护士从离职意愿到离职决策过程的扎根理论研究

From the turnover intention to decision in nurses:a grounded theory study

目的 :探寻护士从离职意愿到离职决策过程中的不同阶段,使管理者更早预见和捕捉护士离职前的迹象,从而采取有效应对措施。方法 :采用目的抽样与理论抽样相结合的方法,选取近10年内主动提出离职的护士作为研究对象,采用Charmaz建构主义扎根理论的范式收集和分析资料。结果 :护士离职过程经历了意愿潜伏期、意愿权衡期、意愿加速期、离职决策期4个时期,产生导火索、燃料、助燃剂和阻燃剂4个本土元素,并构建离职过程的框架。结论 :护理管理者可以依据护士经历的离职过程和产生的元素,预见护士离职并提前捕捉相关元素,多维度调整管理策略,及时发现护士的离职念头和离职倾向,跟踪离职轨迹的发展状况,深入探究原因,帮助护士重新建立对护理专业的热爱,降低其离职意愿并减少护士离职。

Objective:To explore and describe the different stages during the process when nurses develop the turnover intention and make their turnover decision,to help nursing managers capture the early signs and predict the turning point before their leaving,so as to take effective countermeasures.Methods:The study used both purposeful sampling and theoretical sampling to select clinical nurses and head nurses who proposed resignation in the past 10 years as the research objects,and collected and analyzed the data using the constructivist grounded theory paradigm established by Charmaz.Results:Nurses with the intention to turnover underwent four stages:willingness incubation period,willingness weighing period,willingness acceleration period,and turnover decision-making period,generating four native elements included blasting fuse,fuel,combustion promoter,and flame retardant.Conclusion:Nursing managers can predict nurses turnover in advance and capture relevant factors according to the stages of nurses turnover experience and the corresponding native elements to discover nurses'turnover thoughts and turnover intentions in time and help nurses re-establish their adherence to the profession to avoid their turnover intention and decision by means of adjusting management strategies in multiple dimensions,tracking the development of turnover trajectory and deeply exploring the reasons.