在台灣，護理人員的高流動率導致人力缺口，不論是社會環境對醫療的不確定性、醫療工作的高危險性、還是健保制度造成醫療院所訴求低成本高品質化，另外還有輪班及評鑑制度的壓力等，直接或間接地影響台灣護理生態，呈現護理人力短缺、離職率高、且不從事護理工作者，逐漸有增加的趨勢。本研究欲深入著墨護理人員本身的專業承諾與對醫療院所的組織承諾間的相互關係，藉此討論組織承諾、專業承諾是否影響離職及離業傾向，又其組織承諾、專業承諾是否扮演著干擾的角色。 本研究採用橫斷式研究設計，以便利抽樣及使用紙本問卷及電子問卷蒐集研究資料，抽樣對象分佈於公立醫院與私立醫院各式不同的組織層級及職務類別和部門別，有效樣本共423份。將有效問卷應用SPSS軟體進行描述性統計、因素分析及信度分析、皮爾森相關分析、共線性問題檢定及線性迴歸分析方法，針對本研究提出之假設模式進行驗證分析。 結果：（1）護理人員組織承諾對離職傾向有負向影響（2）護理人員的專業認同、專業忠誠、轉業風險構面增強了組織承諾對離職傾向的負向效果（3）護理人員的專業承諾－專業認同、專業忠誠構面對離業傾向具有負向影響（4）護理人員的組織承諾增強了專業忠誠、轉業風險對離業傾向的負向效果。 本研究結果可供醫療院所的管理者了解護理人員離職之關鍵因子的影響，並依據研究結果提供醫療機構管理方法上的建議，以降低護理人員的流失，提升護理品質及護理專業承諾。 ;High turnover rate in nursing staff leads to the nursing workforce insufficiency in Taiwan. It directly or indirectly affected nursing ecology that the uncertainty of social environment, high diseases infection rates in medical environment, the budgetary constraints caused by National Health Insurance (NHI) implementation and pressure of working in shifts and hospital accreditation end in nursing workforce shortage, high turnover rate and low recruitment. This study investigated if the correlation between professional commitment and organizational commitment has effect on intention to leave organization/profession and further examined the moderating effect of professional commitment and organizational commitment. We adapt a cross-sectional research design with accidental sampling. The survey conducting in divergent positions and divisions among public and private hospitals in Taiwan, the data was collected from both paper and electronic questionnaires and participants were all nurses. A total of 423 valid questionnaires were received, using SPSS software for data analysis comprising descriptive statistics, factor and reliability analysis, Pearson correlation tests, analysis of covariance , linear regression analysis and the proposed model test. Our findings revealed that (1) organizational commitment has a negative effect on intention to leave organization (2) professional identity, professional loyalty and risk of leave profession strengthen the negative relationship between organizational commitment and intention to leave organization (3) professional identity and professional loyalty has a negative effect on intention to leave profession (4) organizational commitment strengthen the negative relationship between professional loyalty, risk of leave profession and intention to leave profession. The findings of this study provide hospital administrators with the insight of the key factors of nurse turnover. There are some implementations providing in this study for nursing administrators to decrease nurses’ turnover intention, to improve the quality of nursing workplace and to increase nurses’ professional commitment.
