臺灣博碩士論文加值系統

用藥疏失涵蓋各種不同因素，這些結合起來，造成壓力、緊張、精神不集中，而影響給藥的正確性。本研究，期能了解國內藥師工作壓力的來源、感受度及感受頻次，進一步了解他們的趨避反應及工作滿意度，並提供給醫院管理者，改善壓力源，適時指導藥師做好情緒管理，幫忙疏解壓力，儘可能避免用藥疏失的案例發生。
本研究以雲、嘉區域醫院共8家，地區醫院共37家等醫院藥師為對象，採問卷調查法，總計發出問卷320份，回收277份，回收率為86.56%。以平均數、標準差、百分比、主成份分析、t檢定、變異數分析、次數分配等統計來分析，結果發現：
1. 在37項壓力源中，中等壓力以上的只有怕調劑錯誤而造成醫療糾紛、怕調劑錯而給病人及藥品更換頻繁3題項。總壓力感受度介於輕微與中等壓力之間。
2. 從主成份分析的構面觀之，不管是壓力感受度、感受頻次以及趨避意向反應，均以「安全感」的平均分數為最高。
3. 工作滿意度只與個人屬性中的職位成低度正相關；與壓力感受度、感受頻次各構面成低度負相關；與趨避反應各構面成低度正相關。
4. 趨避意向各構面與其感受度及感受頻次的相關性，凡是有顯著性者，均成低度負相關。藥師的趨避意向多數偏向接受現況與謀求改善。
5. 與壓力感受度具有顯著意義的題項都是女性大於男性，已婚的大於未婚，要輪值的大於不要輪值的，1個小孩大於沒有小孩，大學大於專科，教會醫院大於其他屬性醫院，但是在「臨床資訊不足」這個壓力源，是署立醫院大於其他屬性醫院。與壓力感受頻次具有顯著意義的題項都是已婚的大於未婚，要輪值的大於不要輪值的，1個小孩大於沒有小孩。與趨避意向具有顯著意義的題項都是女性大於男性，大學大於專科，區域或區域教學醫院大於地區醫院，教會醫院大於其他屬性醫院。

There are many factors contributing to medication error. A combination of these factors will create stress, nervousness, and distraction that would affect the dispensing accuracy. We expect this research to identify source of the stress of our pharmacists, how they feel and the frequency of such encounter. We also want to understand how they avoid the stress and their job satisfaction. It is our hope that this research can provide hospital management with guidelines to mitigate source of the stress and better emotion management for the pharmacist to reduce medication error..
This research was conducted by taking the questionnaires from 8 regional and 37 district hospital’s pharmacists and interims in Yun-Lin and Chia-Yi counties. In total, 320 questionnaires were distributed and 277.responded and received. The response ratio was 86.56%. We measured the job stress scores, frequency, the intent to avoid stress and the job satisfaction. The statistics matrix used in our measure includes mean, standard deviation, percentage, principal components analysis, t test, ANOVA, and frequency distribution. Our findings are:
1. The fear of medication error that causes medical dispute, fear of dispensing wrong medicine and frequently changed medicine are the only three items out of 37 sources of stress recorded medium and above scale. The top five of job stress are correlated with sex, age, children number, service year, characteristic and level of a hospital. The total stress scores range between low and medium.
2. The sense of secure scored the highest in principal component analysis in terms of magnitude of feeling stress, frequency and the intent to avoid stress.
3. The job satisfaction has low positive correlation with positions, low negative correlation with magnitude of feeling stress and frequency, low positive correlation with intent to avoid stress.
4. Significant differences have low correlation with intent to avoid stress, magnitude of feeling stress and frequency. The intent of avoiding stress for pharmacists is leaning toward accepting status quo and looking for improvement.
5. Significant differences of the magnitude of feeling stress are greater for female than male, married than unmarried, rotating shift than no rotation, one child than no child, university graduate than college’s, and Christian hospital than others. Yet for the “insufficient clinical information” source of stress, provincial hospital is greater than other hospitals. Significant differences of the frequency are greater for married than unmarried, rotating shift than no rotation and one child than no child. Significant differences of intent to avoid stress are greater for female than male, university graduate than college’s, region or regional education hospital than district hospital and Christian hospital than others

目 錄
中文摘要 -------------------------------------------------------------------------- i
英文摘要 -------------------------------------------------------------------------- ii
誌謝 -------------------------------------------------------------------------- iv
目錄 -------------------------------------------------------------------------- v
表目錄 -------------------------------------------------------------------------- viii
圖目錄 -------------------------------------------------------------------------- x
第一章 緒論------------------------------------------------------------------- 1
1.1 研究背景與動機---------------------------------------------------- 1
1.2 研究目的------------------------------------------------------------- 2
1.3 研究範圍與限制---------------------------------------------------- 3
1.4 研究步驟與論文架構---------------------------------------------- 3
第二章 文獻探討------------------------------------------------------------- 5
2.1 壓力的定義---------------------------------------------------------- 5
2.2 工作壓力與健康的關係------------------------------------------- 8
2.3 壓力適應三階段---------------------------------------------------- 9
2.4 工作壓力的來源---------------------------------------------------- 9
2.5 藥師工作壓力源---------------------------------------------------- 12
2.6 趨避意向------------------------------------------------------------- 14
2.7 工作滿意度---------------------------------------------------------- 15
第三章 研究方法------------------------------------------------------------- 17
3.1 研究架構------------------------------------------------------------- 17
3.2 名詞解釋------------------------------------------------------------- 18
3.3 計分方式------------------------------------------------------------- 18
3.3.1 壓力感受量表------------------------------------------------------- 18
3.3.2 壓力頻次量表------------------------------------------------------- 18
3.3.3 趨避意向量表------------------------------------------------------- 19
3.3.4 滿意度量表---------------------------------------------------------- 19
3.4 壓力源量表之內容效度------------------------------------------- 19
3.5 壓力源量表之信度------------------------------------------------- 21
3.6 問卷前測與修改---------------------------------------------------- 21
3.7 問卷調查對象及發放方式---------------------------------------- 21
3.8 資料編碼------------------------------------------------------------- 22
3.9 統計分析------------------------------------------------------------- 22
第四章 研究結果與討論---------------------------------------------------- 23
4.1 問卷發出及回收統計情------------------------------------------- 23
4.2 個人屬性之描述性分析------------------------------------------- 24
4.3 工作滿意量表之描述性分析------------------------------------- 26
4.4 工作壓力感受度量表的描述性統計與信度分析------------- 28
4.5 工作壓力感受頻次量表的描述性分析------------------------- 31
4.6 工作壓力趨避意向反應量表的描述性分析------------------- 33
4.7 主成份分析---------------------------------------------------------- 35
4.8 總工作滿意度與個人屬性及壓力感受度、壓力感受頻次、趨避反應構面間平均數之相關分析---------------------------- 41
4.9 獨立樣本t檢定----------------------------------------------------- 44
4.10 單因子變異數分析------------------------------------------------- 47
4.11 交互作用 (二因子變異數分析) --------------------------------- 52
4.12 壓力感受度前五名與其趨避意向的相關性及次數分配分析---------------------------------------------------------------------- 59
4.13 總壓力感受度與其趨避意向的次數分配分析---------------- 61
第五章 結論與建議---------------------------------------------------------- 63
5.1 結論------------------------------------------------------------------- 63
5.1.1 醫院藥師對壓力源的感受程度---------------------------------- 63
5.1.2 藥師的壓力感受度、感受頻次、趨避反應、工作滿意度的關係------------------------------------------------------------------- 63
5.1.3 個人屬性與壓力源、壓力感受度、感受頻次、趨避反應、工作滿意度的關係------------------------------------------------- 63
5.2 建議------------------------------------------------------------------- 64
5.2.1 醫院藥局主任的建議整合---------------------------------------- 64
5.2.2 壓力的預防管理---------------------------------------------------- 65
5.2.2.1 個人壓力的預防管理---------------------------------------------- 65
5.2.2.1.1 初級預防------------------------------------------------------------- 65
5.2.2.1.2 次級預防------------------------------------------------------------- 66
5.2.2.1.3 三級預防------------------------------------------------------------- 66
5.2.2.2 組織壓力的預防管理---------------------------------------------- 66
5.2.2.2.1 工作和身體的需求------------------------------------------------- 66
5.2.2.2.2 角色和人際關係的需求------------------------------------------- 67
參考文獻 -------------------------------------------------------------------------- 69
附件一 問卷調查表：個人基本資料、滿意度-------------------------- 73
問卷調查表：感受度、感受頻次、趨避意向----------------- 74

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