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題名:最後一哩學程改善新進護理人員職場疲勞與工作表現之成效探討
書刊名:護理雜誌
作者:吳秀美劉佩芬何雪華陳品玲 引用關係趙慧玲陳小蓮
作者(外文):Wu, Hsiu-meiLiu, Pei-fenHo, Hsueh-huaChen, Ping-lingChao, Hui-linChen, Hsiao-lien
出版日期:2012
卷期:59:4
頁次:頁30-42
主題關鍵詞:最後一哩護理工作表現職場疲勞工作適應Last mile programNursing job performanceOccupational burnoutWork adaption
原始連結:連回原系統網址new window
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  • 被引用次數被引用次數:期刊(7) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:7
  • 共同引用共同引用:100
  • 點閱點閱:74
背景 : 新進護理人員進入臨床是一段壓力與挑戰的角色轉換過程,臨床技能不足與工作適應困難,導致新進人員離職率居高不下,進一步加劇健康照護部門護理專業人員的短缺。最後一哩學程強調透過產學合作,共同設計課程,以彌補學校教育與實際作業之差距,增加應屆畢業護生之職場適應能力。 目的 : 本研究目的為探討最後一哩學程改善新進護理人員職場疲勞與工作表現之成效。 方法 : 採類實驗研究設計,以三所護理技職體系學校應屆畢業生為對象,分為最後一哩學程組( n = 29)和沒有參加最後一哩學程組( n = 94)。最後一哩學程是由研究者與學校共同規劃並經專家效度檢定,學程包括課室教學 84小時和臨床實習 160小時。護理工作表現量表採國外 Greenslade和 Jimmieson發展之問卷,經翻譯、回返翻譯建立中文版,再以因素分析取得八因素,社會支持、提供資訊、協調照護、技術性照護歸類為任務工作表現概念,人際間支持、工作職務支援、自願負擔額外任務以及遵從性歸類為情境工作表現概念,八因素信度介於 .70-.95。職場疲勞量表分為個人疲勞、工作疲勞、服務對象疲勞以及工作過分投入四概念,信度介於 .84-.90。在新進護理人員到職第 1、3、6個月進行資料收集,並以重複測量變異數分析法、獨立 t檢定進行資料分析。 結果 : 123位新進護理人員,平均年齡 23歲,有無參加最後一哩學程者在教育程度、工作單位等基本屬性皆無統計差異。在護理工作表現方面,參加最後一哩學程新進護理人員於到職 6個月時的工作職務支援、自願負擔額外任務以及整體任務、情境表現顯著高於沒有參加最後一哩學程的新進護理人員。職場疲勞方面,參加最後一哩學程的新進護理人員於到職 6個月時的服務對象疲勞亦顯著低於沒有參加者。 結論/實務應用 : 最後一哩學程能增加新進護理人員情境工作表現並減低其對服務對象之疲勞。本研究建立之學校、醫院共同合作模式,可提供醫院管理者和教育者於規劃新進護理人員留任策略之參考。
Background : New nurses undergo a stressful and challenging transition process in the nursing workplace. Lack of patient care knowledge and skills and work adaption difficulties lead to a high turnover rate that drains essential newtalent away from the nursing profession and further exacerbates professional staffing shortages in the healthcare sector. The “last mile” program is a program developed jointly by a nursing school and hospital as a mechanism to bridgeclassroom learning to clinical practice and smooth the transition of nursing students into nursing professionals. Purpose : The purpose of this study was to understand the effect of the “last mile” program on job performance and occupational burnout among new nurses. Methods : We conducted a quasi-experimental study in 2009 on a convenience sample of new nurses in a medicalcenter. Participants were assigned into two groups, namely those enrolled in the last mile program (n = 29) and those not enrolled in the program (n = 94). Research team members and several collaborative universities developed the lastmile program used in this study; Seven experts established content validity; The last mile program included 84 hoursof lecture courses and 160 hours of clinical practice. Data was collected using the nursing job performance scale developed in 2007 by Greenslade and Jimmieson and translated / back translated into an equivalent Chinese version. Exploratory factor analysis showed all items aggraded into 8 factors, which could be divided into task performance andcontextual performance concept categories. Task performance concepts included: social support, information, coordination of care, and technical care; Contextual performance concepts included: interpersonal support, job-task support, volunteering for additional duties and compliance. The Cronbach’s α for the 8 factors were .70-.95. The occupational burnout inventory included the 4 subscales of personal burnout, work-related burnout, client-related burnout, and over-commitment, with associated Cronbach’s α ranging from .84-.90. Data was collected at one, three, and six months after employment. Repeated measures ANOVA and an independent t-test were used to analyze data. Results : The average age of the 123 participants surveyed was 23 years, with no differences identified between last-mile and non-last-mile groups in terms of education level, work unit, or other demographic variables. New nurses whoparticipated in the last mile program achieved significantly higher performance scores for job-task support, volunteering for additional duties, and overall task and contextual performance than those who did not. Last-mile-program group participants also had significantly lower client-related burnout than their non-last-mile-program peers. Conclusions / Implications for Practice : The last mile program facilitates new nurses’ contextual performanceand reduces incidence of care burnout. The cooperative education model linking universities and hospitals can be apositive component in a new nurse retention strategy for hospital administrators and educators.
Other
1.Casey, K., Fink, R., Krugman, R., & Propst, J.(2004)。The graduate nurse experience。  new window
2.Kramer, M.(1974)。Reality shock: Why nurses leave nursing。  new window
期刊論文
1.蔡秋月、黃良志、葉淑娟(20030100)。護理人員組織承諾、工作滿足與組織公民行為之研究。秀傳醫學雜誌,4(1),35-45。  延伸查詢new window
2.Halfer, D.、Graf, E.(2006)。Graduate nurse perceptions of the work experience。Nursing Economic,24(3),150-155。  new window
3.鍾月琴、馮英鳳、陳蕙玲、游金靖(20080800)。產學合作計畫於護理系應屆畢業生之成效評估--以血液透析訓練為例。安泰醫護雜誌,14(2),61-71。  延伸查詢new window
4.Duchscher, J. E. B.(2009)。Transition shock: the initial stage of role adaptation for newly graduated Registered Nurses。Journal of Advanced Nursing,65(5),1103-1113。  new window
5.Yeh, M. C.、Yu, S.(2009)。Job stress and intention to quit in newly-graduated nurses during the first three months of work in Taiwan。Journal of Clinical Nursing,18(24),3450-3460。  new window
6.Kristensen, Tage S.、Borritz, Marianne、Villadsen, Ebbe、Christensen, Karl Bang(2005)。The Copenhagen Burnout Inventory: A New Tool for the Assessment of Burnout。Work & Stress,19(3),192-207。  new window
7.葉婉榆、鄭雅文、陳美如、邱文祥(20081000)。職場疲勞量表的編製與信效度分析。臺灣公共衛生雜誌,27(5),349-364。new window  延伸查詢new window
8.黃璉華(20040800)。從護生到護士--談新進護理人員的適應。護理雜誌,51(4),33-36。new window  延伸查詢new window
9.Atack, L.、Comacu, M.、Kenny, R.、LaBelle, N.、Miller, D.(2000)。Student and staff relationships in a clinical practice model: Impact on learning。Journal of Nursing Education,39(9),387-392。  new window
10.何雪華、劉佩芬、胡曉珍、黃素菲、陳小蓮(20101200)。新進護理人員角色轉換與工作適應歷程之質性研究。護理雜誌,57(6),31-41。new window  延伸查詢new window
11.Altuntas, S.、Baykal, U.(2010)。Relationship between nurses' organizational trust levels and their organizational citizenship behaviors。Journal of Nursing Scholarship,42(2),186-194。  new window
12.Freudenberger, Herbert J.(1974)。Staff Burnout。Journal of Social Issues,30(1),159-165。  new window
13.Beaton, Dorcas E.、Bombardier, Claire、Guillemin, Francis、Ferraz, Marcos Bosi(2000)。Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures。Spine,25(24),3186-3191。  new window
14.林麗英、蔡淑芳(20100900)。比較兩種新進護理人員訓練制度對提昇能力之成效評估。榮總護理,27(3),231-239。new window  延伸查詢new window
15.Maslach, Christina、Schaufeli, Wilmar B.、Leiter, Michael P.(2001)。Job Burnout。Annual Review of Psychology,52(1),397-422。  new window
16.余玉眉、戴玉慈、張媚(20101000)。我國護理教育、考試制度與專業核心能力--從國際接軌角度探討。護理雜誌,57(5),5-11。new window  延伸查詢new window
其他
1.尹祚芊Yin, J. C.(200409)。90-92年護理人員未滿一年離職情況分析Analysis of turnover for nurses hired for less than one year (2001-2003)。  延伸查詢new window
2.吳清山林天佑Wu, C. S., & Lin, T. Y.(2003)。最後一哩Last mile。  延伸查詢new window
3.陳端容Chen, D. R.(2006)。工作組織社會心理特質與自評健康:比較DC與ERI工作壓力模式對醫師族群之適用性Psychosocial work environment and self-rated health: A comparative study of DC and ERI models in a sample of medical specialists。  延伸查詢new window
4.葉明珍Yeh, M. C.(2007)。應屆畢業護生進入職場前預期工作壓力與企盼資源Expecting job stress and resources needed by graduating nursing students preentry to nursing occupation。  延伸查詢new window
5.劉杏元、張家臻、于桂蘭、何英奇、曾銀貞、吳曉明Liu, H. Y., Chang, C. C., Yu, K. L., Ho, Y. C., Tzeng, Y. J. & Wu, S. M.(2010)。最後一哩課程對四技護生學習成效之探究The implementation and learning effects of last-mile curriculum among nursing students of a four-year technology college。  延伸查詢new window
6.簡麗瑜、黃湘萍、王瑜欣、黃翠媛(2011)。多重學制下的護理課程目標區隔-修訂版Bloom教育目標分類的應用The application of revised bloom taxonomy with multiple educational systems to nursing curriculum differentiation。  延伸查詢new window
7.羅煥鉅、陳端容Lo, H. C., & Chen, D. R.(2008)。組織公平性認知與放射科醫師健康相關性之研究:以付出回饋失衡與程序公平為例Perceived fairness of work organization associated with psychosocial health of radiologist in Taiwan。  延伸查詢new window
8.Chen, C. Y., & Lee, Y. J.(2006)。Specific practice of the last mile project at Taiwanese universities of science and technology: The topping course。  new window
9.Chu, C. I., & Hsu, Y. F.(2011)。Hospital nurse job attitudes and performance: The impact of employment status。  new window
10.Chu, C. I., Lee, M. S., Hsu, H. M., & Chen, I. C.(2005)。Clarification of the antecedents of hospital nurse organizational citizenship behavior: An example from a Taiwan regional hospital。  new window
11.Curtis, J.(2007)。Working together: A joint initiative between academics and clinicians to prepare undergraduate nursing students to work in mental health settings。  new window
12.Greenslade, J. H., & Jimmieson, N. L.(2007)。Distinguishing between task and contextual performance for nurses: Development of a job performance scale。  new window
13.Hardyman, R., & Hickey, G.(2001)。What do newly-qualified nurses expert from preceptorship? Exploring the perspective of the preceptee。  new window
14.Khomeiran, R. T., Yekta, Z. P., Kiger, A. M., & Ahmadi, F.(2006)。Professional competence: Factors described by nurses as influencing their development。  new window
15.Kovner, C. T., Brewer, C. S., Fairchild, S., Poornima, S., Kim, H., & Djukic, M.(2007)。Newly licensed RNs’: Characteristics, work attitudes, and intentions to work。  new window
16.Laschinger, H. K., Grau, A. L., Finegan, J., & Wilk, P.(2010)。New graduate nurses’ experiences of bullying and burnout in hospital settings。  new window
17.Newhouse, R. P., Hoffman, J. J., Suflita, J., & Hairston, D. P.(2007)。Evaluating an innovative program to improve new nurse graduate socialization into the acute healthcare setting。  new window
18.Schwirian, P. M.(1978)。Evaluating the performance of nurses: A multidemensional approach。  new window
19.Sonnentag, S., & Frese, M.(2002)。Performance concepts and performance theory。  new window
20.Unruh, L. Y., & Nooney, J.(2011)。Newly licensed registered nurses’ perceptions of job difficulties, demands and control: Individual and organizational predictors。  new window
21.Watson, R., Deary, I., Thompson, D., & Li, G.(2008)。A study of stress and burnout in nursing students in Hong Kong: A questionnaire survey。  new window
圖書論文
1.Kane, J. S.、Lawler, E. E.(1976)。Performance appraisal effectiveness: its assessment and determinants。Research in Organizational Behavior。Greenwich, CT:JAI Press。  new window
2.Borman, Walter C.、Motowidlo, Stephan J.(1993)。Expanding the Criterion Domain to Include Elements of Contextual Performance。Personnel selection in organizations。Jossey-Bass。  new window
 
 
 
 
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