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研究生:游淑真
研究生(外文):YOU, SU-JANE
論文名稱:台灣骨科專科醫師倦怠之調查研究
論文名稱(外文):Burnout Study of Orthopedic Surgeons in Taiwan
指導教授:賴世烱賴世烱引用關係
指導教授(外文):LAI, SHIH-CHIUNG
口試委員:馬筱笠邱方遙
口試委員(外文):MA, HSIAO-LICHIU, FAN-YAO
口試日期:2021-06-01
學位類別:碩士
校院名稱:國立臺北護理健康大學
系所名稱:運動保健研究所
學門:民生學門
學類:運動休閒及休閒管理學類
論文出版年:2021
畢業學年度:109
語文別:中文
論文頁數:86
中文關鍵詞:⾻科專科醫師Maslach 倦怠量表情緒耗竭個⼈成就去⼈格化
外文關鍵詞:orthopedic surgeonMaslach burnout Inventoryemotional exhaustionpersonal accomplishmentdepersonalization
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倦怠會導致醫護人員所提供的照護或服務的質量惡化,是工作週轉率、缺 勤和士氣低落的一個因素。WHO 於 2019 年明確定義工作倦怠(burnout)為 「一種症候群,來自於工作場所長期的壓力,而未曾被成功處理者」並納入第 11 版國際疾病分類中。而國內學界對醫療及助人專業人員相關研究多針對護理 人員與社工人員,對於骨科專科醫師倦怠的相關議題探討甚少,因此本研究以 國內骨科專科醫師在不同工作場域,因不同背景及不同工作內容所呈現的倦怠 情形進行調查研究與分析,並採用由情緒耗竭、個人成就與去人格化等三個面 向所組成的 Maslach 倦怠量表 (MBI-HSS) 為主要研究工具。
本研究之母群體研究對象為截至 2020 年 9 月在台灣擁有骨科專科醫師執 照,並且從事骨科專科職務者共計 2077 名醫師。研究者運用 Google 線上問 卷,調查骨科專科醫師在不同醫療機構,不同工作內容與不同背景變項下之倦 怠狀況。調查結果以 IBM SPSS 20.0 for Windows 統計套裝軟體進行數據分 析,統計方法包括描述性統計 (descriptive statistics)、t-test 分析、單因子變異分 析 (one-way ANOVA)、多元線性迴歸分析 (multiple regression analysis) 及皮爾森積差相關係數 (Pearson’s correlation coefficient) 分析,所有顯著水準皆定為 α = .05。
經分析有效回收問卷 236 份,本研究發現:一、醫學中心、非醫學中心及 診所的骨科專科醫師,其倦怠的三個面向(情緒耗竭、個人成就、去人格 化),程度並無不同。二、無次專科之骨科專科醫師之個人成就感,普遍低於 有次專科之骨科專科醫師。然而,若每週平均門診病人數高於 250 人,可顯著 提高個人成就感。三、每週有 1-3 小時研究或教學工作的骨科專科醫師,其去 人格化之程度會顯著低於無研究或教學之骨科專科醫師。四、取得骨科專科醫 師資格之年資越久,會同時增加其情緒耗竭程度及個人成就。五、增加骨科專 科醫師每週運動天數,可顯著降低其情緒耗竭及去人格化之程度。
Burnout, a factor for job turnover rate, absence, and low morale, can lead to a deterioration in the quality of care or services provided by medical staff. The World Health Organization (WHO) defined burnout as a syndrome resulting from chronic workplace stress that has not been successfully managed, making burnout become one part of the 11th Revision of the International Classification of Diseases (ICD-11) in 2019. Few studies have been reported regarding burnout among orthopedic surgeons in Taiwan. Therefore, using the Maslach Burnout Inventory-Human Service Survey (MBI-HSS), which is composed of emotional exhaustion, personal accomplishment, and depersonalization, the current study investigated the burnout phenomenon in the orthopedic surgeons in Taiwan.
There were totally 2077 licensed and active orthopedic surgeons in Taiwan in 2020. The participants were asking to fill in a researcher designed Google online MBI-HSS questionnaire. The data were analyzed by means of the descriptive statistics, t-test analysis, one-way ANOVA, multiple regression analysis, and Pearson's correlation coefficient using the IBM SPSS 20.0 for Windows (IBM, New York). All significant levels were set at α = .05.
There were effective 236 questionnaires collected and analyzed. We found that: 1) The orthopedic surgeons showed no differences in emotional exhaustion, personal accomplishment, and depersonalization, no matter whether they are in medical centers, non-medical centers, or in local clinics. 2) The orthopedic surgeons without any subspecialty showed a lower personal accomplishment compared with those with certain subspecialty. However, personal accomplishment could be significantly higher with an outpatient number more than 250 per week. 3) The orthopedic surgeons having 1-3 hours in research or teaching per week showed a significantly lower depersonalization than those without any research or teaching works. 4) The longer qualified as orthopedic surgeons the higher emotional exhaustion and personal accomplishment could be. 5) The orthopedic surgeons with more weekly days of 30-minute exercise showed significantly decreases in emotional exhaustion and depersonalization.
中文摘要 .................................................................................................................. i
英文摘要 ...................................................................................................................iii
目次 ..........................................................................................................................v
表次...........................................................................................................................viii
第一章 緒論...............................................................................................................1
第一節 研究背景......................................................................................................1
第二節 研究目的......................................................................................................6
第三節 研究假說......................................................................................................6
第四節 名詞解釋......................................................................................................7
第五節 研究範圍與限制...........................................................................................8
第二章 理論基礎與相關文獻探討...............................................................................9
第一節 台灣專科醫師的養成教育.............................................................................9
第二節 骨科專科醫師倦怠相關文獻探討..................................................................16
第三節 工作倦怠與倦怠文獻探討.............................................................................25
第四節 全球矚目的倦怠現象....................................................................................31
第五節 小結............................................................................................................36
第三章 研究方法.......................................................................................................37
第一節 參加者.........................................................................................................37
第二節 研究工具.....................................................................................................37
第三節 研究流程.....................................................................................................42
第四節 資料處理與統計分析...................................................................................43
第四章 結果與討論...................................................................................................45
第一節 研究參加者基本資料之描述性統計分析.......................................................45
第二節 不同背景變項各組別對情緒耗竭之推論統計分析.........................................48
第三節 不同背景變項各組別對個人成就之推論統計分析.........................................50
第四節 不同背景變項各組別對去人格化之推論統計分析.........................................53
第五節 各連續變項對倦怠三個面向之複迴歸分析....................................................56
第六節 各連續變項對倦怠三個面向之相關分析........................................................59
第五章 結論與建議....................................................................................................62
第一節 結論.............................................................................................................62
第二節 建議.............................................................................................................63
參考文獻...................................................................................................................64
中文文獻...................................................................................................................64
英文文獻...................................................................................................................68
附錄一 參加者知情同意書及 Maslach 倦怠量表.........................................................71
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