三级医院与社区医院护士执业环境和职业倦怠的现状分析

Status analysis of nurses'practice environment and job burnout in tertiary hospitals and community hospitals

目的调查上海市三级医院和社区医院护士执业环境、职业倦怠现状,比较两者之间差异。方法采用便利抽样法,使用一般资料问卷、护士执业环境测评量表、Maslach职业倦怠量表对三级医院和社区医院的护士进行问卷调查。结果891名护士参与护士执业环境测评调查,其中三级医院563名护士对执业环境总体评价得分为(63.66±27.34)分,社区医院328名护士对执业环境总体评价得分为(70.99±26.60)分;799名护士参与职业倦怠调查,三级医院507名护士中职业倦怠人数占比为85.8%,社区医院292名护士中职业倦怠人数占比为78.4%,差异有统计学意义(P<0.05)。结论三级医院护士的执业环境总评低于社区医院,职业倦怠较社区医院严重;医院管理者不仅要从外部回报方面制定相关激励措施,而且要从个人发展、职业规划、人文关怀等内部回报方面制定相应的解决方案,稳定护理队伍。

Objective To explore the status of practice environment and job burnout of nurses among tertiary hospitals and community hospitals in Shanghai,and compare their differences.Methods Nurses in tertiary hospitals and community hospitals were investigated by general information questionnaire,Practice Environment Scale of the Nursing Work Index(PES-NWI)and Maslach Burnout Inventory based on the convenience sampling method.Results Totally 891 nurses participated in PES-NWI survey,among which,the overall evaluation scores of practice environment of 563 nurses from tertiary hospitals and 328 nurses from community hospitals were(63.66±27.34)points and(70.99±26.60)points,respectively.Totally 799 nurses participated in the job burnout survey,among which,the proportion of job burnout in 507 nurses from tertiary hospitals and 292 nurses from community hospitals was 85.8%and 78.4%,respectively,and with statistically significant difference(P<0.05).Conclusion Nurses in tertiary hospitals score lower on the practice environment than in community hospitals,and job burnout was worse than in community hospitals.Hospital managers should not only formulate relevant incentive measures from the aspect of external returns,but also formulate corresponding solutions from the aspects of internal returns such as personal development,career planning and humanistic care,so as to stabilize the nursing staff.