新农合实行后护生到乡镇卫生院就业意向及影响因素分析

Job-hunting Intentions to Town-ship Hospitals of Nursing Graduates with Different Educational Background after Implementation of New-type Rural Cooperative Medical System and Its Influence Factors

目的分析新农合实行后护理毕业生到乡镇卫生院就业意向的影响因素,为学校择业观教育及管理部门决策提供理论依据。方法以某校护理学院中专、高职、大专、本科的701名2014年毕业生为调查对象,自行设计问卷,采用分层抽样的方法,对每个学历层次大约选取60%的实习生,再以班为单位发放问卷,进行多因素Logistic回归分析以寻找护理毕业生到乡镇卫生院就意向的影响因素。结果愿意到乡镇卫生院就业护生仅占总人数的25.8%;多因素分析结果显示:本科护生相对于中专护生更不愿意去乡镇卫生院(P=0.001);对于医院所在地环境和医院等级规模不太重视的护生更倾向于去乡镇卫生院就业(P=0.027或0.001);对乡镇经济发展状况了解程度越低的护生越不愿意去乡镇卫生院就业(P=0.001);对乡镇卫生院护士经济收入不清楚的护生更倾向于到乡镇卫生院就业(P=0.006);对新农合给乡镇卫生院带来的作用持否定态度和"不清楚"的护生更不愿意去乡镇卫生院就业(P=0.014或0.002)。结论各层次护理毕业生到乡镇卫生院工作的意向性较低,主要受学历层次高低、对乡镇卫生院护士经济收益的了解程度、认为新农合政策有无促进乡镇卫生院发展等因素影响,学校方面在培养基层医疗卫生服务人才时,须加强护生对乡镇卫生院的认知教育,进行理性的择业引导。

Objective To explore the influence factors of working in town-ship hospitals of nursing graduates with different educational background and to provide a theoretical guidance for nursing education and management policy. Methods A self-designed questionnaire was applied in the investigation covering 701 nursing graduates with different education background in Sichuan Medical University. Results Students lacked enthusiasm of working in town-ship hospitals generally and only 25.8% of the nursing graduates had intention to work in town-ship hospitals when hunting jobs, which was mainly related to educational background, hospital scale, economic development, living environment and the comprehension of New-type Rural Cooperative Medical System. Conclusion Nursing students in spite of their educational background present low enthusiasm of working in town-ship hospitals. More chances to know about town-ship hospitals and New-type Rural Cooperative Medical System and appropriate career guidance are needed.