身心障礙福利機構照服員情緒勞務與工作倦怠關連性之研究：以社會支持為調節變數

A Research on the Relationship Between Emotional Labor and Job Burnout of Nursing Assistants in Welfare Agencies for People with Disabilities: Social Support as a Moderator

10.30401/RSS.202306_17(1).0003

王光旭(Guang-Xu Wang)；陳怡君(Yi-Jun Chen)；呂季蓉(Chi-Jung Lu)

照服員 ； 情緒勞務 ； 工作倦怠 ； 社會支持 ； 長期照護 ； nursing assistant ； emotional labor ； job burnout ； social support ； long-term care

社會科學論叢

17卷1期（2023 / 06 / 01）

81 - 131

繁體中文;英文

照服員是長期照護體系中最重要的人力資源，但卻因為工作本身情緒勞務的特質，而容易導致工作倦怠，特別是在身心障礙住宿式服務機構的照服員，工作更為辛勞，如何留任人員，是維繫長照服務的重要關鍵。本研究以中南部四縣市18間身心障礙福利機構為範圍，並針對機構內照服員進行問卷調查，探討照服員的情緒勞務與工作倦怠之狀態，並以社會支持做為調節變數，瞭解照服員的工作倦怠情形及影響因素，提出政策建議。本研究共計回收315份有效問卷，研究結果發現：（1）情緒勞務的表層演出與照服員的情緒耗竭、去人性化與低個人成就感有正向關連性，也就是身心障礙機構要求照服員要用愛心與耐心來照顧這些身心障礙者，不得對服務使用者或其家屬發脾氣，讓照服員在工作中必須隱藏或壓抑真實情緒，同樣也會形成工作壓力，產生工作倦怠，而想逃避工作、與人疏離，或是對自己持負面評價等症狀；然而，照服員的深層演出頻率與工作倦怠則呈現負相關，若照服員能有效察覺、了解自己的情緒，並做好自己的情緒管理，使內外在情緒表現一致，自然不容易產生工作倦怠；（2）主管支持與同事支持具有顯著調節效果，可緩和因提供表層演出情緒勞務而變得沒有人情味、與人疏離等去人性化的症狀，但無法緩和對情緒耗竭與低個人成就感的影響。據此，本研究建議機構應提供主管與員工適合的情緒展演與教育訓練課程，並營造主管與員工間良好的溝通環境，以減緩工作中表層演出負擔，並降低工作倦怠產生。

The purpose of this study was to investigate the emotional labor, job burnout, and social support among nursing assistants in physical and mental disorder welfare agencies. The study aimed to understand the degree of job burnout and its influencing factors and propose policy recommendations. The study surveyed 18 physical and mental disorder welfare agencies in Yunlin, Chiayi, and Tainan and collected 315 valid questionnaires from nursing assistants within these institutions. The results indicate that surface acting of emotional labor is positively correlated with nursing assistants' emotional exhaustion, dehumanization, and low personal accomplishment. However, deep acting of emotional labor is negatively correlated with nursing assistants' emotional exhaustion, dehumanization, and low personal accomplishment. Supervisor support has a negative adjustment effect between surface acting and dehumanization and a positive adjustment effect between deep acting and dehumanization. Similarly, colleagues' support has a negative adjustment effect between surface acting and dehumanization and a positive adjustment effect between deep acting and dehumanization. While supervisor and peer support can alleviate the impact of emotional labor on dehumanization, they do not mitigate the impact of emotional exhaustion and low personal accomplishment. Based on these findings, the study suggests that welfare agencies should provide emotional labor education and training courses for supervisors and employees and create a good communication environment between them. These measures can help reduce the burden of surface acting at work and minimize the occurrence of job burnout among nursing assistants.

1. Lin, Y. W.,Huang, Y. W.(2014).Team Climate, Emotional Labor and Burnout of Physicians: A Multilevel Model.Taiwan Journal of Public Health,33(3),271-289.
   連結：
2. Wang, M. L.,Chang, S. C.(2016).The Impact of Job Involvement on Emotional Labor to Customer-Oriented Behavior : An Empirical Study of Hospital Nurses.The Journal of Nursing Research,24(2),153-162.
   連結：
3. 朱正一(2013)。探討醫學中心護理人員情緒勞務對工作滿意度與工作倦怠之影響。臺灣衛誌，32(3)，266-278。
   連結：
4. 吳肖琪(2017)。我國長照政策之新契機。長期照護雜誌，21(1)，1-7。
   連結：
5. 李俊達,洪基貴(2020)。臺北市公立長照機構服務人員情緒勞務與離職傾向之研究：工作滿意度的中介效果。社會政策與社會工作學刊，24(1)，35-77。
   連結：
6. 李昭憲,賴家欣,楊燦,黃貞綺(2015)。長期照護機構照服員職業疲潰及其相關因素之探討。美和學報，34(2)，97-114。
   連結：
7. 李婉禎,林木泉,朱正一(2013)。身心障礙照護機構照服員工作倦怠、社會支持與留任意願相關性探討。醫務管理期刊，14(1)，38-54。
   連結：
8. 汪美伶,陳玉蓮(2014)。工作壓力對身心健康之影響-社會支持之調節作用。東吳經濟商學學報，86，61-92。
   連結：
9. 林少龍,繆敏志(2020)。深層演出與情緒耗竭的關係：關係能量及情緒智商之角色。人力資源管理學報，20(1)，75-99。
   連結：
10. 林育秀,梁亞文,張曉鳳(2017)。長期照護機構照服員之工作壓力源與職業疲勞探討。醫學與健康期刊，6(2)，17-29。
    連結：
11. 洪瑞斌(2013)。職業倦怠研究在台灣之回顧與前瞻。人力資源管理學報，13(3)，107-140。
    連結：
12. 洪瑞斌,陳怡璇(2009)。工作倦怠歷程模式之探索：以餐飲企業主管為例。應用心理研究，43，19-48。
    連結：
13. 紀乃文(2014)。情緒勞動對組織是利是弊?探討知覺主管支持、同事支持對情緒勞動與服務績效、離職傾向關係的差異化干擾效果。組織與管理，7(1)，115-160。
    連結：
14. 劉榆華,謝智偉(2016)。消極展現規則與工作倦怠：以臺北市區公所員工為例調查情緒失調之中介效果與服務氣候之調節效果。中國行政評論，22(2)，81-100。
    連結：
15. 鄭怡世,巫麗雪,劉幸宜(2017)。台灣老人日間照顧服務從業人員職場疲勞之探究。社會政策與社會工作學刊，21(2)，1-53。
    連結：
16. 謝玉玲(2011)。看得到的照護政策、看不見的勞動差異：照顧工作者與勞動場域的檢視。臺灣社會福利學刊，10(1)，53-96。
    連結：
17. (2014).Wellbeing: A Complete Reference Guide.
18. Aiken, L. S.,West, S. G.(1991).Multiple Regression: Testing and Interpreting Interactions.Newbury Park, CA:Sage.
19. Bakker, A. B.,Demerouti, E.(2007).The Job Demands-Resources Model: State of the Art.Journal of Managerial Psychology,22(3),309-328.
20. Bakker, A. B.,Demerouti, E.,Sanz-Vergel, A. I.(2014).Burnout and Work Engagement: The JD–R Approach.Annual Review of Organizational Psychology and Organizational Behavior,1(1),389-411.
21. Bakker, A. B.,Demoerouti, E.,Euwema, M. C.(2005).Job Resources Buffer the Impact of Job Demands on Burnout.Journal of Occupational Health Psychology,10(2),170-180.
22. Bakker, A. B.,Demoerouti, E.,Verbeke, W.(2004).Using the Job DemandsResources Model to Predict Burnout and Performance.Human Resource Management,43(1),83-104.
23. Beehr, T. A.,Jex, S. M.,Stacy, B.,Murray, M.(2000).Work Stressors and Coworker Support as Predictors of Individual Strains and Performance.Journal of Organizational Behavior,21(4),391-405.
24. Brotheridge, C. M.,Grandey, A. A.(2002).Emotional Labor and Burnout:Comparing Two Perspectives of “People Work”.Journal of Vocational Behavior,60(1),17-39.
25. Caplan, G.(1974).Support Systems and Community Mental Health: Lectures on Concept Development.New York, NY:Behavioral Publications.
26. Choi, Y. G.,Kim, K. S.(2015).The Influence of Emotional Labor on Burnout:Centered on the Stress Coping Strategy and Moderating Effect of Social Support.International Journal of Humanities and Social Science,5,583-588.
27. Cohen, S.,Hoberman, H. M.(1983).Positive Events and Social Supports as Buffers of Life Change Stress.Journal of Applied Social Psychology,13(2),99-125.
28. Deci, E. L.,Ryan, R. M.(1985).Intrinsic Motivation and Self-Determination in Human Behavior.New York, NY:Plenum Press.
29. Demerouti, E,Bakker, A. B.,Nachreiner, F.,Schaufeli, W. B.(2001).The Job Demands: Resources Model of Burnout.Journal of Applied Social Psychology,86(3),499-512.
30. Dimunova, L,Soosova, M. S.,Mohnyanszki, F.(2018).Work-Related Factors Influencing Burnout Syndrome in Nurses.Clinical Social Work and Health Intervention,9(1),25-30.
31. Freudenberger, H. J.(1974).Staff Burnout.The Journal of Social Issues,31,159-165.
32. Ganster, D. C.,Fusilier, M. R.,Mayes, B. T.(1986).Roles of Social Support in the Experience of Stress at Work.Journal of Applied Social Psychology,71(1),102-110.
33. Goodwin, R. E.,Groth, M.,Frenkel, S. J.(2011).Relationships Between Emotional Labor, Job Performance, and Turnover.Journal of Vocational Behavior,79(2),538-548.
34. Grandey, A. A.(2003).When “the Show Must Go On”: Surface Acting and Deep Acting as Determinations of Emotional Exhaustion and Peer-Rated Service Delivery.Academy of Management Journal,46(1),48-96.
35. Grandey, A. A.(2000).Emotion Regulation in the Workplace: A New Way to Conceptualize Emotional Labor.Journal of Occupational Health Psychology,1,95-110.
36. Grandey, A. A.,Gabriel, A. S.(2015).Emotional Labor at a Crossroads: Where Do We Go from Here?.The Annual Review of Organizational Psychology and Organizational Behaviour,2,323-349.
37. Hobfoll, S. E.(1989).The Ecology of Stress.New York:Hemisphe.
38. Hobfoll, S. E.,Johnson, R. J.,Ennis, N.,Jackson, A. P.(2003).Resource Loss, Resource Gain, and Emotional Outcomes Among Inner City Women.Journal of Personality and Social Psychology,84(3),632.
39. Hochschild, A. R.(1983).The Managed Heart Commercialization of Human Feeling Arlie Russell Hochschild.Berkely, CA:University of California Press.
40. House, J. S.(1981).Work Stress and Social Support.Reading, MA:Addison-Wesley.
41. Hsieh, C.,Jin, M.,Guy, M. E.(2012).Consequences of Work-Related Emotions: Analysis of a Cross-Section of Public Service Workers.The American Review of Public Administration,42(1),39-53.
42. Jiska, C. M.(1997).Turnover Among Nursing Home Staff: A Review.Nursing Management,28(5),59-64.
43. Karasek, R. A.(1979).Job Demands, Job Decision Latitude and Mental Strain:Implication for Job Design.Administrative Science Quarterly,24,285-308.
44. Karatepe, O. M.,Yorganci, I.,Haktanir, M.(2010).An Investigation of the Role of Job Resources in Mitigating Customer-Related Social Stressors and Emotional Exhaustion.Service Marketing Quarterly,31(1),72-88.
45. Karimi, L.,Leggat, S. G.,Donohue, L.,Farrell, G.,Couper, G. E.(2014).Emotional Rescue: the Role of Emotional Intelligence and Emotional Labour on Well-Being and Job-Stress Among Community Nurses.Journal of Advanced Nursing,70(1),176-186.
46. Kruml, S. M.,Geddes, D.(2000).Exploring the Dimensions of Emotional Labor: The Heart of Hochschild’s Work.Management Communication Quarterly,14(1),8-49.
47. Liaw, Y. J.,Chi, N. W.,Chuang, A. C.(2010).Examining the Mechanisms Linking Transformational Leadership, Employee Customer Orientation and Service Performance: The Mediating Roles of Perceived Supervisor and Coworker Support.Journal of Business and Psychology,25,477-492.
48. Maslash, C,Jackson, S. E.(1981).The Measurement of Experienced Burnout.Journal of Organizational Behavior,2(2),99-113.
49. Owens, B. P.,Baker, W. E.,Sumpter, D. M.,Cameron, K. S.(2016).Relational energy at work: Implications for job engagement and job performance.Journal of Applied Psychology,101(1),35-49.
50. Peeters, M. C. W.,Le Blanc, P. M.(2001).Toward a Match Between Job Demand and Sources of Social Support : A Study Among Oncology Care Providers.European Journal of Work and Organization Psychology,10(1),53-72.
51. Pugh, S. D.(2001).Service With a Smile: Emotional Contagion in the Service Counter.Academy of Management Journal,44(5),1018-1027.
52. Quick, J.C.(ed.),Tetrick, L.E.(ed.)(2003).Handbook of Occupational Health Psychology.Washington, DC:American Psychological Association.
53. Rhoades, L.,Eisenberger, R.,Armeli, S.(2001).Affective Commitment to the Organization: The Contribution of Perceived Organizational Support.Journal of Applied Psychology,86(5),825-836.
54. Ross, M. M.,Dalziel, M. B.(2002).Staff Burnout in Long-Term Care Facilities.Geriatrics Today,5(3),132-135.
55. Schieman, S.(2013).Job-Related Resources and the Pressure of Work Life.Social Science Research,42(2),271-282.
56. Scott, B. A.,Barnes, C. M.(2011).A Multilevel Field Investigation of Emotional Labor, Affect, Work Withdrawal, and Gender.Academy of Management Journal,54(1),116-136.
57. Woodhead, E. L.,Northrop, L.,Edelstein, B.(2016).Stress, Social Support, and Burnout Among Long-Term Care Nursing Staff.Journal of Applied Gerontology,35(1),84-105.
58. 王光旭(2016)。社區照顧關懷據點服務志工情緒勞務的前置因素與其結果關係之研究。第八屆公共治理國際學術研討會及實務論壇「國家政策、區域聯合治理、地方發展」，台中:
59. 王潔媛(2016)。全球化的跨國勞動力-外籍看護工在長照機構之情緒勞動。社區發展季刊，153，154-169。
60. 呂旻芬,許靖岱,黃靖,蔡江欽,黃芷苓(2017)。都會區及鄉鎮區醫院護理人員之職業疲勞相關因素探討。台灣醫學，21(3)，257-266。
61. 李卓倫,呂育陞,劉立凡(2010)。高齡照護體系中之專業人力。臺灣老年學論壇，6，1-12。
62. 高淑華(2014)。私立美和科技大學健康照護研究所。
63. 張美珍(2012)。國立高雄師範大學人力與知識管理研究所。
64. 許哲瀚,鞏建吉,趙建蕾,張馨云,楊典諺(2013)。長期照護人員職業倦怠與自覺健康之關聯性研究。澄清醫護管理雜誌，9(2)，48-57。
65. 趙建蕾,鞏建吉,吳惠琪,許哲瀚(2009)。長期照護之照服員情緒智慧與職業倦怠關聯性探討。長期照護雜誌，13(1)，41-55。
66. 衛生福利部，2020，「長照2.0執行現況及檢討專案報告」，立法院第10屆第2會期社會福利及衛生環境委員會第10次全體委員會（11月16日）。
67. 衛生福利部，2023，「長期照顧十年計畫2.0-長照服務涵蓋率」，長期照顧：https://1966.gov.tw/LTC/lp-6485-207.html。2023/06/20。
68. 衛生福利部(2016).長照十年計畫2.0核定本.台北:衛生福利部.
69. 鄭伯壎,姜定宇,吳宗祐,高鳳霞(2015).組織行為研究在臺灣四十年深化與展望.台北:華泰.
70. 鄭雅雯（編）(2019).職災之後：補償的意義、困境與出路.台北:巨流.
71. 盧玉嬴,陳瑞貞,梁淑媛,吳淑芳(2014)。護理人員之工作與職場疲勞之相關性探討。護理暨健康照護研究，10(4)，276-285。
72. 賴添福，2023，「長照場域導入科技的現況、困境及展望」，ĀnkěCare創新照顧：https://www.ankecare.com/article/2364-2023-01-25-17-14-10。2023/03/15。
73. 賴惠德,楊惠雯(2016)。情緒勞務與離職意圖關係之探討：德行領導與知覺同事支持的中介效果。社會科學學報，24，1-30。

1. (2024)。精神科男性護理人員工作之情緒勞務經驗。精神衛生護理雜誌，18(3)，22-29。