醫師工作負荷與職業倦怠、憂鬱傾向、職業滿意度及醫療糾紛之關係

Elucidating the Relationships between Job Strains and Burnout, Depression, Career Satisfaction, Medical Dispute among Doctors

10.6342/NTU.2013.00126

郭彥君

醫師、工作負荷 ； 職業倦怠 ； 憂鬱 ； 職業滿意度 ； 醫療訴訟 ； doctors ； job strain ； burnout ； depression ； career satisfaction ； medical dispute

國立臺灣大學健康政策與管理研究所學位論文

2013年

碩士

林能白

繁體中文

自健保開辦以來，民眾醫療利用率增加上健保政策改變、醫療糾紛層出不窮，令醫師診療壓力大增。醫療人員長期過勞將不利醫療判斷，且影響心理健康（如憂鬱、自殺意念），有研究亦指出醫療訴訟和過勞、職業倦怠及憂鬱及有強烈關連性。國內過去關於醫師的職業倦怠研究不多，並且高風險科別的給付與其承擔風險不成比例和醫療訴訟層出不窮，被認為是醫療科別不均之因。 本研究欲了解醫師的職業倦怠並與國內資料比較，並找出工作負荷與職業倦怠、憂鬱傾向、職業滿意度與醫療糾紛之間的關係。 本研究方法為橫斷性匿名問卷調查，對象為醫學院畢業，仍從事臨床病患照護工作之醫師，共發出905份紙本問卷，有效樣本紙本問卷261份，網路問卷87份，總共348份。 研究發現醫師的職業倦怠較一般職場為高，憂鬱傾向介於身心適應良好與輕度情緒困擾之間。「每週平均執行緊急手術或治療數多並且工作量多」的科別和「職業倦怠與憂鬱傾向整體分數」最高及「地方法院醫療糾紛刑事判決實證研究」中被告最多的科別大致相符，而這些科別也正好是目前人力供需失衡的科別。工作負荷（含工作屬性與工作量）中，工作屬性僅與醫療糾紛相關；工作量與職業倦怠、憂鬱傾向皆相關，其中門診量與職業滿意度成正相關，每月值夜班數與工作滿意度負相關。醫療糾紛與職業倦怠、憂鬱傾向及職業滿意度均不相關。 本研究依據結果對未來研究、醫療機構管理者以及衛生主管機關做出建議，希望能增進職場健康、改善科別不均現狀並促進病患滿意度及民眾就醫品質。

The purpose of this study is to investigate the situation of burnout and depression among doctors in Taiwan. Furthermore, the relationships between job strains (job characteristics and job workload) and burnout, depression, career satisfaction, and medical dispute are surveyed. Paper and Web Questionnaires containing the Chinese version of the Copenhagen Burnout Inventory (C-CBI) and Brief Symptoms Rating Scale（BSRS-5）were delivered A total of 348 doctors responded the questionnaires. The mean burnout scores of doctors were higher than paid employees in Taiwan. The average depression score was between healthy and mild mood disturbance. The job characteristics are significantly associated with medical dispute; on the other hand, the job workload is associated with burnout, depression and career satisfaction. There is an incidental finding that the specialties of doctors are almost the same among “doctors who are dealing with more emergencies and work loading”, “doctors who are most suffering from burnout and depression” and “doctors who are convicted by medical malpractice judgments from district criminal courts in Taiwan”. This conclusion explains to some extent why certain medical specialties are lack of doctors now. Actions should be taken to mitigate the stress and get through the difficult situation.

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