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研究生:余幸宜
研究生(外文):Hsing-Yi Yu
論文名稱:回任醫院護理工作之意向與考量因素:未執業護理人員與護理主管的觀點
論文名稱(外文):Intention and Consideration of Returning to Hospital Nursing Job:Perceptions of Inactive Nurses and Nursing Managers
指導教授:于漱于漱引用關係
指導教授(外文):Shu Yu
學位類別:博士
校院名稱:國立陽明大學
系所名稱:護理學系暨研究所
學門:醫藥衛生學門
學類:護理學類
論文種類:學術論文
論文出版年:2012
畢業學年度:100
語文別:中文
論文頁數:260
中文關鍵詞:未執業護理人員回任意向護理主管聘任意向護理專業承諾護理能力回任重視因素聘任重視因素
外文關鍵詞:inactive nurseintention to reentrynurse managerintention to recruitnursing professional commitmentnursing competencereturn considerationsrecruiting considerations
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全球性的護理人力短缺是一個重要議題;在台灣,許多醫院也面臨護理人力短缺。為了解決此問題,聘用未執業護理人員回任醫院護理工作對於降低短缺有其價值。本研究分三部份,第一部份研究目的在調查台灣未執業護理人員人口學屬性、人力資本、工作狀況、回任意向及回任重視因素,同時探討回任意向預測因子。此部份以台灣地區未執業護理人員為研究對象,採系統性隨機抽樣法自母群體抽取個案,以郵寄問卷收集資料,回收有效問卷共328份,問卷回收率34.9%;研究結果發現,未執業護理人員擁有中上程度的人力資本,包含離業前護理服務年資為10.29年,92.7%的未執業護理人員表示健康狀態為普通以上,中上程度護理專業承諾及護理能力。43.0%未執業護理人員有回任意向,九成以上有回任意向未執業護理人員認為足夠護理人力、工作環境安全、提供回任訓練課程、彈性排休及合理薪資在其考慮回任時非常重要;至於未執業護理人員回任意向的預測因子有健康狀況、離業時間、離業前薪資、社會支持及工作與家庭衝突。第二部份研究目的在瞭解護理主管聘任未執業護理人員意向、聘任重視因素及聘任意向預測因子;此部份以全台灣地區醫院以上453位護理主任為研究母群體進行郵寄問卷普查,回收有效問卷共392份,問卷回收率86.5%。研究結果發現89.0%護理主任願意聘任未執業護理人員,多數護理主任聘任未執業護理人員認為重要的因素有輪班配合度、健康狀態、護理師證照、護理專業承諾、護理能力及個人組織契合度。至於護理主任聘任意向的預測因子有年齡、護理能力、輪班配合度、選擇護理人員偏好及護理人員離職率。第三部份研究目的在比較未執業護理人員個人條件與護理主管聘任條件的差異,比較分析發現未執業護理人員與護理主管在離業時間、護理專業承諾、護理能力、離業醫院等級的條件有較大的差異。本研究建議未執業護理人員在回任護理職場前,應審視個人條件與護理主管聘任條件的差異,並改進個人條件及態度,以符合主管需求;政策上應協助未執業護理人員回任,可先從補足護理人力、提高工作環境安全、提供回任訓練課程、落實彈性排休及提高薪資著手;護理實務與行政上,回任訓練課程(包含醫療現況、照護能力、電腦能力及研究能力)的提供有其必要性,未來在護理研究上,建議進行未執業護理人員回任歷程、回任障礙研究及回任訓練課程的成效評估應及早開始。
Global nursing shortage is an important issue. In Twiwan, many hospitals also face the problem of nurse shortage. In order to resolve the problem, recruit inactive nurses is valueable for decreasing shortag. This study included three parts. The purpose of the part one was to explore inavtive nurses’ personal characteristics, human capital,intention, considerations to return to hospital nursing job and predictors of intention to return. A cross-sectional survey with systematic random sampling was used. We collected data using a questionnaire mailed to inactive nurses in Taiwan. Finally, 328 valid questionnaires were return and the response rate was 34.9%. The results revealed that inavtive nurses have moderate to high level human capital (include average seniority=10.29 years, inactive nurses of 92.7% have moderate to high level health status and moderate to high level nursing professional commitment and nursing competence). Inavtive nurses of 43.0% want to return to hospital nursing job. More than 90% of inactive nurses reported sufficient nursing manpower, safety working environment, nurse refresher programs, flexible work schedule and reasonable salary were the most important considerations of returning to hospital nursing job. Health status, time of leaving nursing, salary before leaving, social support and family-work conflict were the predictors of intention to return. In part two, the purpose was to explore nurse managers’ intention, considerations to recruit inavtive nurse and the predictors of intention to recruit. A census survey was used and data were collected by a questionnaire mailed to 453 nurse directors in Taiwan. Finally, 392 valid questionnaires were return and the response rate was 86.5%. The result revealed that nurse directors of 89.0% were willing to recruit inavtive nurses. The important considerations of recruting inactive nurses included acceptance of alternating shift, health status, nurse licence, nursing professional commitment, nursing competence and person-organization fit. Age, nursing competence, acceptance of alternating shift, nurse preferences and nurse turnover rate were the predictors of intention to recruit. In part three, the purpose was to compare the differences of personal characteristics of inactive nurses and recruitting criteria of nurse managers. The differences in leaving nursing time, nursing professional commitment, nursing competence, hospital degree of leaving between inactive nurse and nurse manager were found. We suggest inactive nurse should review the differences of personal characteristics and recruitting criteria of nurse managers and modify personal characteristics and attitude for fitting nurse managers’ request before returning to nursing job. In nursing policy, sufficient nursing manpower, safety working environment, provision of nurse refresher programs, flexible work schedule and reasonable salary may be helpful in recruiting inactive nurse returning to hospital nursing job. Nursing practice must provide the refresher programs including current trends in medical treatment, nursing practical training, informance competence and research competence. In future, more researches about returning barrier, returning career of inactive nurses and evaluation of refresh programs should be started.
目錄
誌謝 I
中文摘要 II
英文摘要 III
目錄 IV
圖目錄 VII
表目錄 VIII
第一章 緒論 1
第一節 研究背景、動機及重要性 1
第二節 研究目的 6
第二章 文獻查證 7
第一節 未執業護理人員回任醫院護理工作意向 7
壹、未執業護理人員定義 7
貳、回任與回任意向概念與定義 8
參、未執業護理人員回任意向 9
第二節 未執業護理人員回任醫院護理工作的影響因素 14
壹、個人因素 14
貳、家庭因素 50
參、機構因素 66
肆、未執業護理人員回任意向影響因素架構圖 73
伍、研究名詞定義 75
第三節 護理主管聘任未執業護理人員意向及聘任影響因素 78
壹、聘任與聘任意向的概念與定義 78
貳、影響護理主管聘任未執業護理人員意向的影響因素 79
一、未執業護理人員因素 80
二、護理主管因素 92
三、機構因素 94
參、護理主管聘任未執業護理人員意向影響因素架構圖 96
肆、研究名詞定義 97
第三章 研究方法 99
第一節 未執業護理人員回任醫院護理工作意向及影響因素研究99
壹、研究設計 99
貳、研究對象 99
參、研究工具 103
肆、研究工具信、效度檢測 105
伍、研究步驟 125
陸、倫理考量 125
柒、資料分析方法 127
第二節 護理主管聘任未執業人員意向及影響因素研究 129
壹、研究設計 129
貳、研究對象 129
參、研究工具 129
肆、研究步驟 148
伍、倫理考量 149
陸、資料分析方法 149
第四章 結果 151
第一節 未執業護理人員基本資料(包含個人因素、家庭因素)151
第二節 未執業護理人員回任意向、回任重視因素及回任意向預測因子 160
壹、未執業護理人員回任意向 160
貳、未執業護理人員回任醫院護理工作重視因素 162
參、未執業護理人員回任醫院護理工作意向預測因子 164
第三節 護理主管基本資料 170
第四節 護理主管聘任未執業護理人員意向、聘任重視因素及聘任意向預測因子 173
壹、護理主管聘任未執業護理人員意向 173
貳、護理主管聘任未執業護理人員重視因素 176
參、護理主管聘任未執業護理人員意向預測因子 182
第五節 比較未執業護理人員與護理主管在回任意向、聘任意向的差異 185
第六節 比較有回任意向未執業護理人員個人因素與護理主管聘任未執業護理人員時對其個人因素考量程度的差異 187
第五章 討論 191
第一節 未執業護理人員人口學屬性、工作現況及人力資本狀況191
第二節 未執業護理人員回任意向、回任重視因素及回任意向預測因子 197
第三節 護理主管聘任未執業護理人員意向、聘任重視因素及聘任意向預測因子 207
第四節 比較未執業護理人員與護理主管在回任意向、聘任意向的差異 215
第五節 比較有回任意向未執業護理人員個人因素與護理主管聘任未執業護理人員時對其個人因素考量程度的差異 216
第六章 結論與建議 219
第一節 主要成果 219
第二節 研究的貢獻性 221
第三節 建議 223
第四節 研究限制 225
參考文獻 226
附錄一 專家名單 249
附錄二 未執業護理人員回任意向問卷 250
附錄三 護理主管聘任未執業護理人員意向問卷 256
附錄四 國立陽明大學人體試驗暨倫理委員會證書 260

圖目錄
圖2-1 未執業護理人員回任意向影響因素架構圖 74
圖2-2 影響護理主管聘任未執業護理人員因素架構圖 96
圖3 1 未執業護理人員分類 100
圖3-2 未執業護理人員問卷回收分析 101
圖3-3 未執業護理人員研究步驟 126
圖3-4 護理主管問卷回收分析 129
圖3-5 護理主管研究步驟 148

表目錄
表2-1 未執業護理人員定義 8
表2-2 未執業護理人員回任意向相關研究 12
表2-3 人力資本概念性定義 19
表2-4 人力資本測量指標 22
表2-5 家庭社經地位指數計算方式 56
表3-1 目標母群體與衛生署醫事處母群體檢定 101
表3-2 回收樣本與拒訪樣本檢定 102
表3-3 未回覆樣本與回收樣本檢定 103
表3-4 各量表信效度檢測-未執業護理人員 109
表3-5 各量表再測信度檢測-未執業護理人員 110
表3-6 專業護理承諾量表項目分析及內在一致性信度-未執業護理人員 111
表3-7 護理能力量表項目分析及內在一致性信度-未執業護理人員 112
表3-8 性別角色態度量表項目分析及內在一致性信度 114
表3-9 社會支持量表項目分析及內在一致性信度 115
表3-10 工作家庭衝突量表項目分析及內在一致性信度 117
表3-11 未執業護理人員研究依變項操作型定義及計分方式 118
表3-12 未執業護理人員研究個人因素變項操作型定義及計分方式119
表3-13 未執業護理人員研究家庭因素變項操作型定義及計分方式122
表3-14 未執業護理人員研究機構因素變項操作型定義及計分方式123
表3-15 各量表的信效度檢測-護理主管 133
表3-16 各量表的再測信度檢測-護理主管 134
表3-17 專業承諾量表項目分析及內在一致性信度-護理主管 135
表3-18 護理能力量表項目分析及內在一致性信度-護理主管 136
表3-19 外表量表項目分析及內在一致性信度 138
表3-20 個人組織契合度量表項目分析及內在一致性信度 139
表3-21 類我感受量表項目分析及內在一致性信度 140
表3-22 護理主管研究依變項操作型定義及計分方式 141
表3-23 護理主管研究未執業護理人員因素操作型定義及計分方式142
表3-24 護理主管研究護理主管因素操作型定義及計分方式 146
表3-25 護理主管研究機構因素操作型定義及計分方式 147
表4-1 不同回任意向未執業護理人員個人因素分析 155
表4-2 不同回任意向未執業護理人員個人因素連續變項分析 157
表4-3 不同回任意向未執業護理人員家庭因素分析 158
表4-4 不同回任意向未執業護理人員家庭因素連續變項分析 159
表4-5 未執業護理人員回任意向 160
表4-6 有回任意向未執業護理人員期望回任護理工作特質 161
表4-7 不同回任意向未執業護理人員回任重視因素分析 163
表4-8 未執業護理人員回任意向複邏輯對數迴歸 167
表4-9 不同聘任意向護理主管因素及機構因素分析 171
表4-10 不同聘任意向護理主管因素及機構因素連續變項分析 172
表4-11 護理主管聘任意向分析 174
表4-12 護理主管聘任未執業護理人員原因分析 175
表4-13 不同聘任意向護理主管聘任未執業護理人員重視因素分析179
表4-14不同聘任意向護理主管聘任未執業護理人員重視因素連續變項分析 181
表4-15 護理主管聘任未執業護理人員意向複邏輯對數迴歸分析184
表4-16 未執業護理人員回任意向與護理主管聘任意向分析 186
表4-17 有回任意向未執業護理人員個人因素與願意聘任護理主管考量因素分析 189
表4-18 有回任意向未執業護理人員個人因素與願意聘任護理主管考量因素連續變項分析 190


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