探討長期照護的照顧服務員工作倦怠與失志現象

背景：隨著醫療進步與高齡化、少子化及家庭結構的改變，台灣對長期照顧服務的需求持續增加。照顧服務員作為第一線人力，承擔了繁重的身心壓力與工作負荷。長期高壓環境容易導致倦怠，甚至出現失志現象，進而影響留任意願與照護品質。然而，目前國內針對照服員「失志現象」的相關研究仍有限。目的：探討照顧服務員的工作倦怠與失志狀態，並分析其相關影響因素，以提供未來改善照服員職場支持與心理健康政策之參考。研究方法：採橫斷式研究設計，以彰化縣市181位照顧服務員為研究對象，並使用中文版失志量表與中文版職場倦怠量表進行資料收集。所得資料透過 SPSS 29 版進行統計分析，分析方法包含描述性統計、獨立樣本 t 檢定以及單因子變異數分析（ANOVA）。研究結果：照顧服務員的整體工作倦怠程度達中度以上，而失志程度則偏低。在各構面中，情緒耗竭與失去意義感的平均分數相對較高。進一步分析發現，年齡、婚姻、教育程度、薪資及機構類型等屬性在工作倦怠與失志上均呈現顯著差異，其中年輕、分居或喪偶、高學歷、低薪及任職於住宿式照護機構的照顧服務員，其工作倦怠與失志得分顯著高於其他族群。相關分析亦顯示，工作倦怠與失志之間存在高度正相關，特別在情緒耗竭與失去意義感構面上，兩者關聯最為密切。結論與建議：應高度重視照顧服務員的心理健康與工作支持，並透過營造友善的職場環境以減少壓力來源，進而提升其工作滿意度。同時，政策面可著重於強化專業培訓、休假制度、薪資福利以及情緒支持等資源，以增進照服員的留任意願，並提升整體照護品質。

Background: The growing demand for long-term care services in Taiwan has been driven by advances in medical care, population aging, declining birth rates, and evolving family structures. As the primary frontline workforce, care attendants face substantial physical and psychological burdens, along with heavy workloads. Prolonged exposure to such high-stress environments may lead to burnout and demoralization, ultimately compromising both job retention and the quality of care. Nevertheless, empirical research examining demoralization among care attendants in Taiwan remains scarce.Purpose: This study aims to examine the prevalence of work burnout and demoralization among care attendants and to identify the associated influencing factors, with the goal of providing empirical evidence to guide future strategies for improving workplace support systems and mental health policies in long-term care settings.Methods: This study adopted a cross-sectional research design and recruited 181 care attendants from long-term care institutions in Changhua County, Taiwan. Data were collected using the validated Chinese versions of the Demoralization Scale and the Copenhagen Burnout Inventory. Statistical analyses were performed using SPSS version 29, including descriptive statistics, independent-sample t-tests, and one-way analysis of variance (ANOVA) to examine differences across demographic and work-related variables.Results: The findings revealed that care attendants experienced moderate-to-high levels of work burnout, whereas demoralization remained relatively low. Among the measured dimensions, emotional exhaustion and loss of meaning scored the highest. Further analyses indicated significant differences in both burnout and demoralization across age, marital status, educational attainment, salary level, and type of care institution. Specifically, younger attendants, those who were separated or widowed, individuals with higher educational levels, lower salaries, and those employed in residential care facilities reported significantly higher levels of burnout and demoralization compared to their counterparts. Correlation analysis further demonstrated a strong positive association between burnout and demoralization, particularly within the domains of emotional exhaustion and loss of meaning.Conclusions and Recommendations: Greater attention should be directed toward the mental health and workplace support of care attendants. Creating a supportive and friendly work environment is essential for reducing stressors and improving job satisfaction. At the policy level, emphasis should be placed on strengthening professional training, implementing adequate leave systems, improving salaries and benefits, and providing emotional support resources. These strategies may enhance workforce retention and ultimately improve the overall quality of long-term care services.