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題名 長照2.0照顧服務員留任因素之探討—以基隆市照顧服務員為例
Discussion on the Retention Factors of Long-Term Care 2.0 Attendants: Care Attendants in Keelung
作者 林柏吟
Lin, Po-Yin
貢獻者 傅凱若
Fu, Kai-Jo
林柏吟
Lin, Po-Yin
關鍵詞 長期照顧
照顧服務員
留任
留任意願
Long-Term Care
Care Attendants
Retention
Intent to stay
日期 2023
上傳時間 6-Jul-2023 16:57:10 (UTC+8)
摘要 現今高齡化下，長照需求人數逐年上升，對於負責照顧之照顧服務員（簡稱照服員）人力需求相對也同步增加。然而目前政府舉辦「照顧服務員訓練」培訓照服員以因應長照服務需求，但多數參與培訓者在取得證照後，卻選擇回家照顧親人，並未走入職場，使照服員人力供給與需求不成比例，面臨人力嚴重問題，故如何吸引並維持穩定人力，彌補人力缺口，是急需克服的議題。故本研究期藉由對照服員的生、心理需求及服務工作多一份瞭解，以提供政府採取適當解決方案之參考。
本研究首先就照服員（Care Attendants）、留任（retention）等名詞定義及基隆市長照現況及政策作陳述，接著，整理有關影響人員流動及留任相關模式，以及過往研究照服員流動及留任的影響因素。本研究以Abelson（1986）的整合式流動過程模式（integrated turnover process model）為基礎，以個人因素、組織因素、環境因素等三個構面，探討影響照服員留任意願之重要關鍵因素，包含薪資與福利、機構提供之訓練、社會支持及自我效能與留任意願之關聯性。
本研究政策建議為，鼓勵中年或失業人口再就業，國內照服員需求高，而照服員的入門門檻較簡單，政府未來可加強宣導，並透過補助等方式，鼓勵中年或失業人口加入；強化經濟誘因與福利措施，照服員必須至案家提供服務，本身可能面臨人身安全等工作風險，若能提供穩定的薪資以及適當的健康保障福利，對留任有正向影響；除了基本職前教育訓練，每年安排一定時數進修，提升專業技能，形塑社會大眾對照服員之專業性；對照服員進行職前教育訓練，告知並建立其應對案家及長者之正確觀念，對案家額外要求之家務整理，不應一味接受；藉由主管及同行經驗分享及鼓勵，提升照服員之自我效能感。
With the current aging population, the number of people in need of long-term care is increasing year by year, so as the manpower needs for care attendants. In order to meet the needs of long-term care service, the government at present organizes "care service training" to train care attendants to meet the needs of long-term care services. However, after obtaining the certificates, most of the trainees choose to go home to take care of their relatives instead of entering the workforce. It becomes imbalance between supply and demand for care attendant’s manpower, and there are serious manpower problems. Therefore, how to attract and maintain stable manpower and make up for the manpower gap is an urgent issue to be overcome. Therefore, this research period provides a reference for the government to adopt appropriate solutions by getting a better understanding of care attendants physical and psychological needs and their service work.
This study first makes a statement on the definitions of terms such as care attendants and retention, as well as the current situation and policies of the Mayor of Keelung, and then sorts out the relevant models that affect personnel flow and retention, as well as past research on the flow and retention of care attendants influencing factors. On the basis of Abelson`s (1986) integrated turnover process model, this study discusses the important key factors that affect the willingness of care attendants to stay in the service through three dimensions: personal factors, organizational factors, and environmental factors, including relevance between retention intentions and salary and benefits, training provided by institutions, social support, and self-efficacy.
The policy suggestions of this study are to encourage the middle-aged or unemployed population to re-employ. The demand for domestic care attendants is high, and the requirement of care attendants is relatively low. The government may strengthen middle-aged publicity in the future and encourage middle-aged or unemployed people to join by through subsidies and strengthening economic incentives and welfare measures, the care attendants must go to the case to provide services, they may face work risks such as personal safety concerns, it will have a positive impact on retention; if they are stable wages and appropriate health protection benefits. In addition to basic pre-employment education and training, we should arrange a certain number of hours of further study every year to improve professional skills and shape the professionalism of the general public in comparison with care attendants; conduct pre-employment education and training for care attendants to inform and establish correct concepts such as not blindly accept the additional arrangement of services requested by the client; to improve self-efficacy by experience sharing and encouragement of supervisors and peers.
參考文獻 一、中文資料
王郁智、章淑娟、朱正一（2006）。升遷機會、社會支持、工作滿意度與留任意願之相關性研究。慈濟護理雜誌，5（4），90-101。
台北榮總護理部研究發展委員會（2002）。 社會支持在長期照顧之簡介。 榮總護理， 19（3）， 338-340。
江孟冠（2002）。長期照護管理者之人力資源管理措施與照顧服務員留任關係之探討。國立臺灣大學醫學院護理學系研究所碩士，未出版，臺北。
吳宗憲（2014）。聞聲救苦或濫用靈性？職場靈性影響組織行為之實證研究－以文官靈性為中介變項。公共行政學報，47：73-107。
吳清華（2007）。人格特質及自我效能與工作滿足關係之研究─以考試院及其所屬部會公務人員為例。世新大學行政管理學研究所碩士，未出版，臺北。
李婉禎、林木泉、朱正一（2013）。身心障礙照護機構照顧服務員工作倦怠、社會支持與留任意願相關性之探討。醫務管理期刊，14（1），38-54。
李錦珠（2007）。公立教養機構保育員留任因素之研究-以臺北市立陽明教養院為例。國立暨南國際大學社會政策與社會工作學系研究所碩士，未出版，南投。
汪素敏、龍愛玲、劉倩毓（2009）。某區域教學醫院個別輔導對新進人員留任意願之成效探討。領導護理，10（1），25-37。
林春只、曾明月、竇秀花、許佩容、李世代（2005）。照顧服務員工作倦怠的徵兆與症狀：降低工作滿意與熱忱、工作效率、生產品質、及對組織的承諾，進而造成缺席率及離職率的增加。社區發展季刊，29（131），468-486。
張江清、林秋菊、蔡和蓁、陳武宗（2011）。困境向前行—高雄縣市居家照顧服務員服務經驗探究。弘光學報，64，70-89。
陳怡如（2015）。日照中心員工知識學習、工作價值與工作士氣之關聯性研究─以台南市為例。臺灣醫學人文學刊，16（15），85-111。
陳錦紅（2020）。照顧服務員情緒勞務、自我效能與組織承諾之相關研究-以北部某失智老人養護中心為例。嘉南藥理大學醫務管理系碩士，未出版，臺南。
黃寶園（2010）。社會支持在壓力反應歷程中的中介效果。中華心理衛生學刊，23（3），401-436。
蔡欣晏、胡龍騰（2019年5月）。我們能一起跳支探戈嗎？從制度邏輯觀點探析中央與地方政府之長照2.0 目標偏好。2019年臺灣公共行政與公共事務系所聯合會，臺中。
蔡淑妙、盧美秀（1998）。護理人員生涯發展及其與留任意願相關性之研究。護理研究，6（2），96-108。
蔡淑鳳、陳文意、林育秀、梁亞文（2013）。臺灣地區長期照護機構女性照顧服務員工作壓力源與工作適應、離職意願之調查。臺灣衛誌，32（5），476-490。
蔡麗珍（2007）。不同屬性照顧服務員工作投入、工作滿足、工作表現相關因素之探討—以中部某教學醫院為例。私立亞洲大學長期照護研究所碩士，未出版，臺中。
鄭洺洋（2013）。照顧服務員工作價值觀與工作滿意關係之研究—以高雄市為例。南華大學非營利事業管理學系研究所碩士，未出版，嘉義。
謝佳怡（2010）。高齡者居家照服人力之離職因素探討。長榮大學醫務管理學系研究所碩士，未出版，臺南。
謝美娥（2017）。居家照顧服務員工作留任意願影響因素探討。東吳社會工作學報，23（33），27-62。
簡慧娟（2017）。長照2.0新作為　前瞻、創新、整合—老人社區照顧政策。國土及公共治理季刊，5（3），114-121。
羅詠娜（1993）。居家照顧服務員工作動機與工作滿意度之研究：以臺北市為例。東吳大學社會工作學系研究所碩士，未出版，臺北。
蘇群芳（2013）。由居家服務員督導與照顧服務員角度探討居家服務員督導的功能及滿意度—以大台南為例。國立成功大學老年學研究所碩士，未出版，臺南。
二、英文資料
Abelson, M. A. (1986). Strategic management of turnover: A model of the health service administrator. Health Care Management Review, 11, 61-71.
American Society of Health-System pharmacist. (2003). ASHP guidelines on the recruitment, selection, and retention of pharmacy personnel. American Journal of Health-system Pharmacy, 60(6), 587-593.
Atchison, J. H. (1998). Perceived job satisfaction factors of nursing assistants employed in Midwest nursing homes. Geriatric Nursing, 19(3), 135-138.
Carlson, D. S., & Perrewé, P. L. (1999). The role of social support in the stressor-strain relationship: An examination of work-family conflict. Journal of Management, 25(4), 513-540.
Creswell, J. W. (2005). Educational research: Planning, conducting, and evaluating quantitative and qualitative research (2nd ed.). Upper Saddle River, New Jersey: Merrill Prentice Hall.
Ellenbecker, C. H., Porell, F. W., Samia, L., Byleckie, J. J., & Milburn, M. (2008). Predictors of Home Healthcare Nurse Retention. Health Policy and Systems, 40(2), 151-160.
Fleming, G., & Taylor B. J. (2006). Battle on the Home Care Front: Perceptions of Home Care Workers of Factors Influencing Staff Retention in Northern Ireland. Health and Social Care in the Community, 15(1), 67-76.
Genevieve, E. C. (1990). Retention: Has it obstructed nursing`s view? Nursing Administration, 14(4), 70-75.
Howes, C. (2005). Living Wages and Retention of Homecare Workers in San Francisco. Industrial Relations, 44(1), 139-163.
Kim, S. W., Price, J. L., Mueller, C. W., & Watson, T. W. (1996). The determinants of career intent among physicians at a US Air Force hospital. New York, CA: Sage.
Kozlowski, S. W. J., & Klein, K. J.(2000). A multilevel approach to theory and research in organizations: Contextual, temporal, and emergent processes. In K. J. Klein & S. W. J. Kozlowski (Eds.), Multilevel theory, research, and methods in organizations: Foundations, extensions, and new directions (p. 3-90). Jossey-Bass.
Kunaviktikul, W., Nuntasupawat, R., Srisuphan, W., & Booth, Z. (2000). Relationships among conflict, conflict management, job satisfaction, intent to stay, and turnover of professional nurses in Thailand. Nursing and Health Sciences, 2(1), 9-16.
Mesirow, K. M., Klopp, A., & Olson, L. L. (1988). Improving certified nurse aide retention. A long-term care management challenge. The Journal of nursing administration, 28(3), 56-61.
Mobley, W. H. (1977). Intermediate linkages in the relationship between job satisfaction and employee turnover. Journal of Applied Psychology, 62(2), 237-240.
Mobley, W. H., Horner, S. O., & Hollingsworth, A. T. (1978). An evaluation of precursors of hospital employee turnover. Journal of Applied Psychology, 63, 408-414.
Monahan, R. S., & McCarthy, S. (1992). Nursing home employment: the nurse`s aide`s perspective. Journal of Gerontological Nursing, 18(2), 13-16.
Schwarzer, R., Bäßler, J., Kwiatek, P., Schroder, K., & Zhang, J. X. (1997). The assessment of optimistic self-beliefs: Comparison of the german, Spanish, and Chinese versions of the general self-efficacy scale. Applied Psychology, 46, 69-88.
Remsburg, R. E., Armacost, K. A., & Bennett, R. G. (1999). Improving nursing assistant turnover and stability rates in a long-term care facility. Geriatric Nursing, 20(4), 203-208.
Sourdif, J. (2004). Predictors of nurses’ intent to stay at work in a university health center. Nursing and Health Science, 6, 59-68.
Steers, R. M. (1977). Antecedents and outcomes of organizational commitment. Administrative Science Quarterly, 22, 46-56.
Stetz, T. A., Stetz, M. C. & Bliese, P. D. (2006). The importance of self-efficacy in the moderating effects of social support on stressor–strain relationships. Work & Stress,20(1), 49-59.
描述 碩士
國立政治大學
公共行政學系
106256033
資料來源 http://thesis.lib.nccu.edu.tw/record/#G0106256033
資料類型 thesis
dc.contributor.advisor 傅凱若zh_TW
dc.contributor.advisor Fu, Kai-Joen_US
dc.contributor.author (Authors) 林柏吟zh_TW
dc.contributor.author (Authors) Lin, Po-Yinen_US
dc.creator (作者) 林柏吟zh_TW
dc.creator (作者) Lin, Po-Yinen_US
dc.date (日期) 2023en_US
dc.date.accessioned 6-Jul-2023 16:57:10 (UTC+8)-
dc.date.available 6-Jul-2023 16:57:10 (UTC+8)-
dc.date.issued (上傳時間) 6-Jul-2023 16:57:10 (UTC+8)-
dc.identifier (Other Identifiers) G0106256033en_US
dc.identifier.uri (URI) http://nccur.lib.nccu.edu.tw/handle/140.119/145907-
dc.description (描述) 碩士zh_TW
dc.description (描述) 國立政治大學zh_TW
dc.description (描述) 公共行政學系zh_TW
dc.description (描述) 106256033zh_TW
dc.description.abstract (摘要) 現今高齡化下，長照需求人數逐年上升，對於負責照顧之照顧服務員（簡稱照服員）人力需求相對也同步增加。然而目前政府舉辦「照顧服務員訓練」培訓照服員以因應長照服務需求，但多數參與培訓者在取得證照後，卻選擇回家照顧親人，並未走入職場，使照服員人力供給與需求不成比例，面臨人力嚴重問題，故如何吸引並維持穩定人力，彌補人力缺口，是急需克服的議題。故本研究期藉由對照服員的生、心理需求及服務工作多一份瞭解，以提供政府採取適當解決方案之參考。
本研究首先就照服員（Care Attendants）、留任（retention）等名詞定義及基隆市長照現況及政策作陳述，接著，整理有關影響人員流動及留任相關模式，以及過往研究照服員流動及留任的影響因素。本研究以Abelson（1986）的整合式流動過程模式（integrated turnover process model）為基礎，以個人因素、組織因素、環境因素等三個構面，探討影響照服員留任意願之重要關鍵因素，包含薪資與福利、機構提供之訓練、社會支持及自我效能與留任意願之關聯性。
本研究政策建議為，鼓勵中年或失業人口再就業，國內照服員需求高，而照服員的入門門檻較簡單，政府未來可加強宣導，並透過補助等方式，鼓勵中年或失業人口加入；強化經濟誘因與福利措施，照服員必須至案家提供服務，本身可能面臨人身安全等工作風險，若能提供穩定的薪資以及適當的健康保障福利，對留任有正向影響；除了基本職前教育訓練，每年安排一定時數進修，提升專業技能，形塑社會大眾對照服員之專業性；對照服員進行職前教育訓練，告知並建立其應對案家及長者之正確觀念，對案家額外要求之家務整理，不應一味接受；藉由主管及同行經驗分享及鼓勵，提升照服員之自我效能感。		zh_TW
dc.description.abstract (摘要) With the current aging population, the number of people in need of long-term care is increasing year by year, so as the manpower needs for care attendants. In order to meet the needs of long-term care service, the government at present organizes "care service training" to train care attendants to meet the needs of long-term care services. However, after obtaining the certificates, most of the trainees choose to go home to take care of their relatives instead of entering the workforce. It becomes imbalance between supply and demand for care attendant’s manpower, and there are serious manpower problems. Therefore, how to attract and maintain stable manpower and make up for the manpower gap is an urgent issue to be overcome. Therefore, this research period provides a reference for the government to adopt appropriate solutions by getting a better understanding of care attendants physical and psychological needs and their service work.
This study first makes a statement on the definitions of terms such as care attendants and retention, as well as the current situation and policies of the Mayor of Keelung, and then sorts out the relevant models that affect personnel flow and retention, as well as past research on the flow and retention of care attendants influencing factors. On the basis of Abelson`s (1986) integrated turnover process model, this study discusses the important key factors that affect the willingness of care attendants to stay in the service through three dimensions: personal factors, organizational factors, and environmental factors, including relevance between retention intentions and salary and benefits, training provided by institutions, social support, and self-efficacy.
The policy suggestions of this study are to encourage the middle-aged or unemployed population to re-employ. The demand for domestic care attendants is high, and the requirement of care attendants is relatively low. The government may strengthen middle-aged publicity in the future and encourage middle-aged or unemployed people to join by through subsidies and strengthening economic incentives and welfare measures, the care attendants must go to the case to provide services, they may face work risks such as personal safety concerns, it will have a positive impact on retention; if they are stable wages and appropriate health protection benefits. In addition to basic pre-employment education and training, we should arrange a certain number of hours of further study every year to improve professional skills and shape the professionalism of the general public in comparison with care attendants; conduct pre-employment education and training for care attendants to inform and establish correct concepts such as not blindly accept the additional arrangement of services requested by the client; to improve self-efficacy by experience sharing and encouragement of supervisors and peers.		en_US
dc.description.tableofcontents 第一章　緒論 1
第一節　研究背景與研究動機 1
第二節　研究目的與研究問題 9
第三節　研究流程 11
第四節　名詞界定 13
第二章　文獻回顧 17
第一節　基隆長照現況及政策 17
第二節　人員流動及留任相關模式 25
第三節　照顧服務員流動及留任的影響因素 33
第三章　研究設計 42
第一節　研究方法 42
第二節　量化研究 42
第四章　量化研究分析 55
第一節　預試問卷分析結果 55
第二節　正式問卷分析 56
第五章　研究結論與研究建議 81
第一節 研究結論 81
第二節 研究建議 83
第三節 研究限制與未來研究展望 86
參考文獻 89
附錄一　研究問卷 94
附錄二　問卷編碼簿 99		zh_TW
dc.format.extent 3840944 bytes-
dc.format.mimetype application/pdf-
dc.source.uri (資料來源) http://thesis.lib.nccu.edu.tw/record/#G0106256033en_US
dc.subject (關鍵詞) 長期照顧zh_TW
dc.subject (關鍵詞) 照顧服務員zh_TW
dc.subject (關鍵詞) 留任zh_TW
dc.subject (關鍵詞) 留任意願zh_TW
dc.subject (關鍵詞) Long-Term Careen_US
dc.subject (關鍵詞) Care Attendantsen_US
dc.subject (關鍵詞) Retentionen_US
dc.subject (關鍵詞) Intent to stayen_US
dc.title (題名) 長照2.0照顧服務員留任因素之探討—以基隆市照顧服務員為例zh_TW
dc.title (題名) Discussion on the Retention Factors of Long-Term Care 2.0 Attendants: Care Attendants in Keelungen_US
dc.type (資料類型) thesisen_US
dc.relation.reference (參考文獻) 一、中文資料
王郁智、章淑娟、朱正一（2006）。升遷機會、社會支持、工作滿意度與留任意願之相關性研究。慈濟護理雜誌，5（4），90-101。
台北榮總護理部研究發展委員會（2002）。 社會支持在長期照顧之簡介。 榮總護理， 19（3）， 338-340。
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