Applied Psychology, 56(2), 95-105.
World Health Organization (2002). Strategic directions for strengthening nursing and midwifery services. Retrieved April 17th, 2004, from http://www.who.int/health-services-delivery/nursing/kra1.pdf
World Health Organization (2004) The Observatory''s Health Systems Glossary. Retrieved April 17th, 2004, from http://www.euro.who.int/observatory/Glossary/Toppage?phrase=N
World Health Organization Regional Office for Europe (2000). Health care systems in transitions—Germany. European observatory on health care systems. Retrieved April 17th, 2004, from http://www.euro.who.int/eprise/main/who/countryInformation/Country?AreaCode=DEU
Zimmerman, B. & Dooley, K. (2001). Mergers versus emergers: Structural change in health care systems. Emergence, 3(4), 65-82.
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