临床护士离职倾向预测模型的构建

发布时间：2018-06-24 11:37

本文选题：护士 + 离职倾向　；参考：《南京中医药大学》2017年硕士论文

【摘要】：[目的]1.调查南京地区护士离职现状;2.评估三级综合医院临床护士离职倾向、护理实践环境、工作满意度、职业倦怠及组织承诺的水平;3.探讨社会人口学、护理实践环境、工作满意度、职业倦怠、组织承诺对护士离职倾向(离开病房倾向、离开组织倾向和离开护理专业倾向)的影响程度,并建立相应的预测模型;4.为护理管理者制定有效干预策略,稳定护理人员队伍,提供理论依据。[方法]本研究共两部分,第一部分采用目的抽样,自行设计问卷对南京地区5家三级综合医院2010-2015年护士离职情况进行调查分析,了解离职护士的分布特点。第二部分根据调查结果结合文献回顾,构建临床护士离职倾向预测模型假设。采用多阶段整群抽样方法,在南京地区4家三级综合医院的内科、外科、妇产科、儿科、急诊和重症监护室的科室中各抽1个病区,共抽取24个病区,437名临床护士进行问卷调查。调查问卷包括6部分:一般资料调查问卷,护理实践环境量表,护士工作满意度量表,职业倦怠量表,组织承诺量表及离职倾向量表。运用SPSS18.0软件对调查结果进行统计分析,采用描述性统计分析,t检验,方差分析,Pearson相关分析及有序logistic回归等方法对临床护士的一般资料、护理实践环境、工作满意度、职业倦怠、组织承诺及离职倾向的情况进行统计分析。[结果]第一部分调查结果:南京地区5家综合医院2010-2015年,离职护士共619人,离职率分别 1.29%、1.81%、1.93%、2.05%、2.13%、2.14%,女性占离职总数的 97.7%;25-30岁离职护士占51.3%;1～5年工龄的护士占63.49%。离职护士学历分布集中在大专学历(51.2%);离职护士技术职称分布集中在初级职称;科室主要集中在工作压力和工作强度大的科室。第二部分调查结果:1.一般描述性分析:南京地区三级综合医院临床护士离职倾向的总平均得分为2.053±0.61,其中离开护理专业倾向均分2.35±0.10,离开组织倾向均分1.76±0.78,离开病房倾向均分2.05±0.94;护理实践环境感知均分为3.11±0.51,护士工作满意度均分为3.68±0.7,护士职业倦怠调查总得分19.99±5.41,组织承诺均分3.33±0.90。2.单因素分析:不同年龄、不同工龄、不同学历、不同科室、不同职务及职称之间离职倾向存在差异性,每周加班时间对护士离职倾向的影响具有统计学意义(P0.05);护士离职倾向及各维度与护理实践环境感知,护士工作满意度,情感承诺及规范承诺显著性负相关(P0.01),护士离职倾向及各维度与职业倦怠及继续承诺呈正相关(P0.01)。3.有序logistic回归分析:情感衰竭,工作控制,继续承诺对离开护理专业倾向具有显著的影响(P0.05);情感衰竭,去个性化,家庭与工作平衡,情感承诺,继续承诺,年龄,加班时间对离开组织倾向具有显著的影响(P0.05);情感衰竭,去个性化,护士参与医院管理,福利待遇,情感承诺,继续承诺,加班时间对离开病房倾向具有显著的影响(P0.05)。[结论]1.南京地区护士离职率呈逐渐上升趋势;离职护士主要分布在低年资、初级职称;高学历、护师及以上职称离职护士人数逐年增多;离职护士的科室分布在工作压力和工作强度大的科室;2.南京地区三级综合医院护理实践环境较差,临床护士工作满意度较低,护士有高度职业倦怠,组织承诺及离职倾向处于中度水平。3.年龄、工龄、学历、职称、职务、科室、每周加班时间、护理实践环境、工作满意度、职业倦怠、组织承诺是临床护士离职倾向的影响因素。4.情感衰竭,工作控制及继续承诺是临床护士离开护理专业倾向的主要预测因素;情感衰竭,去个性化,家庭与工作平衡,情感承诺,继续承诺,年龄,加班时间是离开组织倾向的主要预测因素;情感衰竭,去个性化,加班时间,护士参与医院管理,福利待遇,情感承诺,继续承诺是离开病房倾向的主要预测因素。
[Abstract]:[Objective]1. to investigate the status of nurse turnover in Nanjing; 2. to evaluate the turnover intention of clinical nurses in the three level general hospitals, nursing practice environment, job satisfaction, job burnout and organizational commitment; 3. to explore the social demography, nursing practice environment, job satisfaction, professional tiredness, and organizational commitment to leave the ward tendency (leaving the ward tendency, away from the ward). The influence degree of opening the organization tendency and leaving the nursing specialty tendency and establishing the corresponding prediction model; 4. for the nursing managers to formulate effective intervention strategies, stabilize the nursing staff and provide the theoretical basis. [Methods] this study has two parts. The first part uses the purpose sampling, and the self-designed questionnaire on 5 three grade comprehensive hospitals in Nanjing region 2010 The situation of nurses' turnover in -2015 was investigated and analyzed in order to understand the distribution characteristics of turnover nurses. The second part, based on the survey results and literature review, constructed the hypothesis of the prediction model of turnover intention of clinical nurses. The multi stage cluster sampling method was used in the internal medicine, surgery, obstetrics and Gynecology, pediatrics, emergency and critical care in 4 three level comprehensive hospitals in Nanjing. A total of 24 sick areas were extracted from 1 ward in the Department of guardianship, and 437 clinical nurses were investigated. The questionnaire included the general data questionnaire, the nursing practice environment scale, the nurse job satisfaction scale, the job burnout scale, the organizational commitment scale and the turnover intention scale. The SPSS18.0 software was used to study the results of the survey. Statistical analysis, descriptive statistical analysis, t test, variance analysis, Pearson correlation analysis and ordered logistic regression were used to analyze the general data of clinical nurses, nursing practice environment, job satisfaction, job burnout, organizational commitment and turnover intention. [results] the first part of the survey: 5 in Nanjing area In the 2010-2015 years of the general hospital, the turnover nurses were 619. The turnover rate was 1.29%, 1.81%, 1.93%, 2.05%, 2.13%, 2.14%, and 97.7% of the total turnover. 25-30 years old turnover nurses were divided into 25-30 years old nurses. The distribution of nurses' qualifications for 63.49%. turnover nurses was concentrated in junior college education (51.2%); the distribution of technical titles of turnover nurses was concentrated in the junior title. The Department mainly concentrated in the Department of work stress and high intensity of work. The second part of the survey results: 1. general descriptive analysis: the total average score of turnover intention of clinical nurses in Nanjing area three general hospitals was 2.053 + 0.61, of which the separation of nursing professional tendencies was 2.35 + 0.10, the deviation from the open organization was 1.76 + 0.78, leaving the ward tendency. The average score of nursing practice was 2.05 + 0.94, the average score of nursing practice was 3.11 + 0.51, the average score of job satisfaction of nurses was 3.68 + 0.7, the total score of nurses' job burnout was 19.99 + 5.41, and the average score of organizational commitment was 3.33 + 0.90.2.. The difference between different age, different work age, different academic qualifications, different departments, different posts and titles was different. The effect of weekly overtime time on nurses' turnover intention was statistically significant (P0.05); nurses' turnover intention and each dimension were negatively correlated with nursing practice environment perception, nurses' job satisfaction, emotional commitment and normative commitment (P0.01). Nurses' turnover intention and each dimension were positively related to job burnout and continuing commitment (P0.01).3. order Logistic regression analysis: emotional exhaustion, work control, continuing commitment has a significant impact on leaving nursing professional tendencies (P0.05); emotional exhaustion, depersonalization, family and work balance, emotional commitment, continuing commitment, age, and overtime have a significant impact on leaving organizational tendencies (P0.05); emotional exhaustion, personalization, nurses participate in medical treatment. Hospital management, welfare benefits, emotional commitment, continuing commitment and overtime have a significant impact on leaving ward tendency (P0.05). [conclusion the turnover rate of nurses in Nanjing area is increasing gradually; the turnover nurses are mainly distributed in low year and primary titles; the number of nurses with higher education, nurse and above is increasing year by year; The Department is distributed in the Department of work stress and high intensity of work; 2. the nursing practice environment of 2. level three general hospitals in Nanjing is poor, the job satisfaction of clinical nurses is low, the nurses have high job burnout, the organizational commitment and turnover tendency are at the moderate level of.3. age, work age, educational background, title, job, Department, weekly overtime time, nursing practice ring Situation, job satisfaction, job burnout, organizational commitment are the factors affecting the turnover intention of clinical nurses.4. emotional exhaustion, work control and continuing commitment are the main predictors for clinical nurses to leave nursing professional tendencies; emotional exhaustion, depersonalization, family and work balance, emotional commitment, continuing commitment, age, and overtime are leaving the organization. The main predictors of tendencies; emotional exhaustion, depersonalization, overtime, nurses' participation in hospital management, welfare, emotional commitment, and continuing commitment were the main predictors of leaving ward tendency.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R47

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