雙北市長期照護機構照顧服務員職業倦怠、社會支持與憂鬱之研究

Abstract

本研究在探討雙北市長期照護機構服務員之職業倦怠、社會支持及憂鬱之現況，進一步釐清三者間的關係，最後分析背景變項、職業倦怠、社會支持對憂鬱的解釋力。本研究採橫斷性研究，以雙北市16家長期照護機構工作年資滿3個月以上的照顧服務員為研究對象共計379位。以方便取樣及結構式問卷進行資料收集。問卷分五個部分，包括社會人口學變項、職場型態、職場疲勞量表、多向度感知社會支持量表及流行病學研究中心憂鬱量表，調查時間為2022年12月16日至2023年4月12日止。研究結果顯示，雙北市長期照顧服務員憂鬱盛行率為36.94%。本研究發現場所屬別是醫院附設和獨立型態者的職業倦怠程度較高，除此之外，家中需照顧65歲以上及平均每周工作時數40-45小時與46-49小時者的職業倦怠與憂鬱程度高。平均每周工作時數大於50小時者，來自「家人」及「特定人」的社會支持多於平均每周工作時數40-45小時的照顧服務員。雙變項分析結果顯示社會支持度越高憂鬱程度越低，職業倦怠程度越高憂鬱程度越高。逐步複迴歸分析結果呈現，教育程度在國中以下、居住在新北市、平均照顧1至20人、工作年資1至3年、非固定白班、朋友向度的社會支持低、職業倦怠之服務對象疲勞分數高、個人疲勞分數高及工作過度投入分數高者，正向預測憂鬱程度。建議長期照護機構負責人關心這類的高危險群，避免人員產生職業倦怠及憂鬱，使日漸短缺的照護人力，不再流失。

This study explores the job burnout, social support, and depression status of long-term care nursing assistants in Taipei City and New Taipei City. Furthermore, it clarifies the associations among the three variables and finally analyzes the effects of job burnout and social support on depression while controlling for background factors.This study is a cross-sectional research conducted with a total of 379 nursing assistants who have been employed for more than 3 months in 16 long-term care institutions in Taipei City and New Taipei City. The data was collected using convenience sampling and structured questionnaires. The questionnaire is composed of five sections, covering social demography, workplace type, workplace fatigue scale, perceived social support scale, and the Center for Epidemiological Studies Depression Scale. The survey was conducted between December 16, 2022, and April 12, 2023.The findings of this study revealed that the prevalence rate of depression among long-term nursing assistants in Shuangbei City is 36.94%. Nursing assistants working in hospitals or independent centers exhibited higher levels of depression compared to their counterparts. Additionally, nursing assistants responsible for caring for elderly individuals （aged over 65） in their homes and working an average of 40 to 45 hours per week, as well as those working 46 to 49 hours per week, experienced higher levels of job burnout and depression.Furthermore, nursing assistants working more than 50 hours per week reported higher levels of social support from family and specific individuals compared to those working 40 to 45 hours per week. Bivariate analysis demonstrated a negative association between social support and depression, while a positive association was observed between job burnout and depression.

Stepwise regression analysis indicated that nursing assistants with educational levels below middle school, residing in New Taipei City, responsible for caring for 1 to 20 people on average, possessing 1 to 3 years of working experience, working non-fixed day shifts, experiencing low social support from friends, high levels of client fatigue, personal fatigue, and overwork engagement, were significantly more likely to experience higher levels of depression compared to their counterparts.As a recommendation, the leaders of long-term care institutions should be attentive to the well-being of high-risk individuals, aiming to prevent job burnout and depression among nursing assistants. By addressing these issues, the potential scarcity of nursing assistant manpower can be mitigated.