基于自我决定理论的护士组织沉默影响因素及对策研究

Study on influencing factors and countermeasures of nurses'organizational silence based on self-determination theory

目的基于自我决定理论,探究护士组织沉默的影响因素及改善对策。方法采用一般资料调查表、护士组织沉默测评问卷和护士职业认同评定量表,于2021年5月对西安市某综合性三甲医院458名护士进行问卷调查。采用多元线性回归分析护士组织沉默的影响因素,基于自我决定理论提出组织沉默改善对策。结果护士组织沉默总均分为(54.88±13.88)分,处于中等水平,组织沉默受性别、科室和职业认同感的影响(均P<0.05),且护士职业认同感与组织沉默总分及各维度均呈负相关(均P<0.05)。结论组织沉默受职业认同感等多种因素的影响。根据自我决定理论提出,以增强护士的职业认同感为切入点,树立护士建言信念,认可护士建言价值,鼓励护士建言行为等,以改善护士组织沉默现象。

Objective To explore the influencing factors and improvement countermeasures of nurses'organizational silence based on the self-determination theory.Methods A total of 458 nurses from a comprehensive top three hospital in Xi'an were investigated by using the general information questionnaire,the nurses'organizational silence scale and the professional identity scale at May 2021.Multiple linear regression was used to analyze the influencing factors of nurses'organizational silence,and the improvement countermeasures of organizational silence were put forward based on self-determination theory.Results The average score of nurses organizational silence was(54.88±13.88)points,which was in the middle level.Organizational silence was influenced by gender,department and professional identity(all P<0.05).Meanwhile,nurses'professional identity was negatively correlated with organizational silence total score and all dimensions(all P<0.05).Conclusions Organizational silence is influenced by a variety of factors such as professional identity.According to self-determination theory,strategies such as enhancing nurses'professional identity as an entry point,establishing nurses'advice beliefs,recognizing the value of nurses'advice,and encouraging nurses"advice behaviors are proposed to improve the phenomenon of nurse organizational silence.