目標：女性照顧服務員是國内長期照護工作第一線的照護提供者，直接影響照護品質。然 因工作壓力高、負荷重、低社會形象等負向因素，人員招募不易且不易留任，人力長期處於不 足又高流動的狀態。爰此，本研究旨在探討女性照服員工作壓力源對工作適應與離職意願的影 響。方法：本研究為一橫斷性研究，以分層比例抽樣，採結構式問卷，調查450位照服員的工 作壓力源、工作適應及離職意願。我們以多層次線性迴歸和多層次邏輯斯迴歸模型，分別探討 工作壓力源對工作適應及離職意願的影響。結果：多層次線性迴歸分析結果顯示平均月收入、 機構開業年數、機構類型、工作控制、心理負荷及社會支持顯著影響照服員的工作適應；而多 層次邏輯斯迴歸分析結果顯示：婚姻狀況、工作資歷、照顧住民數、社會支持顯著影響照服員 的離職意願。結論：本研究證實工作壓力源會影響照服員的工作適應及離職意願。照服員的工 作適應及離職意願，可能對所照顧對象造成傷害，機構經營管理者不應輕忽此一問題所可能導 致的影響。

Objectives: The aim of this study was to examine the effect of job stressors on work adjustment and intention to leave on female nursing assistants (NAs) in Taiwan’s long-term care facilities. Methods: This was a cross-sectional study using a structured-questionnaire to gather information about job stressors, work adjustment, and background. Data was collected through proportional stratified random sampling of 450 female NAs serving in long-term care facilities over three months. Multi-level linear regression and multi-level logistic regression models were utilized to identify factors associated with work adjustment and intention to leave, respectively. Results: The multi-level linear regression model showed that the significant factors associated with work adjustment included salary per month, type of institution, years of operation, job control, psychological demands, and work-related social support. The multi-level logistic regression model indicated that marital status, length of employment at the current facility, care loads, and work-related social support were significantly associated with NAs’ intention to leave. Conclusions: This study demonstrated that job stressors were the key determinants in female NAs’ work adjustment and intention to leave. NAs’ work adjustment and intention to leave may cause serious medical, social, and financial hardships to residents and their families in long-term care facilities. We suggest potential management strategies to provide assistance to female NAs in order to alleviate work strain.