广东省二、三级综合医院护理工作环境影响因素调查  

Influencing factors of nursing work environment in Class Ⅱ and Ⅲ hospitals of Guangdong Province

作　　者：林惜君 尤黎明[1] 郑晶[1] 刘可[1] 刘佳丽[1] 王筠[1] 郑玲玲[1] 段银菲 裴多多 Lin Xijun;You Liming;Zheng Jing;Liu Ke;Liu Jiali;Wang Yun;Zheng Lingling;Duan Yinfei;Pei Duoduo(School of Nursing,Sun Yat-sen University,Guangzhou 510080,China;the Fourth Ward of Internal Medicine,Sun Yat-sen University Cancer Center,Guangzhou 510060,China)

机构地区：[1]中山大学护理学院,广州510080 [2]中山大学肿瘤防治中心内科四区,广州510060

出　　处：《中华现代护理杂志》2018年第21期2500-2506,共7页Chinese Journal of Modern Nursing

基　　金：美国中华医学基金会基金（10-021）

摘　　要：目的 探讨广东省二、三级综合医院护士评价护理工作环境的影响因素.方法 采用问卷调查法,于2014年对广东省23所二、三级综合医院、133个病区共1904名护士进行抽样调查.采用医院问卷调查医院等级、地点、技术力量等级;病区问卷调查病区类型、护士数;护士问卷包括护士一般资料调查表和护理工作环境量表（PES-NWI）.使用EpiData 3.1软件建立数据库,采用SPSS 19.0软件包进行统计描述,并使用MLwiN 2.32软件进行多水平模型回归分析.结果 1904名护士中71.6％对薪酬不满意,56.2％报告工作超时.将护士、病区、医院一般情况作为解释变量引入三水平模型.结果显示,护士学历越低（β=0.140-0.209,P〈0.05）、薪酬满意度越高（β=0.138-0.513,P〈0.001）,对工作环境5个方面评价均越好;工作未超时（β=0.064-0.076,P〈0.05）、所在病区护患比达标（β=0.082-0.118,P〈0.05）、外科（β=0.130-0.148,P〈0.05）、所在医院技术力量低（β=0.093-0.209,P〈0.05）的护士对工作环境的评价分别好于工作超时、护患比未达标、ICU、所在医院技术力量高的护士.结论 护士初始学历、薪酬满意度、工作负荷（工作超时情况、护患比）、病区类型、医院技术力量是护士评价护理工作环境的影响因素,提示创建良好护理工作环境,要重视人才队伍建设、提高薪酬满意度、保障人力配置,从而稳定护士队伍,从根本上提升护理服务质量.Objective To explore the influencing factors of nursing work environment in Class Ⅱ and Ⅲ hospitals of Guangdong Province. Methods Totals of 1 904 nurses of 133 wards from 23 Class Ⅱ and Ⅲ hospitals of Guangdong Province were investigated with the questionnaires in 2014. The hospital questionnaire was used to investigate hospital level, place and level of technical force. The ward questionnaire was applied to investigate ward types and the number of nurses. The nurse questionnaires included the general information questionnaire and the Practice Environment Scale of Nursing Work Index （PES-NWI）. The EpiData 3.1, SPSS 19.0 and MLwiN 2.32 were used to build a database, statistical description and multilevel models regression analysis respectively. Results A total of 71.6% of 1 904 nurses was dissatisfied with payment and 56.2% of them reported working overtime. The nurses, wards and general information of hospitals were taken as the explaining variable to be led into three-level model. The results showed that nurses who had low educational background （β=0.140-0.209, P 〈 0.05） and high satisfaction with payment （β=0.138-0.513, P 〈 0.001） were with high assessment for five aspects of work environment. Nurses whose work did not time out （β=0.064-0.076, P 〈 0.05）, wards were with nurse-patient ratio reaching the standard （β=0.082-0.118, P 〈 0.05）, were in surgical department （β=0.130-0.148, P 〈 0.05）, whose hospitals was with a low level of technical force （β=0.093-0.209, P 〈 0.05） had higher assessment for work environment than those were with work timeout,whose wards were with nurse-patient ratio not reaching the standard, were in Intensive Care Unit （ICU）, whose hospitals was with a high level of technical force （P 〈 0.05）. Conclusions The influencing factors of nursing work environment assessed by nurses include initial educational background, payment satisfaction, working load （working overtime and nurse-patient ratio）, types of wards and hospital

关 键 词：护士 护理工作环境 影响因素 

分 类 号：R47[医药卫生—护理学]