The Current Work Conditions and Relationships among Job Characteristics、Job Strain and Job Commitment in Taiwan’s Regional Hospital Nurse Case Managers
Date Issued
2007
Date
2007
Author(s)
Chung, Chia-Ling
DOI
zh-TW
Abstract
With the arising managed care environment, the rapid changes in healthcare reform does not only affect the structure, it also affect the staffs’ role play within it. Hence we took the developing nurse case managers as our study subject, and survey their work conditions. We gathered the positive and negative factors of nurse case manegement by means of analyzing their perceptions on job characteristics、job strain and job commitment, further we discuss the relationship among nurse case managers’ perception within the three.
Our sample is mainly included all nurse case managers in different practice or settings in Taiwan’s regional hospitals and above. We issued 177 questionnaires and received 143 effective copies . The response rate is 80.79 %. The data collection is by paper instrument combined structured and semi-structured questionnaire .
Our findings are : 1. The profiles of Taiwan’s regional hospital nurse case managers : (1) no male nurse case managers during data collection time, (2 ) most are aged 31 to 35 (40.7%), (3 ) most are under junior college educated ( 52.5%), (4 ) most has 6 or more years of nursing careers (88.6%), (5 ) most are experienced 1 to 2 years of case management practice (50.7%), and (6 ) most has two more duties of job (53.9%). The work conditions are : (1 )titles vary, ( 2 )face with multiple administrations, (3 ) seldom receive on-job training, (4) lack of clinical pathways , and (5) outcomes are mostly evaluated with patient satisfaction. And the most ranked job descriptions are (1 ) consultant to patients, (2 )communicate with patients/family and (4) patient education.
2. Using ANOVA and t-test for variance analysis. For job commitment, the nurse case managers’ personal attributes varies significantly in ( 1 ) age, (2 ) marital status, (3 ) nursing education background, and (5 ) clinical ladders. And work conditions varies significantly for job commitment are : (1) case load, (2 ) whether use nurse NCM instrument provided by other institutions, (3 ) hospital accreditation level, (4 ) nurse case management status and (5 ) frequency of NCM outcome evaluation.
3. The five core job characteristics in NCMs are of middle-high level, the Motivation potential score (MPS ) is higher than that of staff nurse. Most of their demand-control job strain classification are in low strain and active job , and the job commitment are higher than that of staff nurse.
4. Linear regression found that：the MPS was correlated with job commitment, whereas Logistic regression reveals the MPS was negatively correlated with Demand-Control job strain, and D-C job strain has no mediation effect between job characteristics and job commitment. Conclusions suggest : (1) ensure NCM job position, (2) enhance on-job training, (3) increase the diversity of outcome evaluation, (4) deploy clinical pathways .
Subjects
護理個案管理師
護理個案管理
工作特性
激勵潛能指數
工作壓力
工作承諾
Nurse Case Manager
Nursing Case Management
job characteristics
motivation potential score ( MPS )
job strain
job commitment.
Type
thesis
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