工作重塑和主动性人格在护士长授权赋能与护士建言行为间的中介调节作用

The mediating and moderating effects of job crafting and proactive personality between head nurse empowerment and nurse voice behavior

目的探讨护士长授权赋能对护士建言行为的影响, 以及护士工作重塑和主动性人格在两者间的中介和调节作用。方法 2022年2—3月, 便利抽取山东省4所三级甲等医院的805名临床护士为研究对象, 采用护士长授权赋能行为量表、工作重塑量表、建言行为量表及主动性人格量表进行横断面调查。采用SPSS 26.0和Process3.4插件进行有调节的中介效应分析。结果护士感知护士长授权赋能总分为(4.01 ± 0.57)分, 护士工作重塑总分为(4.19 ± 0.66)分, 护士建言行为总分为(4.12 ± 0.62)分, 主动性人格总分为(6.07 ± 0.90)分。护士长授权赋能与护士工作重塑、建言行为、主动性人格两两相关(r值为0.483~0.824, 均P<0.01);护士工作重塑在护士长授权赋能与护士建言行为间起部分中介作用, 中介效应为0.541, 占总效应的86.4%;主动性人格对中介模型的前半路径具有正向调节作用(△R2=0.163, P<0.01)。结论护士长授权赋能既可以直接又可以通过护士工作重塑间接影响护士建言行为, 主动性人格能够调节护士长授权赋能对护士工作重塑的作用。建议护士长对护士适度放权并积极授权, 识别高主动性人格护士, 激发其工作重塑以及建言行为, 提高护理工作质量。

Objective To explore the influence of head nurse empowerment on nurses′voice behavior and the mediating and moderating effects of nurses′job crafting and proactive personality.Methods A total of 805 nurses from the 4 grade A hospitals in Shandong province from February to March 2022 were selected by convenience sampling method,the Nurse Managers′Empowering Behavioral Scale For Staff Nurses,Job Crafting Scale,Voice Behavior Scale and Proactive Personality Scale were used for cross-sectional survey.The mediating effect was analyzed by SPSS 26.0 and Process 3.4 macro.Results The total score of nurses′perception of head nurse empowerment was(4.01±0.57)points,the total score of nurses′job crafting was(4.19±0.66)points,the total score of nurses′voice behavior was(4.12±0.62)points,and the total score of nurses′proactive personality was(6.07±0.90)points.Head nurse empowerment,nurse job crafting,voice behavior and proactive personality were positively correlated with each other(r values were 0.483-0.824,all P<0.01).The mediating effect of job crafting was 0.541,accounting for 86.4%of the total effect;proactive personality had a positive moderating effect on the first half path of the mediation model(∆R2=0.163,P<0.01).Conclusions Head nurse empowerment influenced voice behavior of nurses directly and indirectly through the mediating role of job crafting,proactive personality can moderate the effect of head nurse empowerment on nurse job crafting.It is suggested that the head nurse appropriately delegate power to the nurses and actively authorize them,identify nurses with high proactive personality,stimulate their job remodeling and voice behavior,and improve the quality of nursing work.