College of Management, Yuan Ze University, 135 Yuan-Tung Road, Chungli, Taoyuan, Taiwan.
Health Policy. 2012 Dec;108(2-3):149-57. doi: 10.1016/j.healthpol.2012.08.027. Epub 2012 Sep 25.
The aim of the present study was to compare the levels of stress, depression, and intention to leave among clinical nurses employed in different medical units in relation to their demographic characteristics under the National Health Insurance (NHI) System in Taiwan.
Cross-sectional Spearman's correlation, one-way ANOVA with Scheffe post hoc analysis tests, and multiple regression analyses were conducted. Several self-report questionnaires, such as the Center for Epidemiological Studies Depression Scale, the Perceived Stress Scale and Intention to Leave Scale, were administered. A total of 314 research participants were surveyed, all of whom came from regional hospitals in Northern Taiwan.
Marital status and working tenure were significant predictors to the levels of stress, depression, and intention to leave among nurses before taking the medical units into consideration. However, with adding medical units as predictors, the effect of marital status and working tenure were insignificant except for the stress model, indicating medical units were showing dominant effect over other variables. In particular, internal medical ward (IMW) nurses experienced a higher prevalence of depression than emergency room (ER) nurses and professional nursing practitioners. External medical ward (EMW) nurses also experienced greater depression than emergency room (ER) nurses. Both IMW and EMW nurses perceived significantly greater stress than ER and dialysis center. Moreover, IMW nurses also perceived greater stress than operating room (OR) nurses and showed stronger intention to leave than their counterparts in the outpatient service departments.
The results indicated that significant differences existed among various medical units with regards to nurses' stress, depression, and intention to leave. Nurses working in internal and external medical wards, especially the inexperienced and married ones, experienced greater depression and stress, thereby developing stronger intention to leave their job.
本研究旨在比较在台湾全民健保制度下,不同医疗单位的临床护士在人口统计学特征方面的压力、抑郁和离职意向水平。
采用横断面 Spearman 相关分析、单因素方差分析和 Scheffe 事后检验以及多元回归分析。共调查了 314 名研究参与者,他们均来自台湾北部的地区医院。采用了几种自我报告问卷,如流行病学研究中心抑郁量表、感知压力量表和离职意向量表。
在不考虑医疗单位的情况下,婚姻状况和工作年限是护士压力、抑郁和离职意向水平的显著预测因素。然而,在加入医疗单位作为预测因素后,除了压力模型外,婚姻状况和工作年限的影响并不显著,表明医疗单位对其他变量具有主导作用。特别是内科病房(IMW)护士的抑郁发生率高于急诊室(ER)护士和专业护理人员。外医疗病房(EMW)护士的抑郁程度也高于急诊室(ER)护士。IMW 和 EMW 护士的压力感知均明显大于 ER 和透析中心。此外,IMW 护士的压力感知也大于手术室(OR)护士,离职意向也比门诊服务部门的同行更强。
结果表明,不同医疗单位的护士在压力、抑郁和离职意向方面存在显著差异。在内科和外科病房工作的护士,尤其是经验不足和已婚的护士,经历了更大的抑郁和压力,从而产生了更强的离职意向。