Workplace stress (WS) has been found to affect job satisfaction (JS), performance, and turnover intentions (TIs) in developed countries, but there is little evidence from other countries and especially rural areas. In rural Taiwan, especially, there is an insufficient health care workforce, and the situation is getting worse. To demonstrate the relationship, we used a cross-sectional structured questionnaire, and data from 344 licensed professionals in 1 rural regional hospital were analyzed using the structural equation model. The results showed that WS had a positive effect on both TI and job performance (JP) but a negative effect on satisfaction. JS did improve performance. For the staff with an external locus of control, stress affected JP and satisfaction significantly. For the staff with lower perceived job characteristics, JS affected performance significantly. The strategies to decrease stress relating to work load, role conflict, family factors, and working environment should be focused and implemented urgently to lower the turnover rate of health care workers in rural Taiwan.

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Introduction—Medical emergency vehicles help patients get to the hospital quickly. However, there were more and more ambulance crashes on the road in Taiwan during the last decade. This study investigated the characteristics of medical emergency vehicle crashes in Taiwan from January 2003 to December 2016. Methods—The ordered logit (OL) model, multinominal logit (MNL) model, and partial proportional odds (PPO) model were applied to investigate the relationship between the severity of ambulance crash injuries and its risk factors. Results—We found the various factors have different effects on the overall severity of ambulance crashes, such as ambulance drivers’ characteristics and road and weather conditions. When another car was involved in ambulance crashes, there was a disproportionate effect on the different overall severity, as found by the PPO model. Conclusions—The results showed that male ambulance drivers and car drivers who failed to yield to an ambulance had a higher risk of severe injury from ambulance crashes. Ambulance crashes are an emerging issue and need further policies and public education regarding Taiwan’s ambulance transportation safety.

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