電子病歷所產生壓力對於病歷室人員工作疲憊與工作績效影響之研究

The Impact of Stress from Electronic Medical Records on the Work Exhaustion and Work Performance of Medical Record Department Staff

張維晏

電子病歷 ； 病歷管理 ； 病歷資訊管理 ； electronic medical records ； medical records management ； medical information management

義守大學醫務管理學系學位論文

2017年

碩士

郭光明

繁體中文

背景與目的：近年來國內政府單位與醫療機構積極規劃及推動電子病歷，除有效運用電子資訊科技節省人力、資源和空間，對醫療機構而言，電子病歷可降低成本及提升績效。然而，電子資訊科技所帶來負面影響也慢慢出現，由於電子病歷在未來勢必全面取代紙本病歷，為避免電子病歷對於病歷室人員造成負面影響，本研究特針對此現象進行探討。 材料與方法：本研究依據以往電子病歷相關文獻，考量電子病歷會造成病歷室人員的壓力特性提出包括：工作超載、入侵效應、複雜度、工作不安全性及技術不確定性等5個變數，用以預測病歷室人員在推動電子病歷時造成工作疲憊及工作績效之原因，進行問卷調查。 結果與結論：本研究共發放235份問卷，回收有效問卷204份，回收率86.8%，經因素分析(包含信、效度檢定)與結構模式，在5個自變數中，工作超載(β = 0.259, p < .001)、入侵效應(β = 0.160, p < .05)與複雜度(β = 0.257, p < .001)可正向顯著預測病歷室人員工作疲憊原因；技術不確定性(β = -0.125, p < .05)可負向顯著預測病歷室人員工作疲憊原因；工作疲憊(β = -0.377, p < .001)可負向顯著預測病歷室人員工作績效原因，依據資料分析結果，本研究建議應當由醫院組織管理者定期主動了解病歷室人員工作疲憊與工作績效原因，讓病歷室人員可獲得即時且舒緩電子病歷所帶來之工作疲憊，如此，病歷室人員進而提升更多工作績效。

Background and purpose: In recent years, our government units and medical institutions are actively planning and promoting electronic medical records. Not only to effectively using information technology to save manpower, resources and space, for medical institutions, but also to cut down the costs and to improve performance. However, the negative impact of information technology is slowly emerging, too. It is because the electronic medical records in the future are going to completely replace the paper medical records. The medical record department staffs could be negatively influenced by electronic medical records. This study is specifically for this phenomenon. Materials and Methods: Based on the literatures of electronic medical records, five variables including techno overload, techno invasion, techno complexity, techno insecurity and techno uncertainty, are proposed and used to predict the determinants of work exhaustion and work performance of the medical record department staffs. Results And Conclusion: Totally, 235 questionnaires were distributed and 204 valid questionnaires were collected. The response rate was 86.8%. The result was analyzed by the factor analysis (including reliability and validity test) and the structural equation modeling. In the five independent variables, the techno overload (β = 0.259, p< .001), techno invasion (β= 0.160, p < .05), the techno complexity (β = 0.257, p < .001), and techno uncertainty (β = -0.125, p< .05) could significantly predict the work exhaustion of the medical record department staffs. Further, work exhaustion (β = -0.377, p< .001) can be used to predict the work performance of the medical record department staffs. According to the result of the data analysis, this study recommends that the hospital organizational managers should regularly take the initiative to understand and improve the determinants of work exhaustion and the work performance of the medical record department staffs. The medical record department staffs can thus reduce the work exhaustion which was caused by the electronic medical records. In the view of this, the medical record department staffs can also improve their work performance.

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