三级医院硕士及以上学历护士工作环境对职业价值观的影响

The relationship between practice environment and professional values among nurses with master or doctoral degree in tertiary hospitals

目的:调查我国三级医院硕士及以上学历护士职业价值观及工作环境现状,并分析工作环境对职业价值观的影响。方法:在全国22个省、自治区、直辖市115所医院选取1 223名硕士/博士学历护士作为研究对象,采用一般资料问卷、护士职业价值观量表和护理工作环境量表进行调查。结果:护士职业价值观总均分为(4.51±0.51)分,各维度均分由高到低依次为提供照顾(4.57±0.52)分、职业特性(4.50±0.60)分、公正(4.47±0.65)分、行为(4.42±0.62)分、信任(3.63±0.45)分;工作环境总均分为(3.21±0.49)分。分层回归结果显示,护士起始学历低(β=-0.097)、职业满意度高(β=0.174)、月收入高(β=0.063)的护士职业价值观越高(R2=0.063);控制一般资料后,护理工作环境中的高质量护理服务基础(β=0.371)、医护合作(β=0.104)可解释职业价值观总变异的16.5%。结论:我国三级医院硕士及以上学历护士职业价值观总体是正向、积极的,受起始学历、职业满意度、月收入和自我感知工作环境的影响,管理者应针对这些影响因素进行科学的引导和管理,使其树立正确的职业价值观。

Objective： To investigate the status of professional values and practice environment among nurses with master or doctoral degree, and analyze the impact of perceived practice environment on professional values. Methods： Totally 1223 nurses with master or doctoral degree from 115 tertiary hospitals in 22 provinces were investigated with the Nurses Professional Values Scale -Revised （NPVS-R） and the Practice Environment Scale of the Nursing Work Index （PES-NWI）. Results： The mean score of professional values was （4.51±0.51）. The factor scores from high to low were caring （4.57±0.52）, professionalism （4.50±0.60）, justice （4.47±0.65）, activism （4.42±0.62） and trust （3.63±0.45）. The mean score of practice environment was （3.21±0.49）. Hierarchical regression showed that nurses with lower initial education （β=-0.097）, higher job satisfaction （β=0.174） and higher monthly income （β=0.063） showed higher professional values （R2=0.063）. After controlling for general information, high-quality care services base （β=0.371） and nurse-physician co-operation （β=0.104） in nursing work environment were significant influencing factors of professional values, which explained 16.5% of the total variance. Conclusion： Nurses with master or doctoral degree in tertiary hospitals show positive professional values, which are influenced by initial education, job satisfaction, monthly income and practice environment. Nursing managers should provide proper guidance and management to help them establish correct professional values.