在醫療產業中，建構完善的安全環境是對組織人員與病人安全來說是重要的議題。本研究在於將對醫療從業人員在工作場所中感知到的安全氣候、專業承諾、任務科技適配、行為表現的影響關係，並加入自尊為調節變項與知識創新應用為中介變項深入探討是否讓醫護人員的工作表現、安全行為與通報意願有所提升。在研究方法部分，本研究以方便抽樣方式進行問卷調查，研究對象為能使用病人安全通報系統的臨床專業醫療人員，包含醫師、醫技與護理人員，依部門或科別進行抽樣規劃；研究實際發放770份問卷，回收690份，回收率為89%，以SPSS 18.0為統計檢測工具與階層迴歸模式進行假說檢定。於研究結果發現，(1)醫療人員的安全氣候感知、專業承諾與任務科技適配對與行為表現中的通報意願有顯著影響；專業承諾與任務科技適配會影響知識創新應用，而知識創新應用會影響通報意願。(2)醫療人員的自尊對安全氣候感知及行為表現中的通報意願與醫療人員的自尊對專業承諾及行為表現中的通報意願有調節效果。(3)知識創新應用對專業承諾、任務科技適配與行為表現中的通報意願皆有中介效果。由此結果可知，本研究結果符合實務上的應用，員工在良好的安全氣候感知下、提升個人的專業承諾及強化資訊科技的熟悉度是能有效影像行為表現的結果。另外，藉由自尊的調節與員工樂於分享知識及經驗也提升了個人行為表現的結果。最後，管理者能藉由教育訓練、流程再造及經驗分享等方式，來提升醫療品質與促進員工的熱誠，將組織、員工與病人之間的醫療照護緊密結合，以達到以病人為中心的目的。

In the medical industry, the security climate perception affects not only the safety of medical staff , but also affect patient safety. Therefore, this study objective explores patient safety climate perceptions, professional commitment, task-technology fit affect the outcome of medical staff, and to explore the study add a moderator variable of self-esteem , and a mediated variable of knowledge innovation, whether the outcome and reporting of medical-professional has improved. In the research methods part, the study use questionnaires convenience sampling method, the subjects were able to use clinical medical staff of patient safety reporting system, comprising physicians, medical technicians and nurses, according departments or divisions to the sampling plan. The study actually paid 770 questionnaires, recycling 690 questionnaires, recovery was 89%. With SPSS18.0 statistical tools to detect and hierarchical regression model hypothesis test . It was found in the study: (1) Medical personnel safety climate perceptions, professional commitment and task-technology fit have significant impact on the outcome of the reporting; Professional Commitment and task-technology fit will affect the knowledge innovation , and the knowledge innovation can affect the reporting; (2) Self-esteem of medical personnel to the security climate perceptions and outcome of the behavior work, and self-esteem of medical personnel to the professional commitment and outcome of the reporting have effect of moderator; (3) Knowledge innovation to the professional commitment, task-technology fit, and outcome of the reporting all have effect of mediated . From this result, the results of the study in line with the practice of application, staff under good safety climate perception, enhance their professional commitment and strengthen familiarity with information technology is effective in imaging outcome. In addition, by moderator of self-esteem and staff willing to share knowledge and experience but also enhance the result of individual outcome. Finally, managers can be education and training, process reengineering and experience sharing and other ways to improve the quality of care and the promotion of staff to the enthusiasm, will be closely integrated health care organization, staff and patients in order to achieve the purpose of patient-centered.

論文審定書 i
誌 謝 ii
中 文 摘 要 iii
Abstract iv
目 錄 vi
圖 次 ix
表 次 x
第一章、緒論 1
第一節、研究背景及動機 1
第二節、研究目的與問題 6
第二章 文獻回顧 7
第一節 安全氣候感知 7
第二節 專業承諾 10
第三節 任務科技適配 12
第四節 自尊 14
第五節 知識創新應用 16
第六節 行為表現 20
第七節 各構面之間的關聯性與假設 30
第九節、研究架構 37
第三章 研究方法 38
第一節 研究對象與資料蒐集 38
第二節、研究變項之操作型定義與測量工具 41
第三節、資料分析方法 45
第四章、研究分析與結果 48
第一節、描述性統計 48
第三節 單因子變異數分析 52
第四節、推論性統計 53
第五章、結論與建議 79
第一節、醫護人員病人安全氣候感知、專業承諾、任務科技適配與 80
行為表現之影響 80
第二節 醫護人員病人安全氣候感知、專業承諾、任務科技適配與 83
行為表現之知識創新應用中介影響 83
第三節 醫護人員病人安全氣候感知、專業承諾、任務科技適配與 85
行為表現之自尊調節影響 85
第四節、研究建議 87
第五節、研究限制 88
參考文獻 89
附錄-醫院安全相關實務與工作狀況 問卷 105

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