本研究主要目的為探討護理人員的角色壓力、工作滿意度、職業承諾與離職傾向之關聯性。
在確定研究動機及研究目的後，對國內外相關文獻加以歸納整理，再根據其理論基礎建立本研究之架構與假說並進行實證分析。問卷調查對象以中央健保局臺北區(臺北市、新北市)之健保特約醫院從業護理人員為主要研究對象，本研究採用滾雪球抽樣法，總計回收有效問卷409份，針對回收的有效樣本409份資料，進行敘述性統計、因素分析、信度分析、變異數分析、相關分析、迴歸分析，最後根據實證之結果提出主要研究結論如下：
1.	護理人員的角色壓力對工作滿意度及職業承諾有顯著的負向影響。
2.	護理人員的角色壓力對離職傾向有顯著的正向影響。
3.	護理人員的工作滿意度對職業承諾有顯著的正向影響。
4.	護理人員的工作滿意度對離職傾向有顯著的負向影響。
5.	護理人員的職業承諾對離職傾向有顯著的負向影響。
6.	工作滿意度在角色壓力與職業承諾之間具有部分中介效果。
7.	工作滿意度在角色壓力與離職傾向之間具有部分中介效果。
8.	職業承諾在角色壓力與離職傾向之間具有部分中介效果。
9.	職業承諾在工作滿意度與離職傾向之間具有部分中介效果。

The main purpose of this thesis is to investigate the relationship among nurses’ role stress, job satisfaction, career commitment and turnover intention. In determining the motivation, development of research and research purposes, using related literatures collected from around the world to confirm the framework and hypothesis of this study and to perform the empirical study. The main subjects of this thesis were the nurses of NHI (National Health Insurance) contracted hospitals in Taipei (Taipei City and Taipei County). The questionnaire survey was used as the research instrument to collect the empirical data. This study adopts judgment sampling to get the samples. To effective 409 materials of sample retrieving, analyze the descriptive statistics, reliability analysis, factor analysis, one way ANOVA, correlation analysis and regression analysis. After the empirical research, the major findings as follows:
1.	Role Stress negatively affects the nurses’ job satisfaction. There is a negative relationship between role stress and career commitment.
2.	Role stress has positively impacts on turnover intention of nurse.
3.	Job satisfaction positively impacts on career commitment of nurse. 
4.	Job satisfaction negatively affects the nurses’ turnover intention.
5.	Career commitment has negatively impacts on turnover intention of nurse.
6.	The relationship between role stress and career commitment is partially mediated by job satisfaction.
7.	The relationship between role stress and turnover intention is partially mediated by job satisfaction.
8.	The relationship between role stress and turnover intention is partially mediated by career commitment.

目錄
目錄	I
表目錄	IV
圖目錄	VI
第一章	緒 論	1
第一節	研究背景與動機	1
第二節	研究目的	3
第三節	研究範圍與對象	3
第四節	研究流程	3
第二章	文獻探討	5
第一節	角色壓力	5
一、	角色壓力的概念	5
二、	角色壓力的分類	6
第二節	護理人員工作滿意度	7
一、	工作滿意度的意涵	7
二、	護理人員工作滿意度的影響因素	8
第三節	職業承諾	9
一、	職業承諾的定義	9
二、	職業承諾影響因素	10
第四節	離職傾向	12
一、	離職傾向的定義	12
二、	護理人員離職傾向的影響因素	13
第五節	研究變項關係探討	14
一、	角色壓力與工作滿意度、職業承諾、離職傾向之關聯探討	14
二、	工作滿意與職業承諾、離職傾向之關聯	15
三、	職業承諾與離職傾向之關聯	16
第六節	臺灣護理現況	17
第三章	研究方法	23
第一節	研究架構	23
第二節	研究假說	24
第三節	研究變項操作型定義與衡量	24
一、	角色壓力	24
二、	工作滿意	25
三、	職業承諾	26
四、	離職傾向	26
五、	個人屬性	27
第四節	抽樣設計	28
第五節	統計分析	28
第四章	資料分析	30
第一節	樣本結構分析	30
一、	問卷回收概況	30
二、	敘述性統計	30
第二節	因素及信度分析	35
一、	因素分析	35
二、	信度分析	37
三、	因素分析後之研究架構	38
第三節	研究變項間之相關分析	39
一、	角色壓力與工作滿意之相關性	39
二、	角色壓力與職業承諾之相關性	39
三、	角色壓力與離職傾向之相關性	40
四、	工作滿意與職業承諾之相關性	40
五、	工作滿意與離職傾向之相關性	40
六、	職業承諾對離職傾向之相關性	40
第四節	研究變項間之影響性分析	42
一、	角色壓力對工作滿意度之影響分析	42
二、	角色壓力對職業承諾之影響分析	43
三、	角色壓力對離職傾向之影響分析	45
四、	工作滿意度對職業承諾之影響分析	46
五、	工作滿意度對離職傾向的影響	46
六、	職業承諾對離職傾向的影響	47
第五節	中介效果分析	48
一、	角色壓力－工作滿意度－職業承諾之中介效果分析	48
二、	角色壓力－工作滿意度－離職傾向之中介效果分析	49
三、	角色壓力－職業承諾－離職傾向之中介效果分析	50
四、	工作滿意度－職業承諾－離職傾向之中介效果分析	51
第六節	差異性分析	52
一、	性別、專業執照及職務層級在角色壓力、工作滿意、職業承諾、離職傾向上的差異性分析		52
二、	問答者的基本資料在角色壓力、工作滿意、職業承諾、離職傾向上的差異性分析	54
第五章	研究與建議	62
第一節	研究結論與發現	62
一、護理人員的角色壓力對工作滿意度有顯著的負向影響	62
二、護理人員的角色壓力對職業承諾有顯著的負向影響	63
三、護理人員的角色壓力對離職傾向有顯著的正向影響	63
四、護理人員的工作滿意度對職業承諾有顯著的正向影響	63
五、護理人員的工作滿意度對離職傾向有顯著的負向影響	63
六、護理人員的職業承諾對離職傾向有顯著的負向影響	64
七、工作滿意在角色壓力與職業承諾、角色壓力及離職傾向中具有部分中介效果	64
八、職業承諾在角色壓力與工作滿意、角色壓力及離職傾向中具有部分中介效果	64
九、護理人員背景變項在角色壓力、工作滿意、職業承諾、離職傾向之差異性	64
第二節	管理意涵	65
第三節	研究限制	66
一、	研究對象	66
二、	研究區域	66
三、	問卷方式	66
第四節	建議	66
一、	對政府、醫院及護理人員之建議	66
二、	後續研究的建議	67
參考文獻	68
問卷調查	80

表目錄
表2-1 我國醫院評鑑護理相關重點項目	20
表2-2 臺北市、新北市醫院護理人員數前20大排名	22
表3-1 角色壓力之衡量題項	25
表3-2 工作滿意度之衡量題項	26
表3-3 職業承諾之衡量題項	26
表4-1 性別分佈狀況	30
表4-2 年齡分佈狀況	31
表4-3 專業執照分佈狀況	31
表4-4 教育程度分佈狀況	31
表4-5 婚姻及家庭分佈狀況	32
表4-6 工作醫院健保特約別分佈狀況	32
表4-7 護理年資分佈狀況	33
表4-8 工作部門分佈狀況	33
表4-9 職務層級分佈狀況	34
表4-10 月平均收入分佈狀況	34
表4-11 離開目前單位及放棄護理專業主要因素分佈狀況	35
表4-12 角色壓力構面之KMO值及BARTLETT球形檢定	36
表4-13 角色壓力構面之因素分析	36
表4-14 職業承諾構面之KMO值及BARTLETT球形檢定	37
表4-15 職業承諾構面之因素分析	37
表4-16 各研究構面之信度分析表	38
表4-17 角色壓力、工作滿意、職業承諾與離職傾向的相關係數表	41
表4-18 角色壓力對工作滿意度之迴歸分析彙整表	42
表4-19 角色壓力構面對工作滿意度之複迴歸分析彙整表	43
表4-20 角色壓力對職業承諾之迴歸分析彙整表	43
表4-21 角色壓力構面對職業承諾之複迴歸分析彙整表	44
表4-22 角色壓力構面對職業承諾構面之複迴歸分析彙整表	45
表4-23 角色壓力對離職傾向之迴歸分析彙整表	45
表4-24 角色壓力構面對離職傾向之複迴歸分析彙整表	46
表4-25 工作滿意度對職業承諾之迴歸分析彙整表	46
表4-26 工作滿意度對離職傾向之迴歸分析彙整表	47
表4-27 職業承諾對離職傾向之迴歸分析彙整表	47
表4-28 職業承諾構面對離職傾向之複迴歸分析彙整表	48
表4-29 角色壓力－工作滿意度－職業承諾之中介效果彙整表	49
表4-30 角色壓力－工作滿意度－離職傾向之中介效果彙整表	50
表4-31 角色壓力－職業承諾－離職傾向之中介效果彙整表	51
表4-32 工作滿意度－職業承諾－離職傾向之中介效果彙整表	51
表4-33 性別對角色壓力、工作滿意、職業承諾、離職傾向各變項之差異分析	52
表4-34 專業執照別對角色壓力、工作滿意、職業承諾、離職傾向各變項之差異分析	53
表4-35 職務層級別對角色壓力、工作滿意、職業承諾、離職傾向各變項之差異分析	54
表4-36 年齡對角色壓力、工作滿意、職業承諾、離職傾向各變項之差異分析	55
表4-37 教育程度對角色壓力、工作滿意、職業承諾、離職傾向各變項之差異分析	56
表4-38 婚姻及家庭狀況對角色壓力、工作滿意、職業承諾、離職傾向各變項之差異分析	57
表4-39 工作醫院健保特約別對角色壓力、工作滿意、職業承諾、離職傾向各變項之差異分析	58
表4-40 護理年資對角色壓力、工作滿意、職業承諾、離職傾向各變項之差異分析	59
表4-41 工作部門對角色壓力、工作滿意、職業承諾、離職傾向各變項之差異分析	60
表4-42 月平均收入對角色壓力、工作滿意、職業承諾、離職傾向各變項之差異分析	61
表5-1 研究假說驗證彙整表	62
圖目錄
圖1-1 研究流程圖	4
圖2-1 護理專業的範疇及影響因素	18
圖2-2 臺灣護理人員臨床專業能力進階制度概念與架構	19
圖3-1 研究架構圖	23
圖4-1 因素分析後之研究架構	39

一、 中文文獻
1.	于真真(2008)。知識型員工職業承諾及其影響因素研究。山東大學人力資源管理研究所碩士學位論文。
2.	王秀紅(2008)。護理台灣Nursing Care in Taiwan。臺北市，行政院衛生署。
3.	王秋絨(1981)。國中組織環境對教師角色壓力之影響。國立台灣師範大學教育研究所碩士論文。
4.	王桂英、周傳姜、黃瑞蘭(2010)。臨床護理人員工作價值觀、專業承諾與離職傾向及其相關因素之探討。護理雜誌，57(1)，22-34 。
5.	王慶玲(2007)。北京市合同護士工作滿意度及應對方式調查。護士進修雜誌，22(23)，2175-2177。
6.	王曉晨(2007)。角色壓力、組織承諾與工作績效關係研究。西南交通大學碩士學位論文。
7.	王霞霞、張進輔(2007)。國內外職業承諾研究述評。心理科學發展雜誌，15(3)，488-497。
8.	台灣護理學會(1992)。醫院基層護理人員臨床專業能力進階制度規劃指引。2011年5月3日取自http://www.twna.org.tw。
9.	石敏、鐘玲、戴志鑫(1997)高等學歷護士心態的調查分析與對策。中華護理雜誌。1997(03)
10.	朱宗藍(2011)。長庚醫訊32(5)。137-139。
11.	行政院衛生署、財團法人醫院評鑑暨醫療品質策進會(2010)。99年度醫院評鑑及教學醫院評鑑基準-試評版說明會會議手冊。行政院衛生署、財團法人醫院評鑑暨醫療品質策進會。
12.	宋振蘭、婁鳳蘭、遲俊濤(2009)。聘用制護士工作滿意度及其與離職傾向的關係研究。國際護理學雜誌。28(8)。1036-1039。
13.	李小甯，李小燕，強水雲等(2004)。臨床護士心理壓力源及應對方式調查。護理學雜誌。19(12)，67-69。
14.	周萍(2008)。護士離職意願及其相關因素的研究。浙江大學醫學院碩士學位論文。
15.	吳宗祐(2008)。由不當督導到情緒耗竭：部屬正義知覺與情緒勞動的中介效果。中華心理學刊，50卷，2期，201-221。
16.	林世昌(1987)。我國會計人員角色壓力與工作滿意、組織承諾的關係。國立政治大學會計研究所碩士論文。
17.	林惠萍(2008)。政府部門主計人員工作滿意度之研究－以農委會會計單位為例。逢甲大學經營管理碩士在職專班碩士論文
18.	林瑞錫(2001)。國民小學校長角色壓力與工作滿意關係之研究－以桃竹苗四縣市為例。國立新竹師範學院學校行政碩士班碩士論文。
19.	金鈺梅，胡雁，錢建萍，邵翠穎，朱勝春(2010)。2010名護士工作滿意度和離職傾向現狀調查分析。中國實用護理雜誌。26(4)，64-67。
20.	祝恩來(2007)。制藥企業員工滿意度、組織承諾與離職意願相關性實證研究－以遼寧好護士藥業集團為例。東北財經大學工商管理學院碩士學位論文。
21.	柯彩霞(2008)。臨床護士離職傾向及其與工作滿意度、組織承諾關係的研究。中山大學碩士學位論文。
22.	尉迎濱(2007)。幼教老師角色失調、職業承諾、工作滿意度關係研究。山西大學碩士學位論文。
23.	陳月枝(2008)。醫療與社會共舞，護理專案的發展與變遷成。臺北市，群學出版有限公司。
24.	陳忠情（2010）。職業承諾、工作壓力、社會支持對組織承諾影響之研究-以某特勤組織為例。淡江大學企業管理學系研究所碩士論文。
25.	陳芙蓉、閻成美(2007)。護士離職意願相關因素研究發展。護理學雜誌。22(11)，78-80。
26.	賀桂芬(2009)。IT企業員工角色壓力、工作滿意度對離職意向的影響研究。福建師範大學碩士學位論文
27.	黃國隆(1984)。我國組織中員工之工作滿足。中國式管理研討會論文集。
28.	黃婉菁(2003)。從工作生活品質、工作壓力觀點探討社會工作者對專業職業承諾之相關研究。高雄醫學大學行為科學研究所碩士論文。
29.	楊美玲，王冉冉，侯淑肖(2006)。在職護士離職傾向及其相關因素調查分析。現代護理。12 (18)，1667-1669。
30.	廖玲珠(2004)。內部稽核人員角色壓力及工作滿足與內部稽核工作品質關係之研究。當代會計。5(2)，235-270。
31.	裴艷(2007)。護士職業承諾水平及離職影響因素研究。中國第二軍醫大學碩士學位論文。
32.	趙瑞(2010)。角色壓力與服務破壞：工作滿意度的中介作用-以醫院護士。河南大學碩士學位論文。
33.	劉曉丹，王幼芳，王芳，吳世菊(2010)。社區護士工作滿意度與離職傾向相關性研究。護士進修雜誌。25(6)，496-498。
34.	劉耀中(2006)電信員工職業承諾因素結構的研究。心理科學。 29(4) ， 994-997。
35.	鄭怡婷(2007)。人資顧客服務代表的角色壓力與工作滿意、工作投入、留任意願之關聯-以知覺人力資源部門主管支持為調節變項。中央大學人力資源管理研究所碩士論文。
36.	鄭得臣(1984)。領導型態、角色壓力、核心生活興趣與組織承諾的關係。國立政治大學碩士論文。
37.	盧美秀(2011)99年醫事人力需求推估論壇護理師(士)職類。中華民國護理師護士公會全國聯合會。
38.	遲俊濤(2006)。聘用制護士工作滿意度及其與組織承諾、離職傾向的關係研究。碩士學位論文。
39.	龍建、龍立榮、王南南(2002)。431名護士職業承諾狀況的調查分析。中華醫院管理雜誌。18(7)，407-408。
40.	鍾明燿(2008)。內部行銷作為、成就動機、組織承諾與離職傾向的關係-以國軍志願役軍士官為例。真理大學管理科學研究所在職碩士專班碩士論文。


二、 英文文獻
1.	Adio Gboyega, Popoola SO (2010). Job satisfaction and career commitment of librarians in federal university libraries in Nigeria. Library Review, 59(3):175-184
2.	Albaugh J (2003). Keeping Nurses in Nursing: The Profession’s Challenge for Today. Urologic Nursing, 23(3):193-199.
3.	Applebaum D, Fowler S, Fiedler N, Osinubi O and Robson M (2010). The impact of environmental factors on nursing stress, job satisfaction, and turnover intention. Journal of Nursing Administration, 40(7/8):323-328.
4.	Aranya N, Pollock J and Amernic J (1981). An Examination of Professional Commitment in Public Accounting. Accounting Organization and Society, 6:271-280.
5.	Argyle M (1987). The Psychology of Happiness. New York: Routedge.
6.	Aryee S and Tan K (1992). Antecedents and outcome of career commitment. Journal of Vocational Behavior, 40:288-305.
7.	Awang, Ahmadz and Zinz (2010). Modelling Job Satisfaction and Work Commitment Among. Journal of Statistical Modeling and Analytics. 1(2):45-59.
8.	Baron RM and Kenny DA (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51:1173-1182.
9.	Behrman DN and Perreault WD (1984). A role stress model of the performance and satisfaction of industrial salespersons. Journal of Marketing, 48:9-21.
10.	Bettencourt LA and Brown SW (2003). Role stressors and customer-oriented boundary-spanning behaviors in service organizations. Journal of the Academy of Marketing Science, 31(4):394-408.
11.	Blau G (2003). Testing for a four-dimensional structure of occupational commitment. Journal of Occupational and Organizational Psychology, 76:469-488.
12.	Blau GJ (1985). The Measurement and Prediction of Career Commitment. Journal of Occupational Psychology, 58:277-288.
13.	Blum ML and Naylor JC (1968). Industrial Psychology, New York, Harper & Row Publishers Inc.
14.	Bratt MM, Broome M, Kelber S and Lostocco L (2000). Influence of stress and nursing leadership on job satisfaction of pediatric intensive care unit nurses. American Journal of Critical Care, 9(5):307-317.
15.	Carson KD (1991). A multidimensional career commitment measure (MCCM) gauging motivation to work in one’s career field (career commitment).  Unpublished doctoral dissertation, University of Indiana.
16.	Carson KD and Bedeian AG (1994). Career commitment: Construction of a measure and examination of its psychometric properties. Journal of Vocational Behavior, 44:237-262.
17.	Carsten JM and Spector PE (1987). Unemployment, Job Satisfaction and Employee Turnover: A meta-analysis test of the Munchinsky model. Journal of Applied Psychology, 72:374-381.
18.	Castle NG and Engberg J (2007). The influence of staffing characteristics on quality of care in nursing homes. Health Services Research, 42(5):1822-1847.
19.	Cesim D (2002). Determining the levelof job satisfaction ofnursesworking at Turkish military forces hospitals. Milit Medic, 167(5):402-440.
20.	Chen YM, Chen SH, Tsai CY and Lo LY (2007). Role stress and job satisfaction for nurse specialists. Journal of Advanced Nursing, 59:497-509.
21.	Chen Ying-Yeh, Tsai Pei-Chen, Chen Pao-Huan, Fan Chun-Chieh, Hung Galen Chin-Lun and Cheng Andrew T. A. (2010). Effect of Media Reporting of the Suicide of a Singer in Taiwan: The Case of Ivy Li. Social Psychiatry and Psychiatric Epidemiology, 45(3):363-369.
22.	Clevenger K (2007). The role of a nurse retention coordinator: one perspective. Nursing Anagement, 38(10):8-10.
23.	Clifford JM (1985). The Relative Importance of Intrinsic and Extrinsic Rewards as Determinants of Work Satisfaction. Sociological Quarterly, 26(3):365-385.
24.	Collarelli S and Bishopm R (1990).Career commitment: Functions, correlates and management. Group and Organization Studies, 15:158-176.
25.	Coogle CL, Parham IA and Young KA (2007). Job satisfaction and career commitment among nursing assistants providing Alzheimer's care. American Journal of Alzheimer's Disease and Other Dementias, 22(4):251-260. 
26.	Cribbin JJ (1972). Effective Managerial Leadership, American Management Association, New York.
27.	Cropanzano R, DE Rupp and ZS Byrne (2003). The Relationship of Emotional Exhaustion to Work Attitudes, Job Performance and Organizational Citizenship Behaviors. Journal of Applied Psychology, 88(1):160-169.
28.	Cuieford (1965). Fundamental statistics in Psychology & Education (4th Ed.), New York: McGraw-Hii.
29.	Curtis EA (2007). Job satisfaction: a survey of nurses in the Public of Ireland. International Nursing Review, 54:92-99.
30.	Diane R and Sophia FD (2005). The nurse manager job satisfaction, the nursing shortage and retention. Journal of Nursing Management, 13:286-295.
31.	Finnep (2001). Autonomy: and important component for nurse job satisfaction. International Journal of Nursing Studies, 38:349-357.
32.	Fochsen G, Sjogren K, Josephson M. and Lagerstrom M (2005). Factors contributing to the decision to leave nursing care: a study among Swedish nursing personnel. Journal of Nursing Management, 13:338-344.
33.	Gaither CA (1999). Career commitment: a mediator of the effects of job stress on pharmacists’ work-related attitudes. Journal of the American Pharmaceutical Association, 39(3):353-361.
34.	Glisson C and Durick M (1988). Predictors of job satisfaction and organizational commitment in human service organizations. Administrative Quarterly, 33:61-81.
35.	Hall DT (1971). A theoretical model of career subidentity development in organizational settings. Organization Behavior and Human Performance, 6:50-76.
36.	Hans Solli-Sæther (2011). Transplants' role stress and work outcome in IT outsourcing relationships. Industrial Management & Data Systems, 111(2):227-245.
37.	Hardy ME and Conway ME (1978). Role theory: Perspectives for hearth professionals, New York: Appleton-Century-Crofts.
38.	Hasselhorm HM, Tackenberg P and Mueller B (2003). Working conditions and intent to leave the profession among nursing staff in Europe. Working Life Research Report 7, National Institute for Working Life.
39.	Haut ER, Sieoutris CP, Meredith DM, et (2006). Improved nurse job satisfaction and job retention with the transition from a “mandatory consultation” model to a “semielosed” surgical intensive care unit: A 1-year Prospective valuation. Critical Care Medieine, 34(2):387-395.
40.	Ho Wen-Hsien, Chang Ching Sheng, Shih Ying-Ling and Liang Rong-Da (2009). Effects of job rotation and role stress among nurses on job satisfaction and organizational commitment. BMC Health Services Research, 9:8, doi:10.1186/1472-6963-9-8
41.	Hoppock R (1935). Job Satisfaction, New York: Halt, Rinenart and Winston.
42.	Hrebiniak LG and Alutto JA (1972). Personal and role related factors in the development of organizational commitment. Administrative Science Quarterly, 17(4):555-573.
43.	Hsieh PC and Su HF (2007). Retention and attrition of certified care assistants in the long-term care industry from the Taipei area: An interview survey. International Journal of Nursing Studies, 44:93-104.
44.	Irvine DM and MG Evans (1995). Job Satisfaction and Turnover among Nurses: Integrating Research Findings across Studies. Nursing Research, 44:246-253.
45.	Irving PG, Coleman DF and Cooper CL (1997). Further Assessments of A Three-Component Model of Occupational Commitment: Generalizability and Differences Across Occu-Pations. Journal of Applied Psychology, 82(3):444-452.
46.	Ivarcevich JM and MT Mattesor (1980). Stress and work: A managerial Perspective, Scott: Foresman and Company.
47.	Jacobson E, Charters WW, Jr. and Lieberman S (1951). The use of the role concept in the study of complex organizations. Journal of Social Issues, 7(3):18-27.
48.	Jamal M (1990). Relationship of job stress and type-A behavior to employees' job satisfaction, organizational commitment, psychosomatic health problem and turnover motivation. Human Relations, 43(8):727-738.
49.	Jaramillo F, Mulki JP and Solomon P (2006). The role of ethical climate on salesperson’s role stress, job attitudes, turnover intention, and job performance.  Journal of Personal Selling & Sales Management, 26(3):271-282.
50.	Jerald G and AB Robert (1995). Behavior Organizations: Understanding And Managing The Human Side Of Work (5th Ed.), New Jersey: Prentice-Hall Inc.
51.	Kacel B, Miller M and Norris D (2005). Measurement of practitioner job satisfaction in a Midwestern State. Journal of American Academy of Nurse Practitioners, 17(1): 27-32.
52.	Kahn RL and Quinn RP (1970). Role stress: a framework for analysis. In McLean, A. (Eds). Occupational Mental Health. Rand-McNally, New York.
53.	Kahn RL, Wolfe DM, Quinn RP and Snoek JD (1964). Organizational stress. New York: Wiley.
54.	Kaiser HF (1974). An Index of Factorial Simplicity. Psychometrika, 39(1):31-36.
55.	Kenny, D. A., Beashy, D. A., and Bolger, N. (1998). Data analysis in social psychology. In D. T. Gilbert & S. T. Fiske (Eds.), The handbook of social psychology (pp. 233-265) New York: McGraw-Hill.
56.	Khurram Shahzad, Umer Rehman, Ikramullah Shad, Asma Gul and Muhammad Amanullah Khan (2011). Work-Life Policies and Job Stress as Determinants of Turnover Intentions of Customer Service Representatives in Pakistan. European Journal of Social Sciences, 19(3):403-411.
57.	Khurshid K, Marchant RJ and Hirani D (2005). Registered nurses perception of work satisfaction at a tertiary care university hospital. Journal of Nurse Management, 13(1):32-39
58.	Kim YG, Kim S and Yoo JL (2011). Travel agency employees' career commitment and turnover intention during the recent global economic crisis. The Service Industries Journal. 1:1-18.
59.	Kivim KM (1995). Job enrichment, work motivation and job satisfaction in hospital wards. Journal of Nursing Management, 25(2):87-91.
60.	Kudo Yasushi, Satoh Toshihiko, Hosoi Kaori, Miki Takeo, Watanabe Mitsuyasu, Kido Shigeri and Aizawa Yoshiharu (2006). Association between Intention to Stay on the Job and Job Satisfaction among Japanese Nurses in Small and Medium-sized Private Hospitals. J Occup Health, 48(6):504-513.
61.	Laureen J Hayes, Linda O’Brien-Pallas and Christine Duffield (2006). Nurse turnover: A literature review. International Journal of Nursing Studies, 43:237-263.
62.	Lee E (1998). Job satisfaction and autonomy of Hong Kong registered nurses.  Journal of Advanced Nursing, 27(1):355-363.
63.	Lee H, Song R, Cho YS, Lee GZ and Daly B (2003). A comprehensive model for predicting burnout in Korean nurses. Journal of Advanced Nursing, 44(5):534-545.
64.	Lee J and Peccei R (2007). Perceived organizational support and affective commitment: the mediating role of organizational- based self-esteem in the context of job insecurity. Journal of Organizational Behavior, 28:661-685.
65.	Lee K, Carswell JJ and Allen NJ (2000). A meta-analytic review of occupational commitment: Relations with person- and work-related variables. Journal of Applied Psychology, 85(5):799-811.
66.	Lee-Ross, D. (2000). Development of the service predisposition instrument.  Journal of Managerial Psychology, 15(2):148-157.
67.	Liisa K, Helena LK and Jouko K (2003). Nurse empowerment job-Related satisfaction and organizational Commitment. Journal of Nursing Care Quality, 18(3):184-192.
68.	Locke EA (1976). Satisfiers and Dissatisfiers among White-Collar and Blue-Collar Employees. Journal of Applied Psychology, 58(1):67-76.
69.	London M (1983). Toward a theory of career motivation. Academy of Management Review, 8:620-630.
70.	Lu H, While A, and Barriball K (2005). Job satisfaction among nurses: a literature review. International Journal of Nursing Studies, 42(2):211-227.
71.	Lu KY, Lin PL, Wu CM, Hsieh YL and Chang YY (2002). The relationships among turnover intentions, professional commitment and job satisfaction of hospital nurses. Journal Professional Nursing, 18(4):214-219.
72.	Lundh U (1999). Job satisfaction among Swedish nurse and laboratory technologists. British Journal of Nursing, 8(14):948-952.
73.	Mahmoud Al-Hussami R (2008). A Study of Nurses' Job Satisfaction: The Relationship to Organizational Commitment, Perceived Organizational Support, Transactional Leadership, Transformational Leadership and Level of Education.  European Journal of Scientific Research, 22(2):286-295.
74.	Melnyk BM (2006). The latest evidence on factors impacting nurse retention and job satisfaction. Worldviews on Evidence-Based Nursing, 3:201-204.
75.	Michaels CE and Spector PE (1982). Causes of Employee Turnover: A Test of the Mobley, Griffeth, Hand, and Meglino Model. Journal of Applied Psychology, 67(1):53-59.
76.	Miller HE and R Katerberg (1979). Evaluation of the Mobley and Hollingsworth Model and Employee Turnover. Journal of Applied Psychology, 64(5):509-517. 
77.	Mobley WH (1977). Intermediate linkages in the relationship between job satisfaction and employee turnover. Journal of Applied Psychology, 62(2):237-240.
78.	Mobley WH, SO Hollingworth and AT (1978). An Evaluation of Precursors of Hospital Employee Turnover. Journal of Applied Psychology, 63(4):408-414.
79.	Morrow PC and Wirth RE (1989). Work commitment among salaried professionals. Journal of Vocational Behavior, 34:40-56.
80.	Mosadeghrad AM, Ferlie E and Rosenberg D (2008). A study of the relationship between job satisfaction, organizational commitment and turnover intention among hospital employees. Health Service Management Research, 21(4):211-227.
81.	Nelson DL and Quick JC (2006). Organizational Behavior: Foundations, Reality and Challenges. South-Western, Nashville, Tennessee.
82.	Newman K and Maylor U (2002). The NHS Plan: nurse satisfaction, commitment and retention strategies. Healthy Services Management Research, 15(2):93-105.
83.	Newman Karin, Maylor Uvanney and Chansarkar Bal (2002). The nurse satisfaction, service quality and nurse retention chain: Implications for management of recruitment and retention. Journal of Management in Medicine, 16(4):271-291.
84.	Parsons SK, Simmons WP, Penn K and Furlough M (2003). Determinants of satisfaction and turnover among nursing assistants. The results of a statewide survey. Journal of Gerontol Nurse, 29(3):51-58.
85.	Porter LW and Lawler EE (1968). Managerial attitudes & performance. Illinois: Homewood Company.
86.	Porter LW, Steers RM, Mowday RT and Boulian PV (1974). Organizational commitment, job satisfaction, and turnover among psychiatric technicians. Journal of Applied Psychology, 59(5):603-609.
87.	Price JL and CW Mueller (1981). A causal model of turnover for nurses. Academy of Management Journal, 24(3):543-565.
88.	Price JL and Mueller CW (1986). Absenteeism and Turnover of Hospital Employees. CT: JAI Press.
89.	Price JL and Mueller CW (2001). Reflections on determinants of voluntary turnover. International Journal of Manpower, 2(7):600-624.
90.	Rahim A (1996). Stress, strain, and their moderators: An empirical comparison of entrepreneurs and managers. Journal of Small Business Management, 34:46-58.
91.	Rice AK, Hill JM and Trist EL (1950). The representation of labor turnover as a social process. Human Relations, 3:349-372. 
92.	Rizzo JR, House RJ and Lirtzman SI (1970). Role Conflict and Ambiguity in Complex Organizations. Administrative Science Quarterly, 15(2):150-163.
93.	Robbins SP (2001). Organizational Behavior (9th Ed.). NJ: Prentice-Hall.
94.	Robbins SP and Judge TA (2009). Organizational behavior (13th Ed.). New Jersey: Pearson Education.
95.	Roedel RR and Nystrom PC (1998). Nursing jobs and satisfaction. Nursing Management, 19:34.
96.	Schultz DP and Schultz SE (1994). Psychology and Work Today: An Introduction to Industrial and Organizational Psychology (6th Ed.). New Jersey: Prentice Hall Inc. 
97.	Shader K and Broome MEC (2002). Issues related to staff retention and turnover.  Semin-Nurse Managment, 10(3):171-179.
98.	Sharon KP, William P and Simmons KP (2003). Determinants of satisfaction and turnover among nursing assistants: the result of a statewide survey. Journal of Gerontological Nursing, 29(5):51-58.
99.	Shrder K, Broome ME, Broome CD, et al. (2001). Factors influencing satisfaction and anticipated turnover for nurses in an academic medical center. Journal of Nurs. Adm., 31(4).
100.	Smith PC, Kendall L and Hulin CL (1969). The measurement of satisfaction work and retirement, Chicago: Rand McNally.
101.	Steel RP and Ovale NK (1984). A review and meta‐analysis of research on the relationship between behavioural intentions and employee turnover. Journal of Applied Psychology, 69:673‐686.
102.	Sveinsdottir H, Biering P and Ramel A (2006). Occupational stress, job satisfaction, and working environment Icelandic nurses: A crosssectional questionnaire survey.  International Journal of Nursing Studies, 43:875-889.
103.	Tett R.P. and JP Meyer (1993). Job Satisfaction, Organization Commitment, Turnover Intention, and Turnover: Path Analyses Based on Meta-Analytic Findings.  Personal Psychology, 40:259-291.
104.	Tonges MC, Rothstein H and Carter HK (1998). Sources of satisfaction in hospital nursing practice: a guide to effective job design. Journal of Nursing Administration, 28(5):47-61.
105.	Tullai-McGuinness S, Madigan EA, and Anthony MK (2005). Exercise of autonomous home care practice: the relationship with nurse characteristics. Home Healthcare Nurse, 23(6):378-384.
106.	Valada VU (2003). The interrelationship of organizational characteristics of magnet hospitals, nursing leadership, and nursing job satisfaction. Health Care Managment, 22(2):83-98.
107.	Van Maanen J and Schein EH (1979). Toward a theory of organizational socialization In B. M. Staw (Ed.). Research in Organizational Behavior, 1:209-264.
108.	Van Sell M, Brief AP and Schuler RS (1981). Role conflict and ambiguity: Integration of the literature and directions for future research. Human Relations, 34: 43-91.
109.	Vroom V (1973). A New Look at Managerial Decision-Making. Organizational Behavior, 3:66-80.
110.	Vroom VH (1967). Work and motivation, New York: John Willey & Sons Inc.
111.	Wexley KN and Yukl GC (1977). Organization Behavior and Personnel Psychology, Ploa Honewood Ⅲ: Richard D. Irwin.
112.	Yousef DA (2002). Job Satisfaction as A Mediator of the Relationship Between Job Stressors and Affective, Continuance, and Normative Commitment:A Path Analytical Approach. International Journal of Stress Management, 9(2):99-112.
113.	Zhang G and Lee G (2010). The Moderation Effects of Perceptions of Organizational Politics on the Relationship between Work Stress and Turnover Intention: An Empirical Study about Civilian in Skeleton Government of China. iBusiness, 2:268-273.
114.	Zhou Haimin, Xiao Long, Dong Yuexia, Wang Chunzeng, Wang Fangzheng and Ni Pingze (2009). Geochemical and geochronological study of the Sanshui basin bimodal volcanic rock suite, China: Implications for basin dynamics in southeastern China. Journal of Asian Earth Sciences, 34(2):178-189.

三、 網路文獻
1.	中華民國護理師護士公會全國聯合會網站，2011年4月
(http://www.nurse.org.tw/DataSearch/Manpower.aspx)
2.	法務部，全國法規資料庫，全民健康保險法施行細則，2010年10月
(http://law.moj.gov.tw/LawClass/LawContent.aspx?pcode=L0060002)
3.	行政院衛生署，醫事機構開業登記資料查詢。2010年10月14日(http://www.doh.gov.tw/DOHS/)
4.	行政院衛署，衛生法規資料檢索系統。2011年5月3日
(http://dohlaw.doh.gov.tw/Chi/FLAW/FLAWDAT0201.asp?lsid=FL014029)
5.	今日新聞網。2011年5月21日
(http://www.nownews.com/2011/05/21/10844-2714298.htm)