| ObjectivesThe main purpose of the study was to identify the determinants of worker motivation,to compare variances of various determinants among types of workers and hospitals,and to test associations between working performance,job satisfaction, organizational commitment and worker motivation.MethodsIn-depth individual interview and questionnaire survey were been used in the study.All workers who were authorized by County Health Bureau and still working in Township Hospitals were objective of the study.33 workers collected at random were interviewed.112 individual worker questionnaires were completed effectually.Factor analysis,t-test,one-way ANOVA and Pearson's product-moment correlation were adopted.ResultsThe statistic result of self-assessment of worker motivation showed:49.11 percent of respondents perceived their work motivation as the medium level.19.64 percent of respondents thought that their work motivation was rather good.13.39 percent of respondents believed that they had high work motivation.8.93 percent of respondents perceived their work motivation as the low level.And 8.93 percent of respondents thought their work motivation was very low level.Factor analysis of the determinants of worker motivation in township hospitals indicated:eigenvalues of personality,hospital management,work itself,relationship and social support,work condition and individual development were 8.300,5.251, 4.804,3.645,3.565 and 2.737.Their explained variances were 20.751%,13.128%, 12.009%,9.112%,8.913%and 6.843%.Cumulative explained variance was 70.755%.An analysis of one-way ANOVA conducted on the demographic items revealed that age was the variable that explained the variance in job characteristics(P<0.05). Degree was the variable that explained the variance in hospital management and work itself(P<0.05).Income was the variable that explained the variance in hospital management and individual development(P<0.05).And the hospital with different development situation was variable that explained the variance in hospital management, work itself and work condition.A statistically significant positive relationship was identified for the worker motivation in relation to working performance,job satisfaction and organizational commitment(P<0.05).The scores awarded to interventions to improve worker motivation were in order. The score of offering social insurance for worker(endowment insurance,medical insurance etc.)was 1.536±1.177.The score of increasing income was 1.500±1.301. The score of supplying the hospital with better,more up-to-date equipment was 1.250±1.312.The score of improving workers' welfare was 0.554±0.879.The score of establishing a remuneration system which was more transparent and leaded to a more stable income was 0.411±0.766.The score of improving physical working conditions was 0.357±0.746.The score of increasing opportunities to develop professional skills was 0.250±0.545.The score of assisting staff with transport problems(e.g.operate a bus service for hospital staff)was 0.116±0.419.The score of establishing a system to recognize good work was 0.027±0.162.The score of increasing the verbal recognition which leader gave to good work was 0.000±0.000.ConclusionsBy information collected by in-depth individual interview and statistical analysis of the data of valid questionnaires,the author makes the conclusions.Firstly,most hospital worker perceived their work motivation as the medium level.Secondly, personality,hospital management,work itself,relationship and social support,work condition,individual development and national policy about rural area health services were the main determinants of worker motivation.Thirdly,junior employee preferred individual development than senior employee.Employee with junior college degree paid more attention to hospital management and work itself than employee with technical secondary school.Employee with high salary placed more emphases on individual development than employee with low salary.The hospitals with better development situation attached more attention to health management,work itself and work condition than the hospitals with worse development situation.Fourthly,the correlation between working performance and worker motivation,the correlation between job satisfaction and worker motivation,and the correlation between organizational commitment and worker motivation were all positively significant. Lastly,offering social insurance(endowment insurance,medical insurance etc.), increasing income and supplying the hospital with better,more up-to-date equipment were the three most important interventions to improve the worker motivation.According to the results of this study,some suggestions were offered to administration concerned,township hospital managers,and future researchers.The author suggests that the administration concerned should enforce education of professional ethic of township hospital staff,invest more resources in rural area health service and enforce the training of knowledge and skill of township hospital managers etc.The township hospital managers should work fairly,open more communication channel,improve themselves management skill,and design motivation measures reasonably.In addition,the future researcher should deeply analyze working process and route of determinants.
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