全健保實施之後，各家醫院為降低成本以利營運，護理人員便成為主要降低人事成本的目標，彈性的護理人力使用，已成為醫院人力運用的一大策略，大量使用約聘雇人員，所造成護理人員的工作壓力，是不容忽視之問題。本研究之目的在探討不同身份別護理人員之工作壓力與組織承諾、專業承諾的關係，以提供學術研究及管理實務上之參考。研究之對象，選擇二家署立醫院之臨床護理人員，隨機取400人，有效問卷263份，有效回收率65.75%，以SPSS套裝軟體作統計分析，研究結果，發現不同身份別護理人員之工作壓力沒有顯著之差異（p > 0.05）﹔護理人員的不同身份別對組織承諾及專業承諾沒有影響 （p > 0.05），但是ANOVA的結果約聘雇護理人員的組織承諾及專業承諾皆低於正式護理人員﹔護理人員之工作壓力對於情感性組織承諾及情感性專業承諾有顯著負向之影響（p < 0.01），護理人員之工作壓力對於持續性組織承諾及持續性專業承諾沒有影響（p > 0.05），然而護理人員之工作年資對於組織承諾及專業承諾二者都有顯著正向之影響（p < 0.05）。 此一研究結果，建議醫院管理者協助減少正式職缺與約聘雇護理人員護理人員的工作壓力，在管理之意涵上提供醫院主管改善護理人員之工作品質。 Job Stress, Organizational Commitment and Occupational Commitment of Nursing Staff with Different Work Status After enforcing the entire People’s Medical Treatment Insurance,one of the strategies that health care services providers adopt is lowering the nursing personnel budget by using the contingent nurses.The purpose of this study is to investigate if work status（full time,and contracted） brings differences nurse’s job stress, organizational commitment and occupational commitment. Study sample were selected randomly from a DOH hospital’s clinical nurses.Among 400 questionnaires distributed,263 valid were returned, which led to a 65.75% response rate.Analyzed by SPSS, research data were concluded that there was no significant difference of job stress among nursing with different work status（p > 0.05） there was no significant difference of organizational commitment and occupational commitment among nursing with different work status,but the result of ANOVA show the average means of contracted nurse is low than the full time nurse；the job stress of nursing resulted in a significant negative effect on affective organizational commitment and affective occupational commitment（p < 0.01）; Job stress did not show significant effect on nurses’ continuous organizational commitment, and continuous occupational commitment（p > 0.05）.However, the seniority of nursing had a significant positive effect on both the organizational commitment and occupational commitment（p < 0.05）. The results of this research suggested that management of health care providers should make efforts on reducing job stress of nurse with both kind of job status. Management implications were provided at the end for hospital to improved the quality of work life of nursing staff.
