The Correlation Among Nurse Practitioner’s Job Stress, Job Fatigue, and Job Satisfaction-Based on Veteran Hospitals in Southern Taiwan

• Main Authors: Yen Ho Lai, 賴彥和
• Other Authors: Whei-Mei Shih
• Format: Others
• Language: zh-TW
• Published: 2015
• Online Access: http://ndltd.ncl.edu.tw/handle/62dksd

碩士 === 長庚科技大學 === 健康照護研究所 === 103 === Research Background and Purposes: The role of nurse practitioners has been established in Taiwan for over twenty years during the resource allocation in the National Health Insurance. In order to maintain the health care levels on the one hand and to account for medical costs on the other, coupled with the fact that the senior nursing personnel had to undertake part of the medical treatments in some medical institutions due to the shortage of resident physicians, the roles of the nursing personnel were thus extended and improved, hence the establishment and development of the system of nurse practitioners. It is a nursing role that has been set up in the United States since the 1950s with a history of over 60 years. In Taiwan, it was set up first in the MacKay Memorial Hospital and was included in the manning quotas and given the title of “clinical nurse practitioners” in 1986. Nurse practitioners were set up in Taiwan as a response to the coming trends in the global medical care industry, the shortage of resident physicians and the promulgated regulations, besides creating the grounds for nurse practitioners in terms of their identity and code of conduct. In the medical care environment that focuses on quality, speed and efficiency as a result of the rapid social changes, the working role for nurse practitioners isn't simply the assistants of physicians, as they used to be, but a highly professional service job. The combination of the system of nurse practitioners with clinical promotion system has moreover extended the entire nurse promotion system. Subject to the extrinsic demands and intrinsic expectations, however, nurse practitioners have to bear higher and more complicated pressure in this working environment. This research is thus set out as a correlation study between the working pressure, burnouts and job satisfaction from the perspective of care. It is hoped that the research could serve as references for hospital managers in their formulation of relevant policies. Research Methodology: This research was designed as a descriptive correlation study and some nurse practitioners from three veterans hospitals in south Taiwan had been selected as the research subjects through purposive sampling. 72 nurse practitioners were included in the sample and the data collection was conducted via structural questionnaires. The inclusion criterion was mostly licensed nurse practitioners who had been working in the hospitals for over a year (including a year). The investigations were carried out through such research tools as "Personal Data Sheet", "Table of Working Pressure", "Table of Work Exhaustion" and "Table of Job Satisfaction". The results were then subject to descriptive and inferential analyses with the help of the software package of SPSS for windows 18.0 in its Chinese version. Results: (1) average age: 39.28±6.224; marital status: mostly married (77.8%); education: mostly college education (94.4%); religion: mostly Taoists (50.0%); most of the subjects had two children (45.8%); the subjects whose youngest child was not older than 6 years old were the largest in number (35.4%); the subjects who lived together with their children dominated (95.7%); the subjects who had been a nurse for over ten years claimed the largest number (91.7%); most of the subjects worked full time (87.5%); the salaries were mostly from 60001 to 70000 NTD (38.9%); average working years for nurse practitioners: 8.1 years; rank of nurse practitioners: mostly NP0s (59.7%); service department: mostly surgical wards (41.7%); work shifts: mostly fixed to work in the daytime (51.4%); (2) The age of the nurse practitioners was positively correlated to their "competency" pressure (p<.01); (3) The total working years as a nurse was significantly negatively correlated with the item of "service exhaustion" under work exhaustion (p<.01); (4) The total working years as a nurse practitioner was significantly positively correlated with the item of "competency" under working pressure and the total scores in job satisfaction (p<.01, p<.05); (5) There were no marked differences between the sub-items in terms of marriage, forms of employment, religion, the age of the youngest child, salaries and in terms of working pressure, work exhaustion and job satisfaction; (6) There were marked differences in terms of work shifts and such pressure as work attention (p<.05); (7) For the subjects in different service departments, their satisfaction with the work shifts were significantly different (p<.05); (8) For nurse practitioners, the general working pressure was significantly correlated with work exhaustion, the working pressure was not significantly correlated with job satisfaction, while the items of "personal reaction", "work attention", and "inability to complete personal tasks" under working pressure were significantly negatively correlated with the items of "interaction", "salaries", "control over the working environment" and "work shifts" under job satisfaction (p<0.05); (9) The item of "inability to complete personal tasks" under working pressure was significantly negatively correlated with the item of "salaries" under job satisfaction (p<0.05), while the item of "competency" under working pressure was significantly positively correlated with the items of "interaction", "professional participation" and "control over the working environment" (p<0.01); (10) Burnouts were significantly negatively correlated with job satisfaction (p<0.05), the item of "over-devotion to work" was significantly negatively correlated with the items of "interaction" and "salaries" under job satisfaction (p<0.05), while the items of "personal exhaustion" and “burnouts" under working pressure were significantly negatively correlated with the items of "interaction", "professional participation", "salaries" and "control over the working environment" under job satisfaction (p<0.01); (11)The total variance concerning the working pressure among the research subjects in terms of burnouts was 46.8%. Conclusion and Suggestions: According to this research, the subjects were mostly dissatisfied with the workload. It is suggested that standards for human labor allocation and work responsibilities be formulated so that the workload could be evenly distributed. The nurse practitioners could thus develop their potentials at the right place and the right time, hence their achievements in self-growth and improvement of self-efficacy. Medical institutions should moreover set up satisfactory communication channels and provide communication platforms for sharing experiences and hardships during the work, so that professional difficulties could be resolved, working pressure be expressed and the interactions between colleagues be increased. Lastly, consultations concerning individual life planning and courses to understand and express pressure should be offered, and effective guidance measures be taken as early as possible, to help the nurse practitioners to improve working pressure and job satisfaction. Regular or irregular caring activities could be organized and growth or support groups be established to show positive supports to the nurse practitioners in the process of sharing sessions and interactions, while helping them develop their potential and improve their self-efficacies. Relevant courses should be offered to improve their expertise as nurse practitioners and psychological consultations be brought in to enhance their identification with the profession, all with the aim to improve their job satisfaction and decrease their working pressure and the number of burnouts.