桃園地區臨床護理人員在健保總額預算期間的工作倦怠及離職意向

Burnout and Quit Intention among Clinical Nurses in Taoyuan during Global Budget Payment System

邱孟君(Meng-Jiun Chiou)；史麗珠(Lai-Chu See)；黃怡樺(Yi-Hua Huang)；張薰榕(Hsun-Jong Chang)；林雪蓉(Sheue-Rong Lin)

工作倦怠 ； 離職意向 ； 臨床護理人員 ； 健保總額預算 ； Burnout ； Quit intention ； Clinical nurses ； Global budget

若瑟醫護雜誌

7卷1期（2013 / 08 / 01）

33 - 44

繁體中文

Background and purpose: Due to frequent change of the payment system of Taiwan National Health Insurance (TNHI), especially after global budget, burnout and intention to quit their job is resulted from increased workload and job stress among clinical nurses. In this study, we investigated the magnitude of job burnout and quit intention, and analyzed factors associated with burnout and quit intention among clinical nurses during the implementation of the global budget payment system of the TNHI. Methods: A cross-sectional study with a stratified and proportional random sampling was used to obtain the study sample in Taoyuan, Taiwan. The Maslach Burnout Inventory-Health Service Survey (MBI-HSS), including three constructs (emotional exhaustion, depersonalization, personal accomplishment), was used. Results: From July to December 2006, 374 valid questionnaires (48.5%) were obtained. The mean score of emotional exhaustion was 27.43 (percentile=50.8), depersonalization was 8.72 (percentile=29.1), and personal accomplishment was 34.06 (percentile=71.0), respectively. Multivariate analysis reveals that medical workers’ stress (p＜.0001), supported coping (p＜0.0001), age (p＜0.0001), and work perceptions about the global budget for medical employees (p＜0.0001) was significantly associated with emotional exhaustion. Age (p＜0.0001), supported coping (p＜0.0001), medical workers’ stress (p＜0.0001), employment status (full time vs. part time)(p=0.0067) was significantly associated with depersonalization. Control coping (p＜0.0001), and age (p＜0.0001) was significantly associated with personal accomplishment. 249 (67.0%) of clinical nurses had an intention to quit their job. Multivariate analysis reveals that work perceptions about the global budget for medical workers (p=0.0039), medical workers’ stress (p＜0.0001), emotional exhaustion (p＜0.0001), personal accomplishment (p=0.0161) was significantly associated with quit intention. Conclusion: During implementation of global budget payment system, there was a serious problem of emotional exhaustion among clinical nurses and two-third of the clinical nurses had an intention to quit their job.

Background and purpose: Due to frequent change of the payment system of Taiwan National Health Insurance (TNHI), especially after global budget, burnout and intention to quit their job is resulted from increased workload and job stress among clinical nurses. In this study, we investigated the magnitude of job burnout and quit intention, and analyzed factors associated with burnout and quit intention among clinical nurses during the implementation of the global budget payment system of the TNHI. Methods: A cross-sectional study with a stratified and proportional random sampling was used to obtain the study sample in Taoyuan, Taiwan. The Maslach Burnout Inventory-Health Service Survey (MBI-HSS), including three constructs (emotional exhaustion, depersonalization, personal accomplishment), was used. Results: From July to December 2006, 374 valid questionnaires (48.5%) were obtained. The mean score of emotional exhaustion was 27.43 (percentile=50.8), depersonalization was 8.72 (percentile=29.1), and personal accomplishment was 34.06 (percentile=71.0), respectively. Multivariate analysis reveals that medical workers’ stress (p＜.0001), supported coping (p＜0.0001), age (p＜0.0001), and work perceptions about the global budget for medical employees (p＜0.0001) was significantly associated with emotional exhaustion. Age (p＜0.0001), supported coping (p＜0.0001), medical workers’ stress (p＜0.0001), employment status (full time vs. part time)(p=0.0067) was significantly associated with depersonalization. Control coping (p＜0.0001), and age (p＜0.0001) was significantly associated with personal accomplishment. 249 (67.0%) of clinical nurses had an intention to quit their job. Multivariate analysis reveals that work perceptions about the global budget for medical workers (p=0.0039), medical workers’ stress (p＜0.0001), emotional exhaustion (p＜0.0001), personal accomplishment (p=0.0161) was significantly associated with quit intention. Conclusion: During implementation of global budget payment system, there was a serious problem of emotional exhaustion among clinical nurses and two-third of the clinical nurses had an intention to quit their job.