探討全天候安寧居家護理師之工作壓力與經驗：混合性研究

Occupational Stressors and Experiences among Nurses of 24-hour on call Hospice Home Care: A Mixed Method Study

10.6537/TJHPC.202303_27(1).01

陳姿穎(Tzu-Ying Chen)；賴維淑(Wei-Shu Lai)；邱智鈴(Ge-Lin Chiu)；劉梨榛(Li-Chen Liu)

安寧居家護理師 ； 工作壓力及經驗 ； 護理工作壓力源量表 ； 混合性研究 ； hospice home care nurse ； occupational stressor and experience ； The Nurse Occupational Stressor Scale (NOSS) ； mixed method study

安寧療護雜誌

27卷1期（2023 / 03 / 01）

1 - 18

繁體中文;英文

研究目的：安寧居家護理師需24小時全天候待命，而其工作壓力及挑戰尚未被探討，故本研究旨在探討全天候安寧居家護理師之工作壓力與經驗。研究方法：本研究旨在探討全天候安寧居家護理師之工作壓力與經驗，採混合性研究，以南部某醫學中心安寧居家護理師為對象，量性資料搜集人口學基本資料、以具備良好信效度「護理工作壓力源量表」測量其工作壓力，採無母數分析方式進行分析；並輔以三次焦點團體訪談收集質性資料，以內容分析法進行分析。研究結果：本研究參與率為100%，工作壓力平均分數為55.22±6.62分，九個面向中以「職業危害」平均得分最高（3.17±0.39）；「告假困難」得分最低（1.86±0.08）。不同婚姻狀況、護理年資、居家安寧年資及安寧相關資格與工作經驗，其工作壓力無顯著差異（p>0.05）；護理年資、居家安寧年資與工作壓力皆無顯著相關（p=0.236;p=0.223），結果顯示全天候工作屬性為影響工作壓力之主要因素。質性分析結果顯示其工作壓力擺盪於在宅善終之護理利他意義和全天候待命之間矛盾共存。結論：希冀本研究結果能作為醫院政策修訂、人力運用及居家護理人才培育之參考，有助於提供高品質安寧居家照護。

Purpose: The occupational stressors and challenges of hospice home care nurses who are on call 24 hours a day have yet to be clearly assessed. This study aims to explore the occupational stressors and experiences among 24-hour on call hospice home care nurses. Method: We conducted a mixed methods study. A total of 18 home care nurses from a medical center in southern Taiwan participated in this study. Demographic information was collected, and the "2020 modified version of The Nurse Occupational Stressor Scale (NOSS)", which has been shown to have good reliability and validity, was used to measure occupational stress. Nonparametric statistics were adopted for quantitative analysis. The qualitative data were collected from three focus group interviews and analyzed via content analysis. Result: The participation rate in this study was 100%. The average NOSS score was 55.22±6.62. Among the nine domains of the NOSS, the domain with the highest average score was "occupational hazards" (3.17±0.39), whereas the domain with the lowest score was "workplace violence and bullying" (1.86±0.08). There was no significant difference in occupational stress based on marital status, working years, hospice home care years, and hospice-related qualifications and work experience (p > 0.05). There was no significant correlation (p = 0.236; p = 0.223) between working years, hospice home care years and occupational stress. The results show that attributes related to 24-hour on call work are the main factors affecting occupational stress. Qualitative results reveal that occupational stress oscillates and paradoxically coexists between the altruism of helping terminally ill patients die peacefully at home and 24-hour on call availability. Conclusion: We hope that the results of this study can be used as a reference for revising hospital policies, optimizing manpower and training home care personnel, thereby resulting in high-quality hospice home care.

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