藥事照護在多個國家已成為減輕醫療成本與維護高齡化多重用藥安全的重要發展，藉探討藥師在執行照護期間的工作壓力，期分析照護需求減少離職意願，建構友善照護條件。目的在探討執行藥事居家照護藥師所承受之工作壓力、壓力來源與離職意願。研究採用結構式問卷調查法，對象選定曾經執行中央健康保險署「藥事居家照護」試辦計劃藥師。結果，全國有74.9%照護藥師參與此研究，整體工作壓力感受得分3.09，略高於量表的中間值。自評壓力分數量表為67.76分。居家照護藥師最大工作壓力源主要為給付條件，藥師認為每次照護費用平均應為1,574元，才符合居家照護藥師專業與軟硬體成本；其他高於中間值壓力源構面，依序為行政管理、顧客關係與工作內容。七項壓力源構面與工作壓力皆呈現正向顯著關係，整體迴歸模式有34%解釋率；顧客關係與工作壓力是正向顯著關係，直線迴歸(Multiple linear regression)達52%預測解釋率；以Pearson分析呈現工作壓力與離職意願為正相關；邏輯斯迴歸(Multiple logistic regression)中，工作內容對於有離職意願對無離職意願的勝算比為9.06。本研究結果期能給予相關教學或組織政策參考，著手調整創建和善藥事照護制度與環境，以增加藥師執行居家照護意願與照護藥師數量，為國家高齡化環境提供充足穩定的人力資源，提供給病人穩定的服務品質，保障受照護民眾的權益與成效，維護民眾用藥安全，並降低國家高齡化醫療經費成本。 The home pharmaceutical care has been an important approach to reduce health care costs and maintaining drug safety for the elders in many countries. This study inents to understand the work related stress and needs of the home care pharmacists in Taiwan, and hopfuly to create friendly environment for them in the future. Therefore, the aim of this study was to analyze the factors of work-related stress that the practicing pharmacists faced, including the origins and types of stress, and turnover intention. Structural questionnaire survey was used. The study targets were those who joined the NHI Home Pharmaceutical Care Program. Almost 75% of the pharmacists who were trained for home pharmaceutical care participated in this research. The score of work related stress that the pharmacists perceived was 3.09 which was higher than the medium value. The origin of the pharmacist’s stress mainly came from the condition of payments. The appropriated amount of payment that the pharmacists perceived is NT$1,574 (U$52.47), which is the amount suffient to cover the all costs related to the pharmaceutical care. Other dimensions which are higher than the average value will be administration and management, customer relationship, contents of work. There are seven dimensions of stressor which had positive relations with working-stress, the overall multiple regression analysis would provide 34% of explanation for the model. The customer relationship also has positive relations with working-stress. The regression results indicated 52% of explanation rate for the model. Presents work stress and turnover intention was positively correlated from Pearson correlation analysis. The content of work provided an odds ratio of 9.06 for leaving the job, comparing with no intention to leave. It’s hope that the results of this research will provide significant information for educational needs or policy-makers, to establish friendly policies and environments for increasing the willingness and numbers of pharmacists to participate the home pharmaceutical care. Not only to provide enough human resource for the nation, but also provide pharmaceutical services with good quality to the patient. Protecting the right and outright of care-participating public, in addition, to maintain the drug safety environments and decrease the medical cost with aging population within the nation.
