【作者】 张会；

【导师】 王珩；

【作者基本信息】 安徽医科大学 ， 公共卫生与预防医学， 2017， 硕士

【摘要】 目的评估县级公立医院护士工作授能和离职意愿现状;分析影响县级公立医院护士工作授能和离职意愿的因素;探究县级公立医院护士工作授能和离职意愿的相关性;为临床护理管理者制定管理策略和工作规划提供科学理论依据。方法采用描述性研究中的横断面调查方法,依据地域和经济水平差异,在皖南、皖中、皖北各随机抽取4家共12家县级公立医院作为样本医院,将样本医院中的临床护士作为研究对象,进行问卷调查。调查问卷的内容主要包括:(1)一般人口学资料:性别、年龄、婚姻状况、教育程度、所在科室、职称、工作年限、工资水平等;(2)工作效能条件量表:包括机会、信息、支持、资源、正式和非正式授能6个维度;(3)离职意愿量表:包括是否考虑辞去目前的工作、是否想要寻找其他相同性质的工作、是否想要寻找其他不同性质的工作等6个条目。采用Epidata3.1进行数据双人双录入,采用SPSS 20.0软件进行统计学分析。计数资料采用例和百分数表示,计量资料符合正态分布采用均数±标准差表示。不同临床特征护士工作授能和离职意愿的比较采用单因素方差分析或成组t检验进行比较。采用Pearson相关分析法分析临床护士工作授能与离职意愿的相关性。采用Logistic回归分析法进行工作授能和离职意愿的影响因素分析。结果1.715名县级公立医院临床护士的工作授能得分为(15.08±3.83)分,其中工作授能6个维度得分由高到低依次为:非正式权力(2.71±0.84)分、机会维度(2.61±0.77)分、支持维度(2.59±0.88)分、资源维度(2.44±0.81)分、信息维度(2.40±0.86)分、正式权力维度(2.33±0.74)分。2.715名县级公立医院临床护士的离职意愿平均分为(10.53±3.23)分,离职意愿Ⅰ即表示辞去目前工作的可能性得分为(3.66±1.36)分;离职意愿Ⅱ即表示寻找其他工作动机的得分为(3.40±1.33)分;离职意愿Ⅲ即表示获得外部工作的可能性得分为(3.47±1.15)分。3.单因素分析结果显示,年龄31-35岁、婚姻状况为已婚和其它、学历本科及以上、职称为主管护师及以上、工作职务为责任组长、科室为其它、工作年限16-20年、月收入≥4001元的护士工作授能水平较高,不同地区、性别、劳动关系的护士工作授能无明显差别。多因素分析结果显示:科室、教育程度、工作年限、月收入和年龄是影响县级医院临床护士工作授能的因素。4.单因素分析结果显示,年龄≤25岁、未婚、中专及以下学历、职称为护士、工作职务为一般护士、工作年限1-5年、劳动关系为合同护士、月收入≤2000元的临床护士离职意愿较高,不同地区、性别和科室的临床护士离职意愿无差别。多元Logistic回归分析结果显示:年龄、婚姻状况、教育程度、职称、劳动关系、月收入是影响县级医院临床护士离职意愿的因素。5.临床护士工作授能总分、机会、信息、支持、资源,正式权力和非正式权力维度得分与离职意愿总分呈负相关,其r值分别为r=-0.184(P<0.001)、r=0.143(P<0.001)、r=-0.171(P<0.001)、r=-0.145(P<0.001)、r=-0.119(P<0.001)、r=-0.136(P<0.001)、r=-0.144(P<0.001)。结论1.县级医院临床护士工作授能处于中等水平,离职意愿较低。2.科室、教育程度、工作年限、月收入和年龄是影响县级医院临床护士工作授能的因素;年龄、婚姻状况、教育程度、职称、劳动关系、月收入是影响县级医院临床护士离职意愿的因素。3.临床护士工作授能与离职意愿呈现负相关,工作授能水平越高,离职意愿水平越低。更多还原

【Abstract】 Objective This research is 1)to assess the status quo of work empowerment and turnover intention among nurses in county-level public hospitals,2)to analyze the factors that affect the work empowerment and turnover intention of nurses at county-level public hospitals,3)to explore the correlation between the work empowerment and turnover intention of nurses at county-level public hospitals,4)to provide scientific and theoretical basis for clinical nursing managers to formulate management strategies and work plans.Methods A cross-sectional investigation method was carried out.According to the difference between location and economic level,we randomly choose clinical nurses from 12 County Public Hospital in southern、middle and northern Anhui province as the samples to fill out questionnaires.The content of the questionnaire mainly includes: 1)demographic data: sex,age,marital status,education level,Department,title,working years,salary level,etc.2)Work Effectiveness Scale: including opportunities,information,support,resources,formal and informal empowerment;3)Turnover intention scale: including whether to consider the resignation of the current work,whether want to find other similar work,whether to find another not similar work.The software of Epi Data 3.1 was used for data entry and SPSS 20.0 software for statistical analysis.The categorical data were expressed as the number of cases and the percentage,and the measurement data conformed to the normal distribution and were expressed as the mean±standard deviation.Comparison of work empowerment and turnover intention among nurses with different clinical characteristics was made by one-way ANOVA or group t test.Pearson correlation analysis was applied to analyze the correlation between work empowerment and turnover intention of clinical nurses.Logistic regression analysis was used to analyze the influencing factors of work empowerment and turnover intention.Results 1.The score of the work empowerment of the 715 clinical nurses in the county-level public hospitals was(15.08±3.83),among which the score of six dimensions from high to low were: the informal power(2.71±0.84),the chance(2.61±0.77),support dimension(2.59±0.88),resource dimension(2.44±0.81),information dimension(2.40±0.86)and formal power dimension(2.33±0.74).2.Average turnover intention scores of 715 clinical nurses was(10.53±3.23)points,turnover intention I-the possibility of resigning from current job gets(3.66±1.36)points,turnover intention II-finding another job score(3.40±1.33),turnover intention III-the possibility of obtaining external work gets(3.47±1.15)points.3.Univariate analysis showed that the nurses who were 31-35 years,married and others,undergraduate degree and above,nurse-in-charge and above,head nurse of responsibility,from the other department,16-20 years of working,and monthly income ≥ 4001 yuan had a higher level of work empowerment.There was no difference of work empowerment between regions,gender and labor.The results of multivariate analysis showed that the department,education level,working life,monthly income and age were the factors influencing the work empowerment of clinical nurses in county-level public hospitals.4.Univariate analysis showed that turnover intention was high in nurses who were the age of ≤ 25 years old,unmarried,secondary and the following qualifications,the title for the nurses,job duties for the general nurses,working years 1-5 years,the labor relationship for the contract nurses,monthly income ≤ 2000 yuan.There had no difference in the willingness to leave the clinical nurses in different regions,sexes and departments.Multivariate logistic regression analysis showed that age,marital status,educational level,title,labor relationship and monthly income were the factors influencing the turnover intention of clinical nurses at county level hospitals.5.Work empowerment scores,opportunities,information,resources and support scores,formal and informal power score were negatively related with nurse turnover intention score(r=-0.183,-0.143,-0.171,-0.145,-0.119,-0.136,-0.144,P<0.001).Conclusion 1.Work empowerment of nurses work in county-level public hospitals are at a moderate level,and turnover intention is at a low level.2.Department,educational level,years of working,monthly income and age are the influencing factors of work empowerment among nurses work in county-level public hospitals.Age,marriage,education,professional title,labor relations and monthly income are the influencing factors of turnover intention among nurses work in county-level public hospitals.3.There is a negative correlation between work empowerment and turnover intention among nurses work in county-level public hospitals.更多还原