工作场所社会资本与护士留职意愿的结构方程模型分析

Workplace social capital and intention to stay among Chinese nurses：a structural equation model

目的 探讨工作场所社会资本与护士组织承诺、工作满意度、职业应激和留职意愿的关系.方法 于2014年9至12月,运用两阶段随机抽样的方法,对上海市某区23个卫生服务机构的护士进行问卷调查,调查内容主要包括工作场所社会资本、留职意愿、组织承诺、工作满意度和职业应激,采用结构方程模型分析上述变量之间的关系.结果 工作场所社会资本（β^^=0.11,P〈0.01）、组织承诺（β^^=0.81,P〈0.01）和工作满意度（β^^=0.03,P〈0.01）对护士留职意愿具有积极的直接效应,职业应激（β^^=-0.03,P〈0.01）对留职意愿具有消极的直接效应.工作场所社会资本对组织承诺（β^^=0.65,P〈0.01）和工作满意度（β^^=0.44,P〈0.01）具有积极直接效应,对职业应激具有消极直接效应（β^^=-0.35,P〈0.01）.社会资本对留职意愿的间接效应为0.55;工作满意度与组织承诺呈正相关（r=0.47,P〈0.01）,与职业应激呈负相关（r=-0.12,P〈0.01）;职业应激与组织承诺呈负相关（r=-0.20,P〈0.01）,结论 工作场所社会资本可以直接影响护士的留职意愿,且可通过组织承诺、工作满意度和职业应激间接影响护士的留职意愿.

Objective To explore a model that workplace social capital is associated with intention to stay （ITS） in the nursing profession and that this association is partially mediated by organizational commitment, job satisfaction, and job stress among Chinese nurses. Methods A cross-sectional, observationalstudy was conducted in Shanghai, China between September and December 2014. Two thousandforty-two nurses from 23 healthcare organizations were recruited for the current study using a two-stage sampling process.Intention to stay, workplace social capital, job satisfaction, organizational commitment, and job stress was measured by validated scale. Measured variable path analysis （MVPA） was used to test their hypothesized relationships. Results There were significant positive direct effects from workplace social capital （β^^=0.11,P〈0.01）, organizational commitment（β^^=0.81,P〈0.01） and job satisfaction（β^^=0.03,P〈0.01） to ITS, and a negative direct effects from job strain to ITS（β^^=-0.03, P〈0.01）. The model explained 84%of the variability in ITS. Additionally, workplace social capital had significant positive direct effects on organizational commitment （β^^=0.65, P〈0.01）, job satisfaction （β^^=0.44, P〈0.01） and negative direct effects on job strain （β^^=-0.35, P〈0.01）. The indirect effect of social capital to ITS was 0.55. Job satisfaction was positively associated with organizational commitment （r=0.47, P〈0.01）, and negtively associated with job stress （r=-0.12, P〈0.01）. Job stress was negtively associated with organizational commitment （r=-0.20, P〈0.01）. Conclusion This study suggests that greater workplace social capital may lead to higher ITS in nursing primarily by increasing commitment to the nursing occupation and their job satisfaction and by reducing their sense of job stress.