研究主要由社會交換理論的觀點探討醫療產業組織中，護理人員之領導－部屬交換關係(leader-member exchange, LMX)是否會提升部屬對直屬上司的信任與知覺支持的程度，進而促使部屬在組織公民行為(organizational citizenship behavior, OCB)上的展現。本研究以3家醫學中心和3家區域教學醫院之護理長與護理人員為主要研究對象，總共回收200對（主管－部屬）有效問卷。研究結果發現護理長和護理人員兩者的交換關係品質，與護理人員對護理長的信任與所知覺的主管支持程度皆呈現正向關係。此外，護理長和護理人員兩者的交換關係品質，會透過護理人員對於護理長的信任與知覺主管支持程度的提升，進而促使其展現組織公民行為。本研究的管理意涵顯示良好的主管與部屬的交換關係品質，不僅會增強護理人員對於組織的承諾，降低其離職意願，並且使之主動展現組織公民行為，進而改善組織的整體效能。

This study examined from a social exchange perspective the influence of leader-member exchange (LMX) on the trust of subordinates in their supervisors as well as their perception of support received from their medical organization supervisors and the subsequent effect of such on organizational citizenship behavior (OCB) in subordinates. Two hundred valid supervisor-subordinate (head nurses-nurses) dyads from 3 medical centers and 3 regional hospitals took part in this study, which found that the quality of leader-member exchange affects nurse trust in their supervisors as well as their perception of supervisor support, which consequently promotes OCB on the part of nurses. Findings imply that a higher level of LMX can enhance nurses' commitment, significantly reduce turnover, and promote their OCB, resulting in greater organizational effectiveness.