| Summary: | 碩士 === 國立臺灣大學 === 醫療機構管理研究所 === 94 === Objectives：This study is aiming at the causes for occupational hazards among female nurses: accidents, needle stick and cutting injuries, with focusing on the aspects of work conditions and psychosocial environment. The “Effort-reward imbalance” model and its questionnaire were used for evaluating the psychosocial environment.
Method:A secondary data consists of a national survey on nurses, conducted by the Commission on Labors, and a national survey on clinical professionals was used for analysis. The target population is clinical nurses who work in regional hospitals or medical centers. There was a total of 12,990 respondents completed the questionnaire. The author used two-stage logistic regression to investigate the impact from organizational environment, work characteristics, as well as psychosocial environment to the causes for accidents, needle stick or cutting injuries. A path analysis was adopted for testing the mediating effect from “Effort-reward imbalance” and to verify the combined impact from other occupational hazard factors.
Result：According to the result of regression analysis, “psychosocial environment”, “unsafe work environment”, “heavy work loadings”, and ”lower work controls” are found to be related with the causes for accidents. Besides, the result of path analysis shows that through the effect of psychosocial environment, nurses who answered “working in hospitals with improper performance evaluation”, “heavy work loadings” , and ”lower work controls” tend to have higher chances in occurrence of accidents. “Psychosocial environment”, “unsafe work environment”, “improper performance evaluation”, and ”lower work controls” are found to be related with the causes for needle stick or cutting injuries. Through the effect of psychosocial environment, nurses who answered” working in hospitals with improper performance evaluation”, “heavy work loadings” , and ”lower work controls” tend to have higher risk in experiencing needle stick or cutting injuries. Nurses who suffered from “Effort-reward imbalance” have higher risk in experiencing occupational hazards than others, and an interaction between “Effort-reward imbalance” and “Over commitment” exists. Through path analysis, the result shows that “Over commitment” has a mediating effect on the impact of occupational hazard from “Effort-reward imbalance”.
Conclusion：Except well-known factors such as physical environment and facilities, the organizational environment, work conditions, and psychosocial environment are all factors related to the causes of occupational hazards. Thus, hospitals are suggested to monitor their workplace safety regularly, to re-evaluation work contents and work loading for nurses, and to give more attention on responding nurses’ psychological needs.
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