醫院行政人員之壓力反應與組織承諾探討

1. 醫院行政人員之壓力反應與組織承諾探討 • 本研究主要探討醫院行政人員之人格特質（內外控傾向）與組織因素的互動關係，進而探討其對壓力反應與組織承諾之相關性，以證實個人的人格特質不同，即使從事相同的工作亦會有不同的工作態度與行為反應。對員工而言，須配合每個員工人格特質之差異，應賦予不同特性的工作，才能有助於其工作與態度上的表現；相反地，對工作環境而言，因工作特性或環境的不同，應配置適當的才能的員工，才得以勝任愉快。　　本研究係採橫斷性研究調查法，針對不同型態醫院（公立、公辦民營、私立醫院）以行政人員為母群體進行問卷的普查工作。問卷內容包括「基本資料」、「組織環境量表」、「內外控量表」、「壓力反應量表」、「組織承諾量表」等結構式問卷，共發出446份問卷，回收341份，扣除無效問卷37份，得有效問卷304份，回收率為76.91%，有效回收率為68.16%。所得資料以平均值、標準差、得分率、T檢定、變異數分析、相關係數分析、迴歸等統計方法進行資料整理。研究結果如下：1. 醫院行政人員整體壓力反應介於輕微與中等之間(平均數:1.67;標準差:9.94)，其中感受壓力較大的為角色負荷（平均數:1.87），最低為角色模糊（平均數:1.53）。2. 醫院行政人員整體組織承諾為中上程度(平均數:3.73;標準差:6.00），其中努力承諾最高（平均數:4.00），最低為留職承諾（平均數:3.53）。3. 在人口統計變項、醫院型態方面，婚姻狀況與壓力反應達統計上顯著差異；年齡、教育程度、婚姻狀況、醫院權屬別與組織承諾分別達統計上的顯著差異。4. 內外控傾向對壓力反應（R2=0.033;P=.002）與組織承諾（R2=0.053;P=.000）達顯著負相關；在組織環境各因素中，醫院行政人員對整體壓力反應效果，依序為領導風格（R2=0.070）工作特性（R2=0.029）管理制度及政策（R2=0.018）實體環境（R2=0.015）的影響程度；另外，在組織環境各因素中，醫院行政人員對組織承諾效果，依序為管理制度及政策（R2=0.320）工作特性（R2=0.213）領導風格（R2=0.153）實體環境（R2=0.130）的影響程度。5. 在「內外控－工作特性」組合方面，醫院行政人員擁有「內控-高MPS」組合將是壓力反應最低且組織承諾最高；在「內外控－組織接受度」組合方面，醫院行政人員擁有「外控-低OE」組合則壓力反應最低，擁有「內控-高OE」組織承諾最高。6. 壓力反應重要的預測因素為「內外控傾向」、「領導風格」變項，總共可解釋12.5%的變異量；組織承諾重要的預測因素為「內外控傾向」、「工作特性」、「管理制度及政策」、「醫院權屬別」「年齡」等變項，總共可解釋49.0%的變異量。　　希望本研究結果能提供醫院行政主管在人員遴選、組織因素的工作設計與管理方面的參考，以降低工作環境或組織所帶來的工作壓力與角色壓力，並提高員工對組織之承諾感，進而提升醫院之行政效率與品質。

2. The Exploration on the Pressure Response and Organizational Commitment of Hospital Staffs • This study is primarily to observe the interaction between hospital staffs’ personality (locus of control) and their organizational contexts. As a result, we intend to investigate above impacts on hospital staffs’ responses to pressure and their commitments to organization. In other words, we would like to verify that people with different personality but doing the same works might have different working attitude and value under similar working environments.In a monotonic working environment, hospital staffs will perform better if their work assignments are based on their personality. In addition, different working environment and job characteristics, to some extents, may play key roles to influence hospital staffs’ performances.A cross-sectional survey was adopted in this study. Sampling population are hospital administration staffs among three different type of hospitals. The structure of the questionnaire is composed of “Basic Data”, “Organizational Environment Inventory”, “Internal-External Control Scale”, “Pressure Response Inventory”, “Organizational Commitment Questionnaires”. Totally, 446 questionnaires were sent out with a effective returned rate of 68.16% (note: 341 questionnaires were returned, with 304 valid questionnaires). We employed mean, standard deviation, percentage, t-test, one-way ANOVA, Pearson’s product-moment correlation, and multiple regression as our statistical tools to analyze our data. Results of this study are as follows:1. The mean (SD) of the whole pressure response of hospital staffs was 1.67 (SD=9.94) as mild to medium level. The strongest pressure was role load (mean=1.87), and role ambiguity (mean=1.53) was the weakest.2. The mean (SD) of the whole organizational commitment of hospital staffs was 3.71 (SD=6.00) as medium level. The highest commitment was endeavor commitment (mean=4.00), and retaining commitment (mean=3.53) was the lowest.3. Among demographic variables and type of hospitals, the correlation between marital status and pressures response are statistically significant; the correlation between organizational commitment and age, education, marital status type of hospitals are significant, respectively.4. Locus of control is negatively correlated with organizational commitment (R2=0.053; P=0.000), and pressure response (R2=0.033; P=0.002). Among organizational factors, their impacts on hospital staffs’ responses to pressure, in a decreasing order, are leadership style (R2=0.070), job characteristics (R2=0.029), hospital management and policy (R2=0.018), physical environment (R2=0.015). In addition, among organizational factors, their impacts on hospital staffs’ organizational commitment, hospital management and policy (R2=0.320), job characteristics (R2=0.213), leadership style (R2=0.153), physical environment (R2=0.130).5. For the combination of “LOS-MPS”, hospital staffs with “Internal control-high MPS” have the lowest pressure response and highest organizational commitment; for the combination of “LOS-OE”, hospital staffs with “External control-low OE” have the lowest pressure response, while hospital staffs with ”Internal control-high OE” have the highest organizational commitment.6. The most influencing factors on hospital staffs’ responses to pressure are “locus of control” and “leadership style”. Those two factors can predict 12.5% of total variances. In the same manor, there are five influencing factors (i.e., “locus of control”, ”job characteristics”, “hospital management and policy”, “type of hospitals”, “age”) on hospital staffs’ commitment to organization. Their can explain around 49% of total variance in the regression equation.The outcomes of this study intend to provide a guideline for hospital administrator in new employee recruitment, job design, and organizational management. Hopefully, our findings can help hospital administration to improve their efficiency and quality through reducing working pressure and promoting organizational commitment.