「職場霸凌」對護理人員「身心健康」之影響 -以自我效能及群體凝聚力為調節效果

Abstract

背景與目的 護理職場中霸凌的現象已日益增加，被認為是護理職場的重要議題。而職場霸凌現象常隱晦不說，往往造成護理人員生理、心理上相當大的負面影響及困擾，長期遭遇霸凌，嚴重者會有自殺意念或對護理工作產生負向觀感，甚至離開護理工作。本研究的目的在瞭解職場霸凌對護理人員身心健康之影響，並且期望可以加入自我效能及群體凝聚力之探討，進一步驗證職場霸凌影響個人身心健康之關聯。 方法 本研究採橫段式的調查方法，以職場霸凌量表、個人自我效能量表、群體凝聚力量表及中國人簡易健康量表（CHQ-12）等測量工具，採立意取樣法選取東北部二家區域教學醫院年資滿6個月之護理人員為研究對象，以結構式問卷收集資料，共計回收909份有效問卷，回收率達94.6%。 結果 研究結果發現，霸凌經驗量表調查結果大多與人際溝通及工作與監督構面有關，約35%~69%表示曾遭受霸凌經驗。主要霸凌者依序為護理同儕49.1%、護理主管34.1%及醫師22.6%。在私人機構、研究所、其他宗教信仰、正職人員、醫技部門、護理之家、開刀房及加護病房與職場霸凌呈現顯著的相關；職場霸凌與自我效能、群體凝聚力呈顯著負相關，職場霸凌與身心健康影響、離職傾向與尋找其他新工作呈顯正相關。 在身心健康影響結果發現，教育程度及工作單位與生理健康影響呈現顯著差異；另教育程度、宗教信仰、工作單位及目前工作年資等四項則與心理健康影響呈現顯著差異。而職場霸凌經驗、自我效能、高中職與大學、道教、加護病房、急診、開刀房、門(健)診、目前工作年資為5年~未滿10年等變項對生理健康影響具有預測因子；職場霸凌經驗、自我效能、加護病房、急診、開刀房、目前工作年資為5年~未滿10年及護理長等變項對心理健康影響具有預測因子。 結論 職場心理健康在職場中扮演重要的角色，管理者應積極投入創造友善的工作環境，激勵並營造正向工作氛圍，帶給人員正面能量，另組織政策清晰可以防止霸凌行為，當這些政策被規範在組織工作中時，職場霸凌可顯著降低。

Background and Aims Workplace bullying in the nursing environment has increased recently and has been deemed as an important issue. Due to the usually victims covering up, this issues has induced an enormous negative impact on nurses physically and psychologically. Nurses who suffer from workplace bullying for a long time may have suicide attempt or quit nursing job. The aim of this study is investigating the impact of workplace bullying on nurses. We also investigated the self-efficiency and group cohesiveness. Methods This is a cross-section study.The study employed a cross-sectional design of survey. Subjects consisted of the nurses who had completed at least six months of service in two regional teaching hospital in northeast Taiwan. The designed structured questionnaire including the Workplace Bullying Questionnaire,Self Efficiency Questionnaire,Group Cohesiveness Questionnaire and Chinese Health Questionnaire is applied. A total of 909 valid questionnaires were completed with the recovery rate of 94.6%. Results The result of Workplace Bullying Questionnaire shows that workplace bullying is mostly associated with interpersonal communication and 35 to 60% of subjects had suffered from workplace bullying. The main bully persons include nursing colleagues (49.1%), nursing surpervisor (34.1%), and doctors (22.6%). In private sectors, graduate schools, full-time employers, medical technological department, nursing home, operative room, and ICU, the rate of workplace bullying increased obviously. Workplace bullying had a negative correlation with self-efficiency and group cohesiveness. To the contrary, workplace bullying had a positive correlation with physical health and quitting rate. Regarding physical and psychological health, our result shows that education level and working unit had significant influence. Education level, religions, working unit, and working years had significant impact on psychological health. Workplace bullying experience, self-efficiency, lower education level, Taoism, ICU, emergency department, operation room, OPD, and working years between 5-10 years were predicting factors for physical health. Workplace bullying experience, self-efficiency,ICU, emergency department, operation room, and working years between 5-10 years were predicting factors for psychological health. Conclusion The occupational psychological health plays an important role during work. The managers should actively create friendly working place to bring in positive energy and to prevent bullying by institutionalizing good policies. Keywords : Workplace Bullying ; Self Efficiency ; Group Cohesiveness