請用此 Handle URI 來引用此文件:
http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/61475
完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 林能白(Neng-Pai Lin) | |
dc.contributor.author | Ian-Jiun Kuo | en |
dc.contributor.author | 郭彥君 | zh_TW |
dc.date.accessioned | 2021-06-16T13:03:49Z | - |
dc.date.available | 2013-09-24 | |
dc.date.copyright | 2013-09-24 | |
dc.date.issued | 2013 | |
dc.date.submitted | 2013-08-05 | |
dc.identifier.citation | Arnetz, B. B. (1997). Physicians' view of their work environment and organisation. Psychother Psychosom, 66(3), 155-162.
Brannon, L., & Feist, J. (2000). Health Psychology: AN Introduction to Behavior and Health(4yh ed.). Pacific Grove: Books/Cole. Center, C., Davis, M., Detre, T., Ford, D. E., Hansbrough, W., Hendin, H., . . . Silverman, M. M. (2003). Confronting depression and suicide in physicians: a consensus statement. JAMA, 289(23), 3161-3166. doi: 10.1001/jama.289.23.3161 Chen, H. C., Wu, C. H., Lee, Y. J., Liao, S. C., & Lee, M. B. (2005). Validity of the five-item Brief Symptom Rating Scale among subjects admitted for general health screening. J Formos Med Assoc, 104(11), 824-829. Cheng, Y., Luh, W. M., & Guo, Y. L. (2003). Reliability and validity of the Chinese version of the Job Content Questionnaire in Taiwanese workers. Int J Behav Med, 10(1), 15-30. Cooper, C. L. (1983). Identifying stressors at work: recent research developments. J Psychosom Res, 27(5), 369-376. Curtis, A.J. (2000). Health Psychology. Boston: Routledge. Dyrbye, L. N., Shanafelt, T. D., Balch, C. M., Satele, D., Sloan, J., & Freischlag, J. (2011). Relationship between work-home conflicts and burnout among American surgeons: a comparison by sex. Arch Surg, 146(2), 211-217. doi: 10.1001/archsurg.2010.310 Ecknrode, J., & Gore, S. (1990). Stress between work and family., Plenum Press. Frank, E., Biola, H., & Burnett, C. A. (2000). Mortality rates and causes among U.S. physicians. Am J Prev Med, 19(3), 155-159. Guest, R. S., Baser, R., Li, Y., Scardino, P. T., Brown, A. E., & Kissane, D. W. (2011). Cancer surgeons' distress and well-being, II: modifiable factors and the potential for organizational interventions. Ann Surg Oncol, 18(5), 1236-1242. doi: 10.1245/s10434-011-1623-5 Howie, J. G., Hopton, J. L., Heaney, D. J., & Porter, A. M. (1992). Attitudes to medical care, the organization of work, and stress among general practitioners. Br J Gen Pract, 42(358), 181-185. Hughes, P. H., Brandenburg, N., Baldwin, D. C., Jr., Storr, C. L., Williams, K. M., Anthony, J. C., & Sheehan, D. V. (1992). Prevalence of substance use among US physicians. JAMA, 267(17), 2333-2339. JR., Guardado. (2011). PRofessional liability insurance indemnity and expenses, claim adjudication, and policy limits, 2000-2009.Policy Research Perspectives . Retrieved from http://www.ama-assn.org/resources/doc/health-care-costs/medical-liability-reform.pdf. Kane CK, ed. (2010). Policy research perspectives: medical liability claim frequency: a 2007-2008 snapshot of phsycians.: Retrieved from http://www.ama-assn.org/resources/doc/hea;th-policy/prp-201001-clain-freq.pdf. Kessler, R. C., Berglund, P., Borges, G., Nock, M., & Wang, P. S. (2005). Trends in suicide ideation, plans, gestures, and attempts in the United States, 1990-1992 to 2001-2003. JAMA, 293(20), 2487-2495. doi: 10.1001/jama.293.20.2487 Kessler, R. C., Borges, G., & Walters, E. E. (1999). Prevalence of and risk factors for lifetime suicide attempts in the National Comorbidity Survey. Arch Gen Psychiatry, 56(7), 617-626. Lennon, M. C., & Rosenfield, S. (1992). Women and mental health: the interaction of job and family conditions. J Health Soc Behav, 33(4), 316-327. Lesage, F. X., Berjot, S., Altintas, E., & Paty, B. (2013). Burnout Among Occupational Physicians: A Threat to Occupational Health Systems?--A Nationwide Cross-sectional Survey. Ann Occup Hyg. doi: 10.1093/annhyg/met013 Lung, F. W., & Lee, M. B. (2008). The five-item Brief-Symptom Rating Scale as a suicide ideation screening instrument for psychiatric inpatients and community residents. BMC Psychiatry, 8, 53. doi: 10.1186/1471-244x-8-53 Rosenfield, S. (1992). The costs of sharing: wives' employment and husbands' mental health. J Health Soc Behav, 33(3), 213-225. Ross, C. E., & Mirowsky, J. (1988). Child care and emotional adjustment to wives' employment. J Health Soc Behav, 29(2), 127-138. Shanafelt, T. D., Balch, C. M., Bechamps, G. J., Russell, T., Dyrbye, L., Satele, D., . . . Freischlag, J. A. (2009). Burnout and career satisfaction among American surgeons. Ann Surg, 250(3), 463-471. doi: 10.1097/SLA.0b013e3181ac4dfd Shanafelt, T. D., Balch, C. M., Dyrbye, L., Bechamps, G., Russell, T., Satele, D., . . . Oreskovich, M. R. (2011). Special report: suicidal ideation among American surgeons. Arch Surg, 146(1), 54-62. doi: 10.1001/archsurg.2010.292 Shanafelt, T. D., Boone, S., Tan, L., Dyrbye, L. N., Sotile, W., Satele, D., . . . Oreskovich, M. R. (2012). Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Arch Intern Med, 172(18), 1377-1385. doi: 10.1001/archinternmed.2012.3199 Standford , S.C, & Salmon, P. (1993). Stress: From Synapse to Syndrome. Sutherland, V.J, & Copper, C.L. (1990). Understanding stress: A psychological perspective for health professionals. London: Chapman & Hall. Syelye, H. (1946). The general adaptation syndrome and the disease of adaptation. J Cli Endocrinol 7(117). Taylor, C., Graham, J., Potts, H., Candy, J., Richards, M., & Ramirez, A. (2007). Impact of hospital consultants' poor mental health on patient care. Br J Psychiatry, 190, 268-269. doi: 10.1192/bjp.bp.106.023234 Taylor, S.E. (1999). Health Psychology. Virtanen, M., Stansfeld, S. A., Fuhrer, R., Ferrie, J. E., & Kivimaki, M. (2012). Overtime work as a predictor of major depressive episode: a 5-year follow-up of the Whitehall II study. PLoS One, 7(1), e30719. doi: 10.1371/journal.pone.0030719 West, C. P., Dyrbye, L. N., Sloan, J. A., & Shanafelt, T. D. (2009). Single item measures of emotional exhaustion and depersonalization are useful for assessing burnout in medical professionals. J Gen Intern Med, 24(12), 1318-1321. doi: 10.1007/s11606-009-1129-z Y., Cheng, H.Y., Huang, P.R., Li, & J.H., Hsu. (2011). Employment insecurity, workplace justice and employees’ burnout in Taiwanese employees: a validation study. International Journal of Behavioral Medicine, 18(4), 391-401. Yeh, W. Y., Cheng, Y., Chen, C. J., Hu, P. Y., & Kristensen, T. S. (2007). Psychometric properties of the Chinese version of Copenhagen burnout inventory among employees in two companies in Taiwan. Int J Behav Med, 14(3), 126-133. 王淑慧. (2005). 發生醫療糾紛,怎麼辦?由醫療糾紛申訴案件談如何避免醫療糾紛. Retrieved from 醫療升級 糾紛遠離�發生醫療糾紛,怎麼辦? website: http://www.consumers.org.tw/unit422.aspx?id=98 張晏蓉, 葉婉榆, 陳春萬, 陳秋蓉, 石東生, & 鄭雅文. (2007). 台灣受僱者疲勞的分布狀況與相關因素. 台灣衛誌, 26(1), 75-87. 陳冠妤. (2008). 近五年台灣地區醫療糾紛分析-以高訴訟風險科別之醫療訴訟案件為中心探討. 臺北醫學大學. Available from Airiti AiritiLibrary database. (2008年) 陳端容, & 鍾政達. (2005). 心臟科醫師工作壓力與身心健康之關係. [Elucidating the Relationships between Physician Job Strains and Health]. The Journal of Health Science, 7(4), 379-392. 陸洛, 李惠美, & 謝天渝. (2005). 牙醫師職業壓力與身心健康、職業壓力之關係:以高雄市牙醫師為例. 應用心理研究, 27, 59-80. 曾慧萍, & 鄭雅文. (2002). 「負荷控制支持」與「付出回饋失衡」工作壓力模型之探討與其中文版量表信效度之檢驗:以電子產業員工為研究對象. 台灣公共衛生雜誌, 21(6), 420-432. 楊長興. (2006). 醫管辭彙. 台北: 合記書局. 楊長興, & 賴芳足. (1996). 全民健保實施對於民眾醫療利用率影響之初期評估. 葉婉榆, 鄭雅文, 陳美如, & 邱文祥. (2008a). 職場疲勞狀況與工作過度投入之相關因素:以臺北市36家職場受雇員工為例. 台灣公共衛生雜誌, 27(6), 463-477. 葉婉榆, 鄭雅文, 陳美如, & 邱文祥. (2008b). 職場疲勞量表的標誌與信效度分析. 台灣衛誌, 27(5), 349-364. 蔡依倫. (2008). 急診醫師疲勞相關因素探討及其對離職意願之影響. (碩士), 臺灣大學, 台北市. Retrieved from http://ndltd.ncl.edu.tw/cgi-bin/gs32/gsweb.cgi?o=dnclcdr&s=id=%22097NTU05529014%22.&searchmode=basic | |
dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/61475 | - |
dc.description.abstract | 自健保開辦以來,民眾醫療利用率增加上健保政策改變、醫療糾紛層出不窮,令醫師診療壓力大增。醫療人員長期過勞將不利醫療判斷,且影響心理健康(如憂鬱、自殺意念),有研究亦指出醫療訴訟和過勞、職業倦怠及憂鬱及有強烈關連性。國內過去關於醫師的職業倦怠研究不多,並且高風險科別的給付與其承擔風險不成比例和醫療訴訟層出不窮,被認為是醫療科別不均之因。
本研究欲了解醫師的職業倦怠並與國內資料比較,並找出工作負荷與職業倦怠、憂鬱傾向、職業滿意度與醫療糾紛之間的關係。 本研究方法為橫斷性匿名問卷調查,對象為醫學院畢業,仍從事臨床病患照護工作之醫師,共發出905份紙本問卷,有效樣本紙本問卷261份,網路問卷87份,總共348份。 研究發現醫師的職業倦怠較一般職場為高,憂鬱傾向介於身心適應良好與輕度情緒困擾之間。「每週平均執行緊急手術或治療數多並且工作量多」的科別和「職業倦怠與憂鬱傾向整體分數」最高及「地方法院醫療糾紛刑事判決實證研究」中被告最多的科別大致相符,而這些科別也正好是目前人力供需失衡的科別。工作負荷(含工作屬性與工作量)中,工作屬性僅與醫療糾紛相關;工作量與職業倦怠、憂鬱傾向皆相關,其中門診量與職業滿意度成正相關,每月值夜班數與工作滿意度負相關。醫療糾紛與職業倦怠、憂鬱傾向及職業滿意度均不相關。 本研究依據結果對未來研究、醫療機構管理者以及衛生主管機關做出建議,希望能增進職場健康、改善科別不均現狀並促進病患滿意度及民眾就醫品質。 | zh_TW |
dc.description.abstract | The purpose of this study is to investigate the situation of burnout and depression among doctors in Taiwan. Furthermore, the relationships between job strains (job characteristics and job workload) and burnout, depression, career satisfaction, and medical dispute are surveyed. Paper and Web Questionnaires containing the Chinese version of the Copenhagen Burnout Inventory (C-CBI) and Brief Symptoms Rating Scale(BSRS-5)were delivered A total of 348 doctors responded the questionnaires. The mean burnout scores of doctors were higher than paid employees in Taiwan. The average depression score was between healthy and mild mood disturbance. The job characteristics are significantly associated with medical dispute; on the other hand, the job workload is associated with burnout, depression and career satisfaction. There is an incidental finding that the specialties of doctors are almost the same among “doctors who are dealing with more emergencies and work loading”, “doctors who are most suffering from burnout and depression” and “doctors who are convicted by medical malpractice judgments from district criminal courts in Taiwan”. This conclusion explains to some extent why certain medical specialties are lack of doctors now. Actions should be taken to mitigate the stress and get through the difficult situation. | en |
dc.description.provenance | Made available in DSpace on 2021-06-16T13:03:49Z (GMT). No. of bitstreams: 1 ntu-102-R99848037-1.pdf: 1138200 bytes, checksum: fa83bc7d4ba2d0cc9791ce757cdf71d0 (MD5) Previous issue date: 2013 | en |
dc.description.tableofcontents | 摘 要 i
Abstract ii 謝 辭 iii 目 次 iv 表 次 vi 圖 次 vii 第一章 緒論 1 第一節 研究背景與動機 1 第二節 研究目的及問題 2 第三節 研究之重要性 3 第二章 文獻探討 4 第一節 工作壓力 4 第二節 職業倦怠 8 第三節 憂鬱症 11 第四節 醫療糾紛 14 第三章 研究方法與架構 17 第一節 研究架構 17 第二節 研究假設 19 第三節 研究變項定義與衡量 20 第四節 研究方法和對象 25 第五節 資料處理和統計分析方法 26 第四章 資料分析與結果 27 第一節 信效度分析 27 第二節 描述性分析 29 第三節 工作負荷與職業倦怠、憂鬱傾向、職業滿意度及醫療糾紛分析 39 第五章 討論與建議 62 第一節 研究結果討論 62 第二節 建議 67 第三節 研究限制 70 參考文獻 71 附錄一 專家校度名單 75 附錄二 樣本適合度檢定 76 附錄三 研究問卷 78 | |
dc.language.iso | zh-TW | |
dc.title | 醫師工作負荷與職業倦怠、憂鬱傾向、職業滿意度及醫療糾紛之關係 | zh_TW |
dc.title | Elucidating the Relationships between Job Strains and Burnout, Depression, Career Satisfaction, Medical Dispute among Doctors | en |
dc.type | Thesis | |
dc.date.schoolyear | 101-2 | |
dc.description.degree | 碩士 | |
dc.contributor.oralexamcommittee | 楊銘欽(Ming-Chin Yang),邱贊仁(Tsan-Jen Chiu) | |
dc.subject.keyword | 醫師、工作負荷,職業倦怠,憂鬱,職業滿意度,醫療訴訟, | zh_TW |
dc.subject.keyword | doctors,job strain,burnout,depression,career satisfaction,medical dispute, | en |
dc.relation.page | 80 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2013-08-05 | |
dc.contributor.author-college | 公共衛生學院 | zh_TW |
dc.contributor.author-dept | 健康政策與管理研究所 | zh_TW |
顯示於系所單位: | 健康政策與管理研究所 |
文件中的檔案:
檔案 | 大小 | 格式 | |
---|---|---|---|
ntu-102-1.pdf 目前未授權公開取用 | 1.11 MB | Adobe PDF |
系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。