乡镇卫生院护理人员工作现状及离职意愿研究

The current situation of nursing staff and their turnover in township health centers

目的:描述乡镇卫生院护理人员工作现状和离职意愿,并分析工作量和工作内容对离职意愿的影响,为改善基层护理工作提出建议。方法:采用多阶段分层整群随机抽样,对我国三个省45家乡镇卫生院的167名护理人员进行问卷调查,并深度访谈44名护理人员。结果:深化医改以来,农村基层护理人员工作量增加,62%认为自己的工作量大。护理工作占护理人员平均工作时间的60%;公共卫生服务工作占平均工作时间的21%。30%的被调查者具有离职意愿。在控制省份、工作量、婚姻状况、编制、文化程度和从医年限等混杂因素后,公共卫生服务参与情况与护理人员离职意愿显著相关(P<0.05)。结论:医改后乡镇卫生院护理人员工作内容扩展、工作量增加,工作内容的扩展降低了护理人员的离职意愿。

Objective： To describe the current situation in the nursing practice and their turnover intention in township health centers,and to analyze the changing potential influence in the nursing practice scope and workloads on their intention to leave those health centers. Methods： By means of a questionnaire,we conducted a survey on 167 nurses and interviewed 44 of them,all from 45 township hospitals within three provinces in China. Results： Since the healthcare system reform,the nursing workload in the township health centers significantly increased. 62% of the respondents considered their workload as heavy. Typically,the nursing work accounted for about 60% and the public health service work accounted for only 21% of the working hours. About 30% of the respondents were intended to leave their current job. The participating public health service was associated with intention to leave the job after controlling the province,workload,marital status,formal position,educational level and length of nursing service（ P〈0. 05）. Conclusions： Since the healthcare system reform,the nursing practice scope in township health centers has been expanded and the workload increased considerably. But so far,expanding the scope of the nursing work may have potentials in reducing the intention of nurses to leave their current positions.