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題名:領導者與部屬交換關係對員工行為與顧客服務滿意度之影響-以北區某衛生福利部所屬醫院護理部門為例
作者:李景如
作者(外文):LEE, CHIN-JU
校院名稱:國立臺北大學
系所名稱:企業管理學系
指導教授:陳宥杉
劉仲矩
學位類別:博士
出版日期:2022
主題關鍵詞:領導者與部屬交換關係工作契合度工作敬業離職傾向顧客服務滿意度Leader-member exchange relationship (LMX)person-job fitwork engagementturnover tendencyservice satisfaction
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「領導者與部屬交換關係」(leader-member exchange relationship, LMX),在說明領導者與其每一位部屬之間會自然發展出不同程度的關係。理論中也說明領導者與部屬之間關係的品質就像是壓力跟工作績效間的緩和劑。管理者的領導型態與效能對部屬的工作態度及離職傾向扮演著重要的角色,護理人員對工作契合度及工作敬業度降低,發現不僅會影響到病人的照護品質及醫院形象,更會帶來醫療負面的反應,台灣地區護理人力不足,主因環境複雜、生態轉變、壓力提升以及與主管關係的型態導致高流動率所致。因此,維持護理人員的工作穩定度與留任意願,實為目前深具挑戰性的問題,研究運用領導者與部屬交換關係,並針對護理人員對自我工作契合度,瞭解第一線與顧客接觸護理人員的工作敬業、以及離職傾向,也希望能了解顧客對專業照護的需求及整體滿意度,藉由實證結果提出相關管理意涵,並針對管理實務提出相關建議。
研究主要採取橫斷面(Cross Section) 量化的研究,針對北區某衛生福利部所屬醫院護理部門之護理人員,發放400份問卷,回收有效問卷395份,有效回收率98.7%。運用結構方程模型(Structural Equational Modeling, SEM)來進行護理低層及中層主管,護理人員以及病人分析。結果發現:領導者(護理長)與部屬(護理人員)交換關係(LMX)會正向影響工作契合度;領導者(護理長)與部屬(護理人員)交換關係LMX會負向影響離職傾向;工作契合度會正向影響工作敬業;工作敬業對領導者(護理長)與部屬(護理人員)交換關係(LMX)與顧客服務滿意度間中介效果不顯著;工作契合度對領導者(護理長)與部屬(護理人員)交換關係(LMX)與顧客服務滿意度間中介效果不顯著;離職傾向對領導者(護理長)與部屬(護理人員)交換關係(LMX)對顧客服務滿意度間中介效果不顯著。
本研究主貢獻有三,首先經研究發現運用領導者與部屬交換關係,以強化工作契合度與工作敬業,促使護理人員獲得資源與支持的認知,產生出相同的工作目標,願意為此工作目標而努力,讓個人與工作契合度更為貼近,並進一步獲得工作就與價值,從而增加工作敬業;提升領導者與部屬交換關係以降低離職傾向,透過領導者讓護理人員認同自我具有良好的資源與支持,進而從對提升領導者與部屬交換關係中以減少其離職傾向;增加護理人員工作敬業與工作契合度以提升顧客服務滿意度,讓護理人員獲得良好的工作契合度與工作敬業,以較好的服務態度與表現提供服務,進而有較好的服務品質,增加顧客服務滿意度。
The “leader-member exchange relationship” (LMX) describes that varying degrees of relationships would naturally develop between a leader and each member. This theory also suggests that the quality of leader-member relationship is akin to a moderator between stress and work performance. The leadership type and efficacy of managers play an important role in the work attitude and turnover tendency of members. It is found that decreased person-job fit and work engagement in nursing staff will not only impact the quality of patient care and image of a hospital but also bring negative medical responses. There is a shortage of nursing staff in Taiwan, mainly because of the high turnover rate caused by the complicated environment, ecological shift, increasing stress, and the type of relationship with the leader. Therefore, maintaining nursing staff’s work stability and intention to stay on the job is a highly challenging topic of today. This study utilizes the LMX theory, focuses on nursing staff’s person-job fit, and examines work engagement and turnover tendency of frontline nursing personnel who have direct contact with customers, while also seeking to understand customers’ needs for and overall satisfaction with professional care services. Based on the empirical results, relevant managerial implications and recommendations for management practices are proposed.
This study mainly adopted a cross-sectional quantitative research method. Four hundred copies of questionnaires were distributed among nursing staff of the nursing department of a hospital in northern Taiwan under the Ministry of Health and Welfare, with 395valid samples recovered, achieving a recovery rate of 98.7%. Structural Equational Modeling (SEM) was employed to analyze low- and mid-level nursing supervisors, nursing staff, and patents. According to analysis results, the following findings are revealed. The head nurse–nursing staff LMX had a positive effect on person-job fit. The head nurse–nursing staff LMX had a negative effect on turnover tendency. Person-job fit had a negative effect on turnover tendency. Work engagement had a no mediating effect between the head nurse-nursing staff LMX and patients’ satisfaction with services. Person-job fit had a no mediating effect between the head nurse–nursing staff LMX and patients’ satisfaction with services. Turnover tendency had a no mediating effect between the head nurse–nursing staff LMX and patients’ satisfaction with services.
This study has three main contributions. Firstly, according to the research findings, the LMX can be used to enhance person-job fit and work engagement, prompt nursing staff to develop an awareness of obtaining resources and support, generate the same work objective, and become willing to make efforts for this objective. In so doing, individuals will have better person-job fit and further gain achievement and value from work, thereby increasing work engagement. Secondly, turnover tendency can be reduced by improving the LMX. Leaders can let nursing staff recognize that they have good resources and support, thereby reducing their turnover tendency by improving the LMX. Thirdly, people’s satisfaction with the services can be improved by increasing nursing staff’s work engagement and person-job fit. Through obtainment of good person-job fit and work engagement, nursing staff would provide services with more positive service attitudes and performance, thereby delivering better service quality and increasing patients’ satisfaction with services.
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