| 摘要: | 「機構有訂定目標或使命」為護理之家評鑑項目之ㄧ，護理之家若無法達成評鑑指標，將會影響其永續經營，清楚訂定使命宣言可讓組織成員清楚組織未來方向、服務範圍，而具有可衡量的使命或目的陳述，可提供策略規劃、行動準則，發展評估測量。使命宣言制定理由的同意度、使命宣言內容要素的清楚程度、使命宣言的滿意度、使命宣言對組織管理連結的影響程度皆會影響健康照護的品質及組織績效，故本研究建構使命宣言制定理由的同意度、使命宣言內容要素的清楚程度、使命宣言的滿意度、使命宣言對組織管理連結的影響程度和組織績效的滿意度之因果路徑。
採用郵寄問卷調查法，於民國98年4月至6月期間，郵寄給全國346家護理之家業務負責人填寫，經過兩次催收共回收118份為研究對象，回收率為34.1%，適合度檢定發現地區別、護理之家年資、病床規模與母群體分佈相似，其量表之信度均大於0.8，內容效度(CVI)均在0.9以上。並以描述性統計、相關分析、因素分析、獨立樣本T檢定及單因子變異數分析、複迴歸分析與偏最小平方法(Partial Least Squares;PLS)，探討護理之家使命宣言制定理由的同意度、使命宣言內容要素的清楚程度、使命宣言的滿意度、使命宣言對組織管理連結的影響程度和組織績效的滿意度之關係。
重要研究結果如下
1. 相關分析發現：使命宣言制定理由的同意度、使命宣言內容要素的清楚程度、使命宣言的滿意度、使命宣言對組織管理連結的影響程度、與組織績效的滿意度呈現正相關；使命宣言內容要素的清楚程度經由因素分析，可分為兩構面，命名為目的(ends)與手段(means)，亦和組織績效的滿意度有正相關。
2. 以獨立樣本T檢定及單因子變異數分析結果發現：使命宣言制定理由的同意度在不同機構經營管理型態、護理之家不同年資中有差異。
(1) 使命宣言內容要素-目的的清楚程度會因機構經營管理型態有差異。
(2) 使命宣言的滿意度會因業務負責人之教育程度、業務負責人年資有差異
3. 複迴歸分析結果發現：使命宣言內容要素-手段的清楚程度(迴歸係數=0.270，p=0.014)、使命宣言的滿意度(迴歸係數=0.551，p=0.000)會影響組織績效的滿意度，解釋總變異為29.8%。
4. 以PLS模式分析：發現建構使命宣言制定理由的同意度、使命宣言內容要素-目的的清楚程度、使命宣言內容要素-手段的清楚程度、使命宣言的滿意度、使命宣言對組織管理連結的影響程度與組織績效的滿意度，各構面之組合信度(CR)皆大於0.7、平均變異萃取量(AVE)亦大於0.5，此模式具有良好之信效度；且
(1) 業務負責人對使命宣言制定理由的同意度會透過使命宣言內容要素-目的的清楚程度、使命宣言的滿意度進而正向影響組織績效的滿意度；
(2) 業務負責人對使命宣言制定理由的同意度亦會透過使命宣言內容要素-目的的清楚程度進而正向影響使命宣言對組織管理連結的影響程度。
欲提升組織績效的滿意度(平均佔床率、市場佔有率、住民進住成長率、品質管理)，應強化使命宣言制定理由的各項動機、並增加使命宣言內容要素-目的的清楚程度與使命宣言的滿意度；且欲增加使命宣言對組織管理連結的影響程度，亦應強化使命宣言制定理由的各項動機、提升使命宣言內容要素-目的的清楚程度。
Institutional goals or mission statements are parts of the accreditation criteria for nursing homes. If nursing homes can not achive the accreditation criteria that will affect their sustainable development of reelizing future. Therefore, the clarity level of mission statement components can make staff to understand the business objective and the scope of business.The measurable mission statements can offer strategic planning, action guilde, and develop criteria measurement. The agreement level of Mission statements rationales, clearity level of mission statement content, mission statement satisfaction, organizational alignment influence all can affect organizational quality and performance in health care institutions. This research aim to explore the causal path among agreement level of Mission statements rationales, clearity level of mission statement content, mission statement satisfaction, organizational alignment influence with organizational performance satisfaction.
This research uses a mailed questionnaire survey method to collect relevant data. Questionnaire surveys were sent out to the heads of operations of 346 nursing homes nationwide during the period between April and June 2009 and, after calling twice to urge the return of the questionnaires, a total of 118 questionnaires were returned, which gave a return rate of 34.1%. Results of the survey goodness-of-fit show that the region, the nursing homes seniority, and the bed size are similar with population. The cronbach’α all are greater than 0.8, and content validity index is greater than 0.9. After that, using the analysis for descriptive statistic analysis, correlation analysis, factor analysis, independent sample T test, one-way ANOVA analysis, multiple resression, partial least squares to explore the relationship among agreement level of Mission statements rationales, clearity level of mission statement content, mission statement satisfaction, organizational alignment influence with organizational performance satisfaction. The study results are as below:
1. Correlation analysis: agreement level of Mission statements rationales, clearity level of mission statement content, mission statement satisfaction, organizational alignment influence have postive relationship with organizational performance satisfaction. After factor analysis clearity level of mission statement content were separate for two deminsion, called “ends” and “means”, it’s will effect organizational performance satisfaction postivly.
2. Independent sample T test and one-way ANOVA analysis: agreement level of Mission statements rationales was significantly different with agency management style and seniority of nursing homes.
(1)The clearity levels of mission statement content-end was significantly different with agency management styles.
(2)Mission statement satisfactions was significantly different with education levels and seniority of the heads of operations.
3.Multiple regression:The clearity levels of mission statement content-end (ß=0.270,p=0.014), mission statement satisfaction(ß=0.551,p=0.000) can affect organizational performance satisfaction, with total variance explained 29.8%.
4. Partial Least Squares: We construct agreement level of Mission statements rationales, clearity level of mission statement content, mission statement satisfaction, organizational alignment influence with organizational performance satisfaction of the causal path model. The composite reliability(CR) are greater than 0.7,Average Variance Extracted(AVE) are greater than 0.5, showing our model with good reliability and validity. Besides,
(1)the heads of operations’s agreement level of Mission statements rationales can through clearity level of mission statement content-end and mission statement satisfaction to postively affect organizational performance satisfaction；
(2)the heads of operations’s agreement level of Mission statements rationales also can through clearity level of mission statement content-end to postively affect organizational alignment influence.
To improve organizational performance satisfaction (average occupancy rate, market share, growth rates of resident coming, quality management) should strengthen the development of mission statement of the reasons for motivation, and increase the factors clearity level of mission statement-ends and mission statement satisfaction; and wishing to increase of the mission statement and the degree of organization and management linkages, they should also strengthen the grounds for the development of the motivation of a mission statement, and promote the mission statement of the clarity of the purpose of elements. |
