目的：新冠疫情期間，國內外少有關於疫情下的病人安全文化差異研究，且國內關於病人安全文化的研究中，「復原力」在病安文化中的分數普遍偏低。因此本研究欲探討疫情前及期間之病人安全文化構面是否具有差異，並進一步探討復原力的影響。
方法：本研究使用回溯性研究，以南部某醫學中心提供2018年至2021年資料，共四年之病人安全態度量表進行對照組之比較研究，研究對象以醫護人員為主，排除非醫療之人員（如行政人員）。以SPSS 25進行描述性統計、t-test、Anova、皮爾森相關分析及迴歸分析。
結果：（1）病人安全文化所有構面皆呈現持續降低趨勢（2）疫情前和疫情期間對病人安全文化有顯著的有性別、年齡、是否擔任主管（副主管）、教育程度、是否直接接觸病人及受雇類別（3）復原力與其餘七構面具有相關性及顯著（4）除了壓力認知，其餘七構面在疫情前和疫情期間對復原力呈顯著影響（5）復原力在疫情前和疫情期間皆對工作滿意、壓力認知、管理感受、工作狀況、工作生活平衡呈顯著影響。
結論：本研究比較了疫情前和疫情期間的病人安全文化差異，以及復原力與病人安全文化的相關性。研究發現，人口統計因素對病人安全文化產生影響，如性別、年齡、是否擔任主管（副主管）、教育程度、是否直接接觸病人及受雇類別等。同時，病人安全文化與復原力密切相關，復原力與病人安全文化為雙向影響。以及有幾個變項是未來需要特別注意的，包含工作年資、教育程度、過去12個月內填寫並提交多少事件通報單、職務類別及受雇類別，這些變項在研究結果中有重要發現。綜上所述，研究結果強調了人口統計變量和復原力在病人安全文化中的重要性，並對未來制定干預措施和策略，加強醫護人員的病人安全文化和應對危機能力。

Purpose: There is a lack of research on patient safety culture differences during the COVID-19 pandemic, both domestically and internationally. Moreover, existing studies on patient safety culture in the domestic context generally show a low emphasis on "resilience" as a dimension. Therefore, this study aims to investigate whether there are differences in patient safety culture dimensions between pre-pandemic and pandemic periods and further explore resilience influences.
Methods: This study employed a retrospective design, using data from a medical center in the southern region from 2018 to 2021. A comparative analysis was conducted using patient safety attitude questionnaires collected over a four-year period. The study focused on healthcare professionals, excluding non-medical personnel such as administrative staff. Descriptive statistics, t-tests, ANOVA, Pearson correlation analysis, and regression analysis were performed using SPSS 25.
Results: （1） The patient safety culture shows a continuous decreasing trend across all dimensions. （2） Gender, age, supervisor (deputy supervisor) status, education level, direct patient contact, and type of employment were significant for patient safety culture before and during the epidemic （3） Resilience was correlated and significant with the other seven dimensions （4） Except for perceived stress , the other seven dimensions significantly impact resilience during both pre-pandemic and pandemic periods. （5） Resilience significantly influenced job satisfaction, perceived stress, managerial support, work conditions, and work-life balance during pre-pandemic and pandemic periods.
CONCLUSION: This study compared the differences in patient safety culture and the correlation between resilience and patient safety culture before and during the epidemic. Demographic factors such as gender, age, supervisor (deputy supervisor) status, education level, direct patient contact, and employment type were found to influence patient safety culture. Patient safety culture was also found to be closely related to resilience, with resilience and patient safety culture having a bidirectional effect. There were also several variables that require special attention in the future, including years of working experience, education, number of incident reports completed and submitted in the past 12 months, job type, and employment type, which were found to be important in the study results. Taken together, the findings emphasize the importance of demographic variables and resilience in patient safety culture and have important implications for the future development of interventions and strategies to enhance patient safety culture and crisis response among healthcare professionals.

論文審定書i
摘要ii
Abstract iii
目錄v
圖次vii
表次viii
第一章、 前言 1
第二章、文獻探討 3
第一節、病人安全文化 3
第二節、病人安全態度量表 4
第三節、疫情對醫護人員之影響 7
第四節、復原力 9
1. 復原力的定義 9
2. 復原力的重要性 9
3. 病人安全文化七構面與復原力之相關性 11
第三章、研究方法 13
第一節、研究架構 13
第二節、研究假設 13
第三節、研究對象 14
第四節、研究工具 14
第五節、統計分析 16
第四章、研究結果 19
第一節、描述性統計 19
一、樣本結構 19
二、八構面在疫情下的趨勢 21
第二節、推論性統計 22
一、獨立樣本 T檢定 23
二、單因子變異數分 析 27
三、人口統計變數之複迴歸分析 43
四、皮爾森相關性分析 63
五、其餘七構面與復原力之複迴歸分析 63
六、復原力與其餘七構面之迴歸分析 64
第五章、討論與建議 66
第一節、研究討論 66
第二節、研究結論 76
第三節、研究限制 78
第四節、研究建議 79
第五節、研究貢獻 80
參考文獻82
附錄一:IRB人體研究計畫同意函 98

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