研究背景與目的：
心理健康(mental health)在近年來逐漸受到世界關注，過去的研究中顯示醫護人員相較於一般大眾更容易產生心理困擾。2019年底，一種新型態的肺炎首次發現於中國武漢，並於2020年初由中國開始擴散傳染至全世界，並於2020年3月11日由世界衛生組織宣布正式進入全球大流行。在過去SARS疫情期間或照顧其他傳染性疾病時，醫護人員皆顯示會因而產生心理困擾，而在目前COVID-19疫情肆虐下，醫護人員的心理健康狀態亦可能會受到巨大的影響。因此，本研究之研究目的在於了解疫情期間台灣醫院醫護人員的壓力源及心理健康狀態，並了解兩者之間的關聯性與醫護人員認為對其有效之改善壓力及心理困擾之方式進行探討。
研究方法：
本研究為橫斷性量化研究，採任意抽樣之方式，研究對象為全台灣醫院醫護人員。問卷內容分別為個人基本資料、DASS-21-C量表、醫護人員壓力原及改善心理困擾或壓力之方式等四個部分。在完成收案後使用SPSS 24.0版進行數據分析。
研究結果：
醫護人員在心理健康狀態上憂鬱、焦慮及壓力分別為13.5%、21.3%、7.9%，不可控制性、生活重大改變、內在衝突等三大構面之壓力源為醫護人員心理困擾之預測因素。壓力源部分，「穿戴防護裝備使工作不方便」、「擔心因為自己染疫而傳染給家人或朋友」、「擔心照顧的病患無法得到妥善的照顧」、「穿戴防護裝備時感到不適」、「指揮中心及院內的防疫政策的改變感到無所適從」、「社交活動因為醫院政策受到限制」為醫護人員在疫情期間所感受到之主要壓力源。改善壓力及心理困擾方式部分，「主管機關或政府機關的實際支持」、「從事休閒活動」、「獲得COVID-19相關專業知識（如：症狀、傳播途徑、治療方式…等）」、「與家人朋友聊聊，獲得其支持」、「獲得大眾支持，降低歧視、排擠情形」為醫護人員對其有效之改善壓力及心理困擾之方式。
研究結論：
不可控制性、生活重大改變、內在衝突等三大構面之壓力源為醫護人員心理困擾之預測因素。主管機關及醫院管理者需因應此問題進行改善，並多提供醫護人員認為能改善其壓力及心理困擾的方式，讓醫護人員有健康之心理狀態，望能有降低醫療失誤率及人力不足之問題，並能在下次又發生類似傳染性疾病大流行時，攜手順利解決。

Background: Mental health has been gaining worldwide attention in recent years, and past studies have shown that health care workers are more likely to experience psychological distress than the general public. In late 2019, a new form of pneumonia was first identified in Wuhan, China, and began spreading worldwide from China in early 2020, and was declared a global pandemic by the World Health Organization on March 11, 2020. Health care workers have been shown to experience psychological distress during past SARS outbreaks or when caring for other infectious diseases, and their mental health status may also be greatly affected by the current COVID-19 epidemic. Therefore, the purpose of this study was to understand the stressors and mental health status of health care workers in Taiwan hospitals during the epidemic, to understand the association between the two, and to examine the ways in which health care workers find them effective in improving their stress and mental distress.
Methods: The study was a cross-sectional quantitative study with random sampling. The questionnaires were divided into four sections: basic personal information, the DASS-21-C scale, stressors in healthcare workers, and ways to improve psychological distress or stress. The data were analyzed using SPSS version 24.0.
Results: Depression, anxiety, and stress were 13.5%, 21.3%, and 7.9%, respectively, in the mental health status of healthcare workers. The three major components of stressors, such as uncontrollability, major life changes, and internal conflicts, were the predictors of psychological distress among healthcare workers. In terms of stressors, "wearing protective equipment makes work inconvenient," "worrying about spreading the disease to family members or friends because of their own infection," "worrying about not being able to take proper care of the patients they care for," "feeling uncomfortable when wearing protective equipment," "feeling confused about changes in the epidemic prevention policies at the command center and in the hospital," and "social activities being restricted because of hospital policies" were the main stressors felt by health care workers during the epidemic. The main source of stress was the "restriction of social activities due to hospital policies". In terms of ways to improve stress and psychological distress, "practical support from authorities or government agencies", "engaging in leisure activities", "gaining professional knowledge about COVID-19 (e.g., symptoms, transmission routes, treatment methods, etc.)", "talking to family and friends to get their support", and "getting support from family and friends", and "getting public support to reduce discrimination and exclusion" were effective ways for healthcare professionals to improve their stress and psychological distress.
Conclusions: Uncontrollability, major life changes, and internal conflicts are the three major components of stressors that predict psychological distress among healthcare workers. The authorities and hospital administrators need to improve this problem and provide more ways to improve the stress and psychological distress of health care workers, so that they can have a healthy psychological state and hopefully reduce the rate of medical errors and manpower shortage, and work together to solve the problem smoothly in the next pandemic of similar infectious diseases.

論文審定書 i
致謝 ii
摘要 iii
Abstract v
目錄 vii
圖目錄 x
表目錄 xi
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
第二章 文獻探討 4
第一節 壓力 4
一、 壓力的定義 4
二、 壓力源(Stressors) 4
三、 面對壓力時的反應 7
第二節 心理健康(mental health) 8
一、 心理健康 8
二、 負面的心理狀態 9
三、 心理健康發生問題時帶來之影響 11
第三節 醫護人員的壓力與心理健康相關研究 13
第三章 研究方法 19
第一節 研究架構 19
第二節 研究假設 20
第三節 研究對象與研究工具 20
一、 研究對象 20
二、 研究工具 20
第四節 研究變項與操作型定義 22
一、 基本人口學特性 22
二、 心理健康狀態 24
三、 醫護人員壓力源 26
四、 改善心理困擾或壓力之方式 26
第五節 問卷之信度及效度分析 27
一、 信度分析 27
二、 效度分析 27
第六節 資料處理與分析 28
一、 描述性統計 29
二、 推論性統計 29
第四章 研究結果 31
第一節 醫護人員基本資料描述性統計 31
一、 醫護人員基本資料描述性統計 31
第二節 疫情期間醫護人員心理健康狀態 34
一、 醫護人員心理健康狀態描述性統計 34
二、 醫護人員基本資料與心理健康狀態分析 43
第三節 疫情期間醫護人員壓力源 57
一、 醫護人員壓力源 57
二、 壓力源與DASS-21-C三個分量表之相關性 58
三、 壓力源對於心理健康狀態之影響 59
四、 醫護人員基本資料與不同類型壓力源之差異性分析 63
第四節 改善心理困擾或壓力之方式 72
第五章 討論 74
第一節 疫情期間醫護人員心理健康狀態 74
第二節 醫護人員壓力源及心理健康狀態 75
一、 疫情期間醫護人員壓力 75
二、 醫護人員與不同類型壓力源之關聯 76
三、 不同類型壓力源對心理健康狀態之影響 78
第三節 改善醫護人員壓力及心理健康狀態之方式 79
第六章 結論與建議 81
第一節 研究結論 81
第二節 研究限制 81
第三節 研究建議 82
第四節 研究貢獻 83
一、 實務管理 83
二、 學術研究 83
參考文獻 84
附件一 專家效度評審名單 95
附件二 DASS-21-C授權同意書 96
附件三 IRB審查通過證明書 97
附件四 問卷內容 98

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