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| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 陳端容(Duan-Rung Chen) | |
| dc.contributor.author | Chia-Ling Chung | en |
| dc.contributor.author | 鍾佳玲 | zh_TW |
| dc.date.accessioned | 2021-06-12T18:16:22Z | - |
| dc.date.available | 2007-09-13 | |
| dc.date.copyright | 2007-09-13 | |
| dc.date.issued | 2007 | |
| dc.date.submitted | 2007-08-30 | |
| dc.identifier.citation | （ㄧ）中文部分
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| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/27704 | - |
| dc.description.abstract | 管理性照護在國內方興未艾，醫療保健環境的快速變化不僅使得體制改變，體制內的工作人員角色也跟著牽動變化，因此本研究以新興的護理個案管理師作為研究對象，進行工作現況調查，並嘗試瞭解護理個案管理師的工作特性、工作壓力及工作承諾，以及三者間的關係。
本研究以全台灣區域醫院以上，所有不同疾病的護理個案管理師為樣本，共發出177份問卷，回收有效問卷143份，有效回收率80.79 %，研究工具採結構式及辦結構式問卷，以郵寄問卷法收集資料。研究重要發現：一、護理個案管理師的個人屬性為1.女性為主、2.年齡以31~35最多(40.7 %)、3.護理教育背景以專科以下為多(52.5 %)、4.總護理年資以≧6年為最多(88.6 %)、5.擔任護理個案管理師之年資以1~2年為最多(50.7 %)、6.擔任身份已有身兼他職佔最多(53.9%) ; 工作現況為：1.稱呼不一、2.管理部門多重、3.護理個案管理的教職教育施行偏低4.臨床路徑使用率低5.成效評量以病患滿意度為最多; 工作內容以1.接受病患諮詢、2.病患/家屬治療溝通協調、3.病患衛生教育最多。二、以ANOVA及t檢定進行變項間在工作承諾上的差異分析 ; 護理個案管理師的個人屬性以1.不同的年齡、2.婚姻狀態、3.護理教育背景及4.護理專業進階在工作承諾上有差異 ; 工作現況以1.目前共有個案量、2.是否使用其他機構提供的個案管理工具、3.醫院評鑑等級、4.護理個案管理之所屬階段及5.護理個案管理成效評估之頻率在工作承諾上有差異 。三、護理個案管理工作的五項工作特性屬中上程度，其工作激勵潛能指數 ( MPS ) 高於一般護理人員 ; 其工作壓力之負荷-控制交叉分類以低工作壓力族群為多，並且主動型職業族群較一般護理人員多。四、線性迴歸得護理個案管理工作的MPS與工作承諾呈正相關 ; 羅吉斯迴歸得MPS與工作壓力呈負相關 ; 工作壓力對MPS與工作承諾的影響不具中介效果。研究建議：1.確立護理個案管理師定位2.加強在職教育訓練3.增加成效評量多樣性4.發展臨床路徑。 | zh_TW |
| dc.description.abstract | With the arising managed care environment, the rapid changes in healthcare reform does not only affect the structure, it also affect the staffs’ role play within it. Hence we took the developing nurse case managers as our study subject, and survey their work conditions. We gathered the positive and negative factors of nurse case manegement by means of analyzing their perceptions on job characteristics、job strain and job commitment, further we discuss the relationship among nurse case managers’ perception within the three.
Our sample is mainly included all nurse case managers in different practice or settings in Taiwan’s regional hospitals and above. We issued 177 questionnaires and received 143 effective copies . The response rate is 80.79 %. The data collection is by paper instrument combined structured and semi-structured questionnaire . Our findings are : 1. The profiles of Taiwan’s regional hospital nurse case managers : (1) no male nurse case managers during data collection time, (2 ) most are aged 31 to 35 (40.7%), (3 ) most are under junior college educated ( 52.5%), (4 ) most has 6 or more years of nursing careers (88.6%), (5 ) most are experienced 1 to 2 years of case management practice (50.7%), and (6 ) most has two more duties of job (53.9%). The work conditions are : (1 )titles vary, ( 2 )face with multiple administrations, (3 ) seldom receive on-job training, (4) lack of clinical pathways , and (5) outcomes are mostly evaluated with patient satisfaction. And the most ranked job descriptions are (1 ) consultant to patients, (2 )communicate with patients/family and (4) patient education. 2. Using ANOVA and t-test for variance analysis. For job commitment, the nurse case managers’ personal attributes varies significantly in ( 1 ) age, (2 ) marital status, (3 ) nursing education background, and (5 ) clinical ladders. And work conditions varies significantly for job commitment are : (1) case load, (2 ) whether use nurse NCM instrument provided by other institutions, (3 ) hospital accreditation level, (4 ) nurse case management status and (5 ) frequency of NCM outcome evaluation. 3. The five core job characteristics in NCMs are of middle-high level, the Motivation potential score (MPS ) is higher than that of staff nurse. Most of their demand-control job strain classification are in low strain and active job , and the job commitment are higher than that of staff nurse. 4. Linear regression found that：the MPS was correlated with job commitment, whereas Logistic regression reveals the MPS was negatively correlated with Demand-Control job strain, and D-C job strain has no mediation effect between job characteristics and job commitment. Conclusions suggest : (1) ensure NCM job position, (2) enhance on-job training, (3) increase the diversity of outcome evaluation, (4) deploy clinical pathways . | en |
| dc.description.provenance | Made available in DSpace on 2021-06-12T18:16:22Z (GMT). No. of bitstreams: 1 ntu-96-P92843013-1.pdf: 796685 bytes, checksum: 9ed1f0829dd8f168db3fae947e7ae9a2 (MD5) Previous issue date: 2007 | en |
| dc.description.tableofcontents | 目錄
致 謝 i 中文摘要 ii 英文摘要 iii 目錄 v 表目錄 vii 圖目錄 viii 第一章 前 言 1 第一節 研究背景與動機 1 第二節 研究目的與研究問題 3 第三節 研究重要性 4 第二章 文獻探討 5 第一節 護理個案管理之發展與相關研究 5 第二節 工作特性 12 第三節 工作壓力 17 第四節 工作承諾 23 第五節 護理人員與工作特性、工作壓力及工作承諾的相關研究回顧 26 第三章 研究設計與方法 30 第一節 研究架構 30 第二節 研究假說 32 第三節 研究變項 32 第四節 研究對象與工具 35 第五節 研究資料收集與統計分析方法 39 第四章 研究結果 41 第一節 問卷回收結果 41 第二節 描述性統計分析 45 第三節 雙變項統計分析 65 第四節 多變項統計分析 68 第五章 結果討論 74 第一節 問卷回收情形 74 第二節 護理個案管理工作現況的相關特性 74 第三節 研究假設驗證 80 第四節 研究限制 81 第六章 結論與建議 83 第一節 結論 83 第二節 建議 84 參考文獻 86 （ㄧ）中文部分 86 （二）西文部分 89 附錄一調查問卷 96 附錄二 工作特質量表的計分方式 100 表目錄 表2- 1護理個案管理師角色功能與職責能力 7 表2- 2負荷-控制交叉表 23 表2- 3 國外護理個案管理師研究結果 27 表4- 1各級醫院問卷回收統計 43 表4- 2醫院地區分佈 43 表4- 3各量表信度分析 45 表4- 4護理個案管理師之基本屬性 46 表4- 5醫院屬性 47 表4- 6護理個案管理師之執業現況 49 表4- 7護理個案管理之醫院管理現況 52 表4- 8護理個案管理師工作特性感受 --工作診斷量表I & II (Job Diagnostic Questionnaire ; JDS ) 59 表4- 9工作控制度與心理負荷量之交叉表 61 表4- 10護理個案管理師之工作壓力感受--工作特質量表 ( Job Content Questionnaire;JCQ )結果 62 表4- 11護理個案管理師的工作承諾感受--工作承諾量表(Job Commitment Qeustionnaire ) 註:轉自組織承諾量表 64 表4- 12護理個案管理師個人屬性與工作承諾差異分析表 65 表4- 13護理個案管理師工作現況與工作承諾差異分析表 67 表4- 14 MPS與工作壓力之logistic迴歸 69 表4- 15表預測分類正確率交叉表 69 表4- 16 MPS與工作承諾之線性迴歸 71 表4- 17 MPS、工作壓力與工作承諾之線性迴歸 73 表5- 1 工作特性各構面指標平均分、標準差及程度指標 78 表5- 2 護理個案管理師之負荷-控制平均得分與其他研究之比較 79 圖目錄 圖 2- 1 Hackman & Oldham 工作特性模式 15 圖 3- 1 研究架構 31 圖 4- 1 問卷回收結果 42 | |
| dc.language.iso | zh-TW | |
| dc.subject | 護理個案管理 | zh_TW |
| dc.subject | 工作承諾 | zh_TW |
| dc.subject | 工作壓力 | zh_TW |
| dc.subject | 護理個案管理師 | zh_TW |
| dc.subject | 激勵潛能指數 | zh_TW |
| dc.subject | 工作特性 | zh_TW |
| dc.subject | Nurse Case Manager | en |
| dc.subject | motivation potential score ( MPS ) | en |
| dc.subject | job characteristics | en |
| dc.subject | Nursing Case Management | en |
| dc.subject | job commitment. | en |
| dc.subject | job strain | en |
| dc.title | 台灣區域醫院以上護理個案管理師之工作現況
及其工作特性、工作壓力與工作承諾關係之探討 | zh_TW |
| dc.title | The Current Work Conditions and Relationships among Job Characteristics、Job Strain and Job Commitment
in Taiwan’s Regional Hospital Nurse Case Managers | en |
| dc.type | Thesis | |
| dc.date.schoolyear | 95-2 | |
| dc.description.degree | 碩士 | |
| dc.contributor.oralexamcommittee | 蘇慧芳,謝碧晴 | |
| dc.subject.keyword | 護理個案管理師,護理個案管理,工作特性,激勵潛能指數,工作壓力,工作承諾, | zh_TW |
| dc.subject.keyword | Nurse Case Manager,Nursing Case Management,job characteristics,motivation potential score ( MPS ),job strain,job commitment., | en |
| dc.relation.page | 100 | |
| dc.rights.note | 有償授權 | |
| dc.date.accepted | 2007-08-30 | |
| dc.contributor.author-college | 公共衛生學院 | zh_TW |
| dc.contributor.author-dept | 醫療機構管理研究所 | zh_TW |
| 顯示於系所單位： | 健康政策與管理研究所 | |
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