近年來為提升營運效率，其組織結構大多朝向扁平化、專業化發展，而醫療產業為了提升醫療照護服務品質，也漸整合為醫療體系，小至疾病認證大至國際醫院評鑑，組織內部的結構也隨著策略方向，朝向專精化內部分工。而相對於非醫事人員來說組織資源也相對有限，也導致組織成員能晉升的機會變少，均可能讓員工產生職涯發展的限制，使得員工可能在此氛圍下認知與組織間的心理契約受到違背。因此，組織應如何減低員工因職涯停滯對於組織所造成的影響，便成為本研究關心的重要議題。本研究基於社會交換理論的觀點，以雙向度職涯停滯為自變項，組織公民行為為依變項，以心理契約違背作為中介變數，並假定具主動性人格特質可調節前述之中介效果，以了解當員工因職涯停滯而心理契約遭到違背時，對組織公民行為之影響。本研究回收兩階段資料共計 114 份有效配對樣本，透過階層迴歸分析檢驗中介效果與調節式中介效果，驗證研究之假設。研究結果發現，雙向度職涯停滯與心理契約違背呈現正向相關、具主動性人格特質者可調節因職涯停滯而產生心理契約違背對特定利他組織公民行為的中介效果，當主動性人格特質越高時，前述之中介效果會減弱。最後根據研究結果提出進一步的討論，並對管理實務及後續研究提出建議。

In order to improve operational efficiency, most of the organizational structures have been flattened and professionalized. Meanwhile, the medical industry has gradually been integrated into a medical system to improve the quality of medical care services. From disease certification to international hospital evaluation, the internal structure has also followed the strategic direction toward specializing in the internal division of labor. Non-medical personnel with relatively limited organizational resources may have fewer opportunities to be promoted. All of these factors may limit employees' career development. Employees may feel that the psychological contract with the organization has been breached. Therefore, how to reduce the impact of employees' career plateau on the organization is the main focus of this research. A total of 114 valid matched samples were collected in this research. The study's hypothesis was verified through hierarchical regression analysis to examine the mediation effect and moderated mediation effect. The study results have found a positive correlation between a two-dimensional career plateau and psychological contract breach. Employee's proactive personality could moderate the mediating effect of psychological contract breach caused by career plateau on specific altruistic organizational citizenship behavior. Finally, a further discussion has been put forward according to the research results. Further suggestions for management practice and follow-up research have been provided.

論文審定書…………………………………………………………………i
摘要…………………………………………………………………...……ii
英文摘要..………………………………………………………………....iii
圖次……………………………………………………………………….vii
表次………………………………………………………………………viii
第一章 緒論...……………........................................................................1
第一節 研究動機……........................................................................1
第二節 研究目的……........................................................................4
第三節 名詞解釋……........................................................................4
一、 職涯停滯……........................................................................4
二、 心理契約違背........................................................................5
三、 組織公民行為........................................................................5
四、 主動性人格…........................................................................5
第二章 文獻探討………….......................................................................7
第一節 職涯停滯及其研究現況………….......................................7
第二節 心理契約違背及其研究現況...............................................9
第三節 職涯停滯與心理契約違背的關係.....................................11
第四節 心理契約違背如何影響組織公民行為.............................12
第五節 主動性人格的調節效果.....................................................13
第三章 研究方法………….....................................................................16
第一節 施測程序…….....................................................................16
第二節 研究樣本…….....................................................................17
第三節 研究工具…….....................................................................18
一、 職涯停滯……....................................................................19
二、 組織公民行為……............................................................20
三、 心理契約違背……............................................................21
四、 主動性人格………............................................................22
五、 控制變項…………............................................................23
六、 共同方法變異處理............................................................24
第四節 分析方法............................................................................24
第四章 研究結果….................................................................................26
第一節 敘述性分析……................................................................26
第二節 相關分析………................................................................26
第三節 驗證性因素分析................................................................27
第四節 假設檢定…........................................................................28
中介效果檢定….........................................................................28
調節式中介效果檢定.................................................................30
補充分析……….........................................................................36
第五章 討論與建議…….........................................................................38
第一節 研究摘述...........................................................................38
第二節 研究發現與討論...............................................................39
雙向度職涯停滯與心理契約違背的關係.................................39
心理契約違背與組織公民行為的關係.....................................39
雙向度職涯停滯與組織公民行為間的關係.............................40
其他研究發現.............................................................................40
第三節 研究限制...........................................................................41
樣本.............................................................................................41
量表.............................................................................................42
第四節 研究建議...........................................................................43
未來研究建議.............................................................................43
實務管理建議.............................................................................44
參考文獻.....................................................................................................46
附錄.............................................................................................................50

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