近年來，安靜離職逐漸成為組織管理與人力資源研究的重要議題。相較於實際離職，安靜離職係指員工在維持聘僱關係的情況下，將工作努力限制於正式職責與基本要求範圍內，並減少主動參與、額外付出及自由裁量努力。醫療機構具有高工作負荷、高情緒性要求及高度專業化等特性，即使組織呈現較低的實際離職率，亦可能存在員工持續留任但逐漸降低額外工作投入的隱性人力風險。因此，本研究以擴充後之工作要求－工作資源模型為理論基礎，探討工作要求、個人要求、工作資源及個人資源對職業倦怠、工作投入與安靜離職行為傾向之影響，並檢驗職業倦怠與工作投入之中介及序列中介效果，以及不同人口背景員工在各研究構面上的差異情形。
本研究採橫斷式量化研究設計，以臺灣南部某大型區域教學醫院之正式員工為研究對象，透過線上結構式問卷及便利取樣方式蒐集資料，共取得390份有效問卷。研究資料採用IBM SPSS Statistics 21.0及IBM SPSS Amos 23.0進行分析，統計方法包括描述性統計、相關分析、信度分析、驗證性因素分析、結構方程模型、Bootstrap中介效果檢定、獨立樣本t檢定及單因子變異數分析。其中，中介效果採用5,000次Bootstrap重抽樣，並以偏差校正95%信賴區間作為顯著性判定依據。
研究結果顯示，受試者之安靜離職行為傾向平均值為2.76，標準差為0.762，低於五點量表中間值，顯示整體樣本尚未呈現普遍且高度的安靜離職現象。然而，第75百分位數為3.33，表示樣本中有部分受試者呈現相對較高程度的安靜離職行為傾向，顯示低實際離職率並不必然代表員工均維持高度投入與額外付出。
結構模型分析結果顯示，工作要求與個人要求對職業倦怠呈顯著正向影響；工作資源與個人資源對職業倦怠呈顯著負向影響，並對工作投入呈顯著正向影響。職業倦怠對工作投入具有顯著負向影響，且對安靜離職具有顯著正向影響，顯示職業倦怠是推動安靜離職行為傾向的重要心理機制。工作要求對工作投入之影響未達顯著水準；個人要求對工作投入及工作投入對安靜離職之影響雖達顯著水準，但其方向均與原研究假設相反，因此相關假設未獲支持。
中介效果分析顯示，職業倦怠在工作要求、個人要求、工作資源及個人資源與安靜離職之間均具有顯著中介效果。其中，工作要求與個人要求對安靜離職之總間接效果達顯著水準，顯示要求因素主要透過提高職業倦怠而增加安靜離職行為傾向。工作資源與個人資源則可透過降低職業倦怠發揮保護作用，但其總間接效果因不同中介路徑方向相互抵銷而未達顯著水準。工作投入的個別中介效果及職業倦怠與工作投入所形成之序列中介效果，未呈現原先預期之降低安靜離職作用，故相關中介假設未獲支持。此結果顯示，工作投入與安靜離職之間可能存在較為複雜的條件性關係或競爭性作用機制。
人口背景差異分析結果顯示，安靜離職行為傾向會因出生世代、婚姻狀況、有無子女、教育程度、服務年資、職類及職務層級不同而呈現顯著差異；各群體間的差異主要集中於個人資源、職業倦怠及安靜離職等構面，反映不同生命階段、職涯階段、工作性質與職務層級之員工，具有不同的心理資源與工作耗損特徵。
本研究結果部分支持工作要求－工作資源模型，其中，以職業倦怠為核心之健康耗損歷程獲得較一致的實證支持，而工作投入在安靜離職形成歷程中的作用則較為複雜。研究結果建議醫療機構除持續關注實際離職率外，亦應將職業倦怠、工作－生活干擾、工作投入及安靜離職行為傾向納入人力風險監測，並透過合理配置工作量、降低不必要之情緒耗損、強化主管與同事支持、提升工作自主性及專業發展機會，以預防員工資源持續耗損，降低安靜離職所形成之隱性人力風險。

Quiet quitting has emerged as a significant concern in organizational management, particularly in healthcare settings characterized by heavy workloads, emotional demands, and professional specialization. Drawing on an extended Job Demands–Resources model, this study examined how job demands, personal demands, job resources, and personal resources influence occupational burnout, work engagement, and quiet quitting behavioral tendencies. It also tested the mediating and sequential mediating roles of occupational burnout and work engagement and examined demographic differences in the study variables.
A cross-sectional survey was conducted among 390 full-time employees of a large regional teaching hospital in southern Taiwan. Data were analyzed using descriptive statistics, confirmatory factor analysis, structural equation modeling, bootstrap mediation analysis, independent-samples t tests, and one-way analysis of variance.
The mean score for quiet quitting behavioral tendencies was 2.76 (SD = 0.762), below the midpoint of the five-point scale; however, approximately one quarter of participants reported relatively high levels. Job demands and personal demands were positively associated with occupational burnout, whereas job resources and personal resources were negatively associated with burnout and positively associated with work engagement. Occupational burnout was negatively associated with work engagement and positively associated with quiet quitting. The effects of personal demands on work engagement and of work engagement on quiet quitting were significant but opposite to the hypothesized directions. Occupational burnout significantly mediated the relationships between all four antecedent variables and quiet quitting, whereas the hypothesized mediating role of work engagement and the sequential mediation involving burnout and work engagement were not supported. Quiet quitting also differed across several demographic and occupational groups.
Overall, the findings provide partial support for the Job Demands–Resources model and identify occupational burnout as the most consistent psychological mechanism underlying quiet quitting. Healthcare organizations should therefore monitor burnout and quiet quitting alongside actual turnover and strengthen workload management, social support, autonomy, and professional development to reduce hidden workforce risks.

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