新医改形势下临床护理队伍稳定性及相关因素研究

Stability and Related Factors of Clinical Nursing Team under the Situation of New Medical Reform

目的通过对护理人员离职意愿调查,了解临床护士离职意愿及其影响因素,为提高护理队伍稳定性提供对策和建议。方法采用自编问卷,通过随机整群抽样方法,对上海某三甲综合类医院的护理人员进行问卷调查,共回收487份有效问卷。采用SPSS 20.0软件进行统计分析。结果护士离职意愿和放弃护理专业的意愿分别为20.1%和18.1%。哥本哈根社会心理学量表结果显示,健康状况、社会支持、福利待遇、工资、收入分配制度、工作量、工作环境及工作总体满意度这7个条目得分较高,均≥3.6;离职意愿较强组和放弃护理专业意愿较强组,其各条目得分均显著高于离职意愿较弱组和放弃护理专业意愿较弱组(P<0.001)。Logistic回归分析结果显示,影响护士离职意愿因素包括户籍、有无孩子、同事合作愉快、公平分配任务、工作充满挑战、健康状况和消极情绪;放弃护理专业意愿的影响因素包括户籍、工作环境、工资、工作充满挑战、工作整体满意度和消极情绪。结论临床护士离职意愿和放弃护理专业的意愿较高。医院管理者应通过改善护士工作条件、落实绩效薪酬机制、降低护士工作压力等一系列措施提高临床护理队伍的稳定性。

Objective To investigate the turnover intention and influencing factors of clinical nurses,so as to provide some suggestions and measures for improving the stability of nursing team.Methods A survey was conducted with self-designed questionnaire.487 nurses were selected and investigated randomly in a tertiary comprehensive hospital in Shanghai.Results The percentages of turnover intention and willingness to give up nursing care were 20.1%and 18.1%,respectively.Results of the Copenhagen social psychology scale showed that the scores of items of health status,social support,benefits,wages,income distribution system,workload,work environment and job sa-tisfaction were high(≥3.6).The scores of all items of high turnover intention group and high willing to give up nursing professional group were higher than that of low turnover intention group and low willing to give up nursing professional group(P﹤0.001).The Logistic regression analysis showed that the influencing factors of turnover intention of nurses included household registration,children,cordial working relationship,equitable allocation of tasks,job challenges,health and negative emotions that the influencing factors of the willingness to give up nursing care included household registration,work environment,wages,job challenges,job satisfaction and negative emotions.Conclusion The turnover intention and willingness to give up nursing specialty of clinical nurses were high.The hospital managers should take various measures to improve the stability of clinical nursing team,including improving the working conditions of nurses,implementing performance pay mechanism,reducing nurses'work pressure.