| 摘要: | 背景與目的：護理人力是醫療產業重要的照護主力；護理人員的高離職率是世界上許多國家共同的問題，台灣地區護理人力不足，並非訓練人數的不足而為大量流失之故。不同世代員工之成長背景不同，形成不同的價值觀，影響員工行為。本研究欲探討不同年齡世代護理人員職涯轉換型態與其相關因素。
研究方法：本研究以苗栗縣護理師護士公會護理人員異動之次級縱貫性資料庫，涵蓋1994年至-2010年2月苗栗縣各醫療機構(含廠護、校護、公衛護士)之護理人員異動資料。研究對象為年齡介於19-70歲者，且完整異動資料者，共計4,087人(6,690異動人次)。研究變項自變項包括：護理人員年齡世代(四年級﹝含以前﹞、五年級、六年級、七年級)、護理人員任職機構權屬、護理人員任職機構評鑑有無、護理人員任職機構類型(區域醫院、地區醫院、診所、非醫療院所)、健保總額政策實施前後、護理人員任職機構所在地都市化程度。依變項包括：護理人員平均每機構任職時間、護理人員工作更換次數。統計方式採用描述性、單變量及複迴歸統計分析。
研究結果：護理人員屬於較年長的年齡世代比較年輕的年齡世代之平均每機構任職時間長。各年齡世代中，四年級(含以前)護理人員平均每機構任職時間與個人因素(每機構到職年齡、前次累計異動次數)、組織因素(機構權屬、機構類型)、環境因素(健保總額政策)相關；五年級護理人員平均每機構任職時間與個人因素(每機構到職年齡、異動次數)、組織因素(機構權屬)、環境因素(健保總額政策)相關；六年級護理人員平均每機構任職時間與個人因素(每機構到職年齡、異動次數)、組織因素(機構權屬、機構類型)、環境因素(健保總額政策、都市化程度)相關；七年級護理人員平均每機構任職時間與個人因素(每機構到職年齡)；環境因素(健保總額政策) 相關。不同年齡世代護理人員工作更換次數有差異，越年輕的世代更換次數越高。
結論與建議：本研究發現不同年齡世代護理人員平均每機構任職時間與工作更換次數有差異；且各年齡世代中，影響護理人員平均每機構任職時間的相關因素有所不同。建議可依每個年齡世代護理人員的異動因素進行規劃以留任護理人員。
Background and Purposes: Nursing manpower is an important factor in medical care industry. The high turnover rate is a common issue of many counties around the world. the deficiency of nursing HR is not caused by the lack of trained nursing staff. but the high turnover rate. The difference in growing background among nurses of different age generations contributes to the formation of different values, which affect their behaviors. This study intended to investigate the types of career transition of nursing staff of different age generations and relevant factors.
Research Method: This study investigated the information concerning the turnover of nursing staff at various medical institutions (including factory nurse, school nurse, and public health nurse) in Miaoli County from 1994 to February 2010 by using the secondary longitudinal database of nursing staff turnover of Miaoli County Nurse Association. The age of the subjects was from 19 to 70, and the complete turnover information of a total of 4,087 nursing staff was obtained with 6,690 turnovers. The independent variable included the age generation of nursing staff (born in 1950s, 1960s, 1970s, and 1980s), ownership of the workplaces, presence of accreditation of workplaces, types of medical institutions (regional hospital, local hospital, clinic, and non-medical institution), implementation of global budgeting policy of national health insurance, and level of urbanization of the locate where the medical institutions locate. The dependent variables included: average length of employment at each medical institution of nursing staff and number of turnover of nursing staff. Data were analyzed using descriptive statistics, one-way ANOVA, and multivariate regression analysis.
Research Results: The average length of employment at each medical institution of nursing staff of older generation was longer than that of those of younger generations. Among various age generations, the length of employment at each medical institution of the nursing staff born in the 1950s (and before) was correlated to number of turnover, personal factor (initial age of service), organizational factors (ownership and type of the medical institution), and environmental factor (global budgeting policy of national health insurance p). The average length of employment at each medical institution of nursing staff born in the 1960s was correlated to the number of turnover, personal factor (initial age of service), organizational factor (ownership of the medical institution), and environmental factor (global budgeting policy of national health insurance). The average length of employment at each medical institution of nursing staff born in the 1970s was correlated to the number of turnover, personal factor (initial age of service), organizational factors (ownership and type of the medical institution), environmental factors (global budgeting policy of national health insurance and level of urbanization). The average length of employment at each medical institution of the nursing staff born in the 1980s was correlated to the initial age of service and environmental factor (global budgeting policy of national health insurance). There was a difference in the number of turnover among nursing staff of different age generations. The number of turnover of younger generation was higher than the rest age generations.
Conclusions and Suggestions: This study found that there is a difference in the average length of employment at each medical institution and number of turnover among nursing staff of different age generations. In addition, among various age generations, the factors affecting the average length of employment of nursing staff are different. To retain nursing staff, it is advised to plan strategically according to the factors affecting the turnover of nursing staff of various age generations. |
