背景：職場霸凌是職場暴力類型之一，長期會造成護理人員嚴重心理及生理負荷，台灣過去多數以大型醫療機構為主，較少針對地區醫院及長照機構深入探討。因此，其職場危害風險可能被忽略或低估，此議題是需要被關注的。

目的：本研究主要目的是應用工作要求-資源模式探討地區醫院護理人員醫療職場遭受同事霸凌之影響因素，提供未來醫療職場健康管理政策參考。

方法：以立意選取北部某地區醫院全體護理人員為研究對象，總計100位。採自填式問卷，施測期間為2019年9-11月，回收問卷共85份，扣除一份無效問卷，共84份有效問卷(有效回收率84%)。資料採用描述性統計、卡方檢定、獨立樣本t檢定及羅吉斯迴歸分析。

結果：研究發現地區醫院臨床護理人員過去六個月內曾發生院內同事霸凌至少每月一次以上為16.7%。控制人口學因素後，羅吉斯迴歸分析結果發現遭受院內霸凌者的工作要求顯著高於未遭受霸凌者 (OR=14.826; 95% CI= 2.254-97.516); 相對的，遭受院內霸凌者的預防霸凌工作資源顯著低於未遭受霸凌者 (OR=0.060; 95% CI =0.008-0.476)。

結論:地區醫院護理人員院內工作要求越高、預防霸凌工作資源越低，發生霸凌風險越高。為了降低院內職場霸凌、提升工作品質，建議醫院主管可強化院內預防霸凌工作資源投入，調整護理人員工作方式以降低其工作要求。

Background: Workplace bullying is a type of workplace violence that can cause long-term psychological and physical strain on the nursing staff. In the past, most of the workplace violence in Taiwan has been focused on large medical institutions, such as regional or medical center, and less on district hospitals or long-term care institutions. Therefore, the risk of workplace harm may be ignored or underestimated, and this issue should be addressed.

Purposes: The main purpose of this study is to apply the job demands-resources model (JD-R) to examine the factors influencing the district hospital workplace bullying of nursing staff for reference of future medical workplace health management policies. Methods: A total of 100 nursing staff from a district hospital in the Northern Taiwan were purposively selected the study. A self-administered questionnaire was administered from September to November 2019. 85 questionnaires were collected, and after excluding one invalid questionnaire, a total of 84 questionnaires were completed (84% response rate). Data were analyzed using descriptive statistics, chi-square, t-test and logistic regression analysis.

Results: The study found that 16.7% of clinical nursing staff in a district hospital had experienced in-hospital bullying by colleagues at least once a month or more in the past six months. After controlling demographic variables, the logistic regression analysis found that those who experienced in-hospital bullying had significantly higher job demands than those who had not experienced bullying (OR=14.826; 95% CI= 2.254-97.516). However, those who experienced in-hospital bullying had significantly lower job resources for bullying prevention than those who were not bullied (OR=0.060; 95% CI =0.008-0.476).

Conclusions: Nursing staff in district hospitals with higher job demands and lower bullying prevention resources have a higher risk of bullying. To reduce workplace bullying and improve work the quality of work, it is proposed that hospital supervisors should strengthen the resources for bullying prevention in the hospital and adjust the work practices of nursing staff to reduce their job demands.