醫務社會工作者職場疲勞之調查研究

Abstract

本研究旨在瞭解醫務社會工作者就業的職場組織與工作特質，對職場疲勞問題之影響；本研究並探討影響醫務社會工作者工作過度投入與工作滿意度的相關因素。研究對象設定為目前在職中的醫務社會工作者，服務單位為醫療機構內設置的社會工作部門，包含擔任主任、組長、督導、正式及約聘的醫務社會工作專業人員，不設限一般科或精神科之醫務社會工作者；研究採「便利抽樣」，研究工具為自填式的結構式問卷，問卷內容包含「工作特質量表」與「哥本哈根疲勞量表」。共回收254份有效問卷；資料分析方法包括描述性統計、t檢定、單因子變異數分析、皮爾森積差相關、史比爾曼等級相關、複線性迴歸分析等。 重要結果如下：1.醫務社會工作者為職場疲勞與工作過度投入的高危險群，職場疲勞與工作過度投入平均分數，相較於全國受僱者常模平均分數高出許多；在工作壓力部份，有34.78％的醫務社會工作者覺得工作「常常或一向有」帶來很大的壓力，比例幾乎是全國受僱者調查(13.4％)的2.6倍。2.在組織特質方面，就業單位屬私部門（相較於公部門）、醫務社會工作者為勞保身份（相較於公保身份）、為正職和長期雇用（相較於約聘僱），疲勞感和工作過度投入都偏高。3.在工作特質層面，醫務社會工作者多數認為工作負荷過重、人力不足、事業發展和晉升前景不好；此外，每週工作時數越高者在個人、工作疲勞和工作過度投入的得分越高，呈現顯著差異，但在服務對象疲勞上則相反，呈現工作時數越高，服務對象疲勞得分反而下降的狀況；低度「工作控制」、高「工作負荷」、「就業缺乏保障」、以及低度「職場正義」等因素，對工作者之個人疲勞與工作疲勞有顯著相關。4.在個人層面，發現女性醫務社會工作者的個人疲勞與工作疲勞指數較男性高，但服務對象疲勞與工作過度投入的指數則低於男性；45歲以上的醫務社會工作者，在個人疲勞、工作疲勞和工作過度投入的得分偏高，尤其在個人和工作疲勞方面特別顯著，有配偶者的個人疲勞得分較未婚者高；未婚者的工作疲勞、服務對象疲勞與工作過度投入的得分都較高；無社工師證照的醫務社會工作者，在工作疲勞、服務對象疲勞與工作過度投入的得分都較有專業證照者為高，尤其在服務對象疲勞方面顯著偏高。 根據本研究結果，我們建議應積極改善醫務社會工作者的工作狀況，除應改善工作負荷過高、人力不足等問題，也可深入探討如何從組織制度層面，提升工作控制、職場正義與就業安全保障，以預防工作者之職場疲勞問題。

The purpose of this study was to examine the effects of psychosocial work characteristics, both at organizational and task levels, on burnout status among medical social workers. Also explored were the correlations of work characteristics between levels of worker’s over-commitment and job satisfaction. Study participants were medical social workers who were on service and worked at social service departments of medical settings, including department directors, senior clerks, supervisors, permanent and contract employees. Study subjects were recruited by 'convenience sampling', and information were obtained by a structuralized self-administered questionnaire. Included in the questionnaire were the 'Job Content Questionnaire' and the 'Copenhagen Burnout Inventory'. A total of 254 valid questionnaires were collected. Data were analyzed with descriptive statistics, t-test, one-way ANOVA , Pearson’s product-moment correlation, Spearman rank order correlation, and multiple regression analysis. Main findings were as the following: 1. Medical social workers were at high risk of burnout, with levels of burnout and over-commitment higher than the national averages of general employees. With regard to perceived levels of job stress, 34.78% medical social workers reported feeling high stress - the percentage was 2.6 times higher than that of national representative employees (13.4%). 2. With regard to organizational work characteristics, medical social workers with the following characteristics were at higher risk of burnout and over-commitment: working in private sector (as compared to public sector), holding labor insurance (as compared to civil insurance), being a permanent employee (as compared to contingent employees). 3. At task level, medical social workers with higher risk of burnout were those with higher job demands, longer working hours, lower job control, and poor career perspectives, In addition, employment insecurity and organizational injustice were also found to be associated with higher levels of burnout in medical social workers. 4. At personal level, we found that the scores of personal and work burnout in female medical social workers were higher than males, but the score of client’s burnout of female workers was lower than males. Those aged older than 45 years old were also found to have higher scores of personal, work burnout and over-commitment. These findings indicated that medical social workers were at high risk of burnout. We suggest that work conditions of medical social workers should be improved, especially on aspects of job control, work demands, employment security and workplace justice.