研究背景
護理人力短缺問題在世界各地普遍存在，隨著COVID-19疫情的爆發，全球醫療體系面臨前所未有的挑戰，護理人力的短缺問題尤為嚴峻。台灣現有的護理執業人力約為18.9萬人，預計到2030年需增至 24.1 萬至 26 萬人，意味著未來幾年內台灣亟需有效策略來增加護理人力。研究顯示，磁吸醫院因建構優質的護理工作環境，有效緩解人力短缺問題，本研究以磁吸醫院暨延展要素分析台灣護理人員對臨床工作環境的感受，探討其對留任意願的影響，期能發掘出有效的留任策略，提升護理人員的留任意願。
研究目的
本研究旨在透過發展護理人員臨床工作現況及留任意願調查問卷，了解在職護理人員臨床工作現況與其環境的各項因素如何影響護理人員的留任意願，並預測影響護理人員留任的主要因素。
研究方法
本研究採用橫斷式研究設計，依據磁吸醫院要素及相關文獻進行設計，自擬「臨床工作現況與留任意願量表」，問卷涵蓋個人基本屬性、留任意願及臨床工作現況等三大部分。資料收集採網路問卷進行，並採用多階段分層隨機抽樣，邀請執業登記於衛生福利部之立案急性醫療機構之護理人員線上填寫問卷。研究資料以SPSS 29.0、JASP進行資料分析，使用探索性、驗證性因素分析、獨立樣本t檢定、單因子變異數分析、卡方檢定、皮爾森相關分析、線性迴歸分析等進行統計分析。
研究結果
本研究共發放1,280份問卷，回收1,015份有效問卷（回收率79.3%），受試者平均年齡34.5歲，絕大多數為女性（93.3%），未婚（57.3%），且76.5%擁有大學及以上學歷。經專家效度、探索性及驗證性因素分析與內部一致性檢定後，自擬的「臨床工作現況量表」共萃取出四個構面：高品質的護理、護理領導力、薪酬與支持性工作環境、以及職場暴力與負荷。結果顯示，四個層面皆與留任意願呈顯著正相關，顯示當護理人員在各面向如有獲得足夠的滿足，其留任意願越高，而在這四個構面中，「職場暴力與負荷」的得分最高（反向計分，3.80±0.78），反映出護理人員普遍認為職場暴力事件較少且負荷適中；「薪酬與支持性工作環境」的得分最低（3.09±0.73），顯示現有的薪資制度及工作環境未達受試者期望。此外，迴歸分析發現，護理領導力、薪酬與支持性工作環境及職場暴力與負荷對留任意願具有顯著正向影響，意即當護理管理與工作支持感受提升時，護理人員的留任傾向也相應增強；反之，當護理人員少受到職場暴力與負荷能夠促進護理人員留任。
研究結論
本研究所發展之「臨床工作現況量表」具備良好信效度，適用於評估護理人員於臨床工作中的感受與經驗。研究結果顯示，臨床工作現況的四個構面皆與護理人員的留任意願呈顯著正相關，而在迴歸分析中，「護理領導力」、「薪酬與支持性工作環境」、「職場暴力與負荷」、「服務單位」及「平均工作時數」為影響留任意願的主要預測因子，其中以護理領導力與薪酬與支持性工作環境最具影響力。值得注意的是，「高品質的護理」雖為護理人員所重視，但對留任意願之預測並不顯著，顯示護理人員的留任意願更受薪資、工作條件與主管支持的影響。雖然護理人員的年齡、婚姻狀況、年資、年所得等個人屬性與留任意願存在相關性，然其解釋力在納入迴歸模型後明顯下降，顯示留任意願為多因素交互影響之結果。整體而言，護理人員的留任意願平均得分為3.18（±0.88），顯示其對留任的態度介於「有時」至「經常」之間。約20%的護理人員留任意願較低，經常評估現職的可能性，反映出臨床人力穩定性之隱憂。若臨床工作環境未獲改善，恐進一步降低留任意願，導致人力流失加劇。本研究結果為護理人力規劃與政策制定提供實證依據，對提升護理人員留任具有重要參考價值。

This study aimed to examine the relationship between the clinical work environment and nurses’ retention intention in Taiwan through a reliable and validate self-developed questionnaire based on the Magnet hospital model. A cross-sectional design with multistage stratified random sampling was used to collect data from 1,015 nurses in acute care hospitals. The questionnaire composed 3 sections, demographic characteristics, retention intention, and clinical work environment. Data analysis was conducted using SPSS 29.0 and JASP, applying EFA, CFA, t-tests, ANOVA, chi-square tests, Pearson correlation, and linear regression. The clinical work environment scale was classified into four factors, quality nursing care, nursing leadership, compensation and supportive work environment, and workplace violence and workload and all dimensions showed significant positive correlations with retention intention. Among these, workplace violence and workload had the highest mean score (reverse-coded, 3.80±0.78), indicating nurses perceived relatively low exposure to violence and manageable workloads, while compensation and supportive work environment had the lowest score (3.09±0.73), reflecting dissatisfaction with current salary and support systems. The average retention score was 3.18 (±0.88), with approximately 20% of nurses frequently considering leaving their positions, raising concerns about workforce stability. Regression results revealed that nursing leadership, compensation and supportive environment, and lower workplace violence significantly predicted higher retention intention. The findings provide empirical evidence for improving nurse retention strategies and workforce planning in Taiwan. The developed scale demonstrated good validity and reliability and can serve as a reference for clinical nursing workforce assessment.

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