婦產科醫師工作現況、工作特性與專業承諾之相關研究

Abstract

國內醫療環境的改變，不僅衝擊婦產科當前結構及未來發展，並影響年輕醫師選擇婦產專科的意願。近年來，雖然女性醫師投入婦產科行列的人數逐漸多於男性醫師，國內婦產科醫師人力仍有不足隱憂。本研究以現役婦產科專科醫師為研究對象，進行工作現況調查，並嚐試瞭解其工作特性、專業承諾及轉業傾向，及三者間的關係。 本研究以臺灣地區區域級以上醫院，年齡介於30-50歲的婦產科專科醫師為抽樣對象，共發出228份問卷，回收有效問卷112份，有效回收率49.1%，研究工具採結構式問卷，以郵寄問卷法收集資料。重要研究發現如下: 一、描述性統計:工作現況中的接生人數及手術人數數量呈兩極化 分佈。 二、雙變項分析:工作自主性和回饋性與情感性承諾呈正相關 (P<0.001)，工作完整性和重要性與持續性承諾呈正相關 (P<0.01)。 三、迴歸分析: 1.女醫師相較於男醫師有較高的情感性承諾；男醫師相較於女 醫師有較高的持續性承諾。若與性別平等意識、工作家庭衝 突交互作用分析則性別無顯著影響。 2.專業承諾與工作的激勵性有關，此關係受到性別平等意識的 影響。 3.專業承諾可預測轉業傾向。 研究建議: 1.醫師工作量的兩極化分佈可進ㄧ步分析其與專業承諾的關 係。 2.醫療機構調整工作內容，提高激勵性，增加專業承諾。 3.前項建議中，最好兼顧醫師工作自主性及行政效率。

With the changing medical environment of Taiwan, the impaction does not only affect the present structure and the future development of Gynecology and Obstetrics, it also affect the young doctors' choices to be a OB/Gynecologist. Though the numbers of female physicians who join Gynecology and Obstetrics are more than male physicians in recent years, the men power of Taiwan's Gynecology and Obstetrics remain shortage. Our study aimed to survey the active practice OB/Gynecologist by means of analyzing their present job conditions, their perceptions on job characteristics, professional commitment and turnover tendency, further we discuss the relationship among them. Our sample included 228 OB/Gynecologists in different settings in Taiwan's regional hospitals and above. Those OB/Gynecologists, aged 30 - 50, were chosen by random. We issued each one a questionnaire and received 112 effective copies. The response rate is 49.1%. The data collection is by paper instrument combined structure questionnaire. Our findings are: 1. In present job conditions, the case numbers of child delivery and OB/Gyn surgery shows M-shaped distribution. 2.Task autonomy and feedback are positively correlated with affective commitment(p<0.001), task identity and significance are positively correlated with continuance commitment (p<0.01). 3.Multiple regression analysis show: a) female OB/Gynecologists have higher affective commitment than male OB/Gynecologists do; meanwhile, male OB/Gynecologists have higher continuance commitment than female OB/Gynecologists do. Sex factor is not significant when corss-link interacting with gender equality and work-family conflict variants. b) professional commitment is correlated with the impellent of job, this correlation can be affected by gender equality consciousness. c) professional commitment predicts turnover tendency. According to this study, we suggest: 1.further study to analysis the correlation between M- shaped distribution of job loading and professional commitment. 2.medical institute elevate the impellent of job in order to stimulate the professional commitment. 3.when doing item 2, it's better to keep the balance between OB/Gynecologist's task autonomy and efficacy of institute.