護理長向下影響行為之探討：比較護理長自覺與護理人員知
覺之差異
A study of head nurse''s downward influence
behaviors: the comparison of perceptions between
head nurses and staff nurse
呂明蕙;盧美秀;陳品玲;李麗傳 摘要 本研究目的在探討護理長自覺與護理人員知覺到常使用的、有效的向下影響行 為；並探討護理長與護理人員之基本屬性不同，其自覺 的向下影響行為之頻率 及有效性之相關；同時比較護理長自覺與護理人員知覺的向下影響行為之頻率與 有效性之差異。本研究之研究工具 為向下影響行為量表，研究對象為衛生署評 鑑合格的一所準醫學中心 之兩院區的護理長與護理人員，共發出問卷數 336 份，有效問卷數為 291 份（有效問卷回收率為 86.6%）。本研究結果顯示：1.護理 長自覺向下影響行為頻率的平均得分為 2.57 分（標準差：0.31），護理長自覺向 下影響行為有效性的平均得 分為 2.84 分（標準差：0.47）；2.護理人員知覺向下 影響行為頻率的 平均得分為 2.35 分（標準差：0.42），護理人員知覺向下影 響行為有效性的平均得分為 2.52 分（標準差：0.57）；顯示護理長自覺與護理人 員知覺的向下影響行為之頻率與有效性都未達中等程度。3.在護理長基本屬性方 面：護理長的單位中護理人員數不同，護理長自覺 強制行為的頻率有顯著性差 異；任本單位護理長年資與強制行為的有 效性呈正相關。4.在護理人員基本屬 性方面：護理人員的專業職等與 行政管理課程不同，其知覺向下影響行為的頻 率及有效性，有顯著性差異；護理人員的教育程度不同，其知覺向下影響行為的 有效性，有顯著性差異；護理人員的婚姻狀態、院區、科別、教育程度、行政管 理課程、專業職等、職稱不同，其知覺各種向下影響行為的頻率或有 效性，有 顯著性差異；護理人員的年齡、本院服務年資與本單位服務 年資對其知覺 友善示好的頻率呈正相關。5.本研究更重要的結果是發 現護理長自覺與護理人 員知覺的向下影響行為之頻率與有效性均呈顯著性差異，護理長的自覺普遍高於 護理人員。由本研究之結果推論，護理管理者若瞭解向下影響行為的重要性與其 效果，將可運用各種不同的向下影響行為來成功地影響部屬，以達組織的目標， 做到有效的管理。且護理管理者，可藉由本研究結果 來瞭解臨床護理人員認為 哪些向下影響行為是有效果的，使將來在向下影響行為的運用上，更加有效。研
究結果建議未來研究方向、護理 行政管理課程設計及提供管理之參考。關鍵字： 向下影響行為、向下影響行為的頻率、向下影響行為的使用效果
Abstract
The purpose of this study was to explore the head nurse''s downward influence behaviors. A comparison of head nurses'' and staff nurses'' perceptions toward head nurse''s downward influence behaviors was also examined.The sample of this study consisted of head nurses and staff nurses from one medical center by using the convenience sampling and random sampling. Three hundred thirty-six questionnaires were mailed to those who were invited and 310 questionnaires were returned at a
response rate of 89.18%. However, there were 15 incomplete
questionnaires dropped from this study. So, the final sample consisted of 291 participants. Results of this study are as follows:1.The mean (SD) of the perceived frequency of downward influences of head nurses was 2.57 (SD= 0.31), and the mean of the effectiveness of downward influences of head nurses was 2.84 (SD=0.47) . 2.The mean (SD) of the perceived frequency of downward influences of staff nurses was 2.35 (SD=0.42), and that of the effectiveness of downward influences of staff nurses was 2.52 (SD= 0.57). The mean of the perceived frequency and effectiveness of head nurse''s downward influence behaviors among head nurses or staff nurses was less than the moderate range. 3.The perceived frequency of press behaviors of head nurses was significantly associated with the number of nurses working in the unit where the head nurse was
responsible for. Moreover, the perceived effectiveness of press behaviors of head nurses was positively associated to their working years in the unit. 4.The staff nurses'' perceived frequency and effectiveness of head nurse''s downward influences were significantly associated with clinical ladder levels, administration programs, marital status, hospitals, departments, education background, and job titles. Moreover, the staff nurses'' perceived frequency of friendliness behaviors of head nurses was
positively related to their age, working years in the hospital, and working years in the unit. 5.A more important result of this study was the evidence of significant difference in the perceived frequency and effectiveness of downward influence behaviors between head nurses'' self consciousness and staff nurses'' consciousness. Head nurse''s self consciousness had been found to be generally higher than staff nurses'' self consciousness. These results suggested that nursing administrators should understand the importance and effectiveness of downward influence behaviors in order
to utilize all kinds of different downward influence behaviors to attain the goal of organization and accomplish effective management. Besides, nursing administrators could recognize which downward influence behaviors were regarded by clinical nurses as effective. It would facilitate more effectively utilize downward influence behaviors in the future. Furthermore, the results of this study offered the direction of future research and provided references for designing of nursing administration courses and management itself.Key words: downward influence
behaviors, frequency of downward influence behaviors, effectiveness of downward influence behaviors.
