基于授权管理模式ICU护士对健康工作环境评价的横断面研究

Evaluation of health working environment by ICU nurses based on empowerment management model: a cross-sectional research

目的了解基于授权管理模式下ICU护士对临床健康工作环境的评价现状及其影响因素,为营造满足护士需求的专业环境提供依据。方法纳入武汉大学人民医院162名ICU护士调查,运用中文版磁性基本要素-Ⅱ量表评价健康工作环境,并采用2个1~10分数据条评价工作满意度和护理工作质量。结果护士对健康工作环境总分为(183.75 ± 1.56)分,各维度分别为医护关系(2.83 ± 0.43)分、对培训的支持(2.88 ± 0.05)分、护理工作的自主性(2.98 ± 0.03)分、对护理实践的控制(2.93 ± 0.03)分、足够的护理人员(2.83 ± 0.33)分、同事的临床能力胜任(3.37 ± 0.04)分、护理管理者的支持(3.50 ± 0.04)分、文化价值观(3.48 ± 0.04)分,对护理工作的满意度(8.12 ± 0.14)分和护理质量评价(8.66 ± 0.12)分较高。护士对健康工作环境评价的显著因素有年龄、护龄、层级、学历及授权水平。学历与健康工作环境呈负相关(r=-0.299,P=0.000),授权项与健康工作环境呈正相关(r=0.236,P=0.003)。"8个维度""学历"及"授权项"的自变量可解释"健康工作环境得分"97.9%的变异量。其中"护理管理者的支持""文化价值观""足够的护理人员"预测变量对健康工作环境评价有较高解释力。结论护士对健康工作环境的评价较高,护理管理者应给予不同层级护士更多的支持,重视培训的需求,加强在医护关系和谐发展中的推动作用,改善健康工作环境的过程指标重点是"护理管理者的支持""文化价值观"和"足够的护理人员",从而营造护士满意的磁性专业环境,提升护理质量。

Objective To investigate the current status of ICU nurses′ evaluation of clinical health work environment and its influence factor under the foundation of empowerment management model. Methods This study included 162 ICU nurses from Renmin Hospital of Wuhan University. The Chinese version of the Essentials of Magnetism II was used to evaluate the healthy working environment and another two 0–10 single-item scales was used to evaluate job satisfaction and quality of care. Results The total score of nurses on the healthy working environment was (183.75±1.56), and score of each dimensions were included medical relationship(2.83±0.43), support for training(2.88±0.05), autonomy of nursing work (2.98±0.03), nursing practical control(2.93±0.03), adequate nursing staff(2.83±0.33), colleagues′ clinical competence(3.37±0.04), nursing manager support(3.50±0.04), cultural values(3.48±0.04), the satisfaction of nursing work(8.12±0.14) and the quality of care evaluation(8.66±0.12) were higher. There were significant statistical difference in the evaluation of nurses′ healthy working environment on age, working years, education and level of authorization. The degree showed low level negative correlation degree and healthy working environment (r=-0.299, P=0.000), the level of authorization showed low level correlation degree and healthy working environment (r=0.236, P=0.003). The independent variable could explain 97.9% of the variation of the dependent variable, among which nursing manager support and cultural values and adequate nursing staff had a high explanatory power for the evaluation of healthy working environment. Conclusions ICU nurses have a higher evaluation of the healthy working environment. Nursing managers should be concerned about more support to different levels of nurses, pay attention to the needs of training, promote the harmonious development of doctor-nurse relationship, improve healthy working environment focuses on the process of nursing manager support and cultural values and adequate nursing staff,so to create a magnetic professional environment that will satisfy the nurses are helpful to improve the quality of care.