急诊科女性护士付出获得不平衡预测模型的研究
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摘要
目的探讨急诊科女性护士付出获得不平衡现状的预测指标,为提出针对性管理措施提供依据。方法采用横断面调查方法,便利选取南通市3所三级甲等综合医院249名急诊科女性护士为研究对象,用一般资料问卷采集社会人口学特征,用付出-获得不平衡量表对其付出获得不平衡现状进行调查。用Logistic回归分析急诊科女性护士付出获得失衡现状的影响因素,用ROC曲线评价不同指标对急诊科女性护士付出获得失衡的预测能力及最佳界值。结果 249名急诊科女性护士中143人(57.43%)存在付出获得不平衡,二元Logistic回归分析显示月收入<4 000元、本科学历、轮夜班、合同制和高超负荷是急诊科女性护士付出获得失衡的危险因素(P<0.05)。综合多指标的预测模型的曲线下面积为0.901,界值为0.43,灵敏度为91.7%,特异度为67.0%,阳性似然比为2.780,阴性似然比为0.120,优于单一指标。结论急诊科女性护士付出获得不平衡预测模型具有较好的预测价值。
Objective To study the prediction index on present situation of imbalance between effort and reward for female nurses in emergency department and provide reference for corresponding management measures.Method 249 emergency female nurses from 3third grade class A general hospitals in Nantong are chosen by convenient sampling using crosssectional method.Collect social demographic characteristics by general information questionnaire and investigate present situation of imbalance between effort and reward by the effort-reward imbalance scale.Analyze the influencing factors of present situation of imbalance between effort and reward for female nurses in emergency department by Logistic regression.Evaluate the prediction ability and optimal cut-off point of different indexes on imbalance between effort and reward for female nurses in emergency department by ROC curve.Result There is 143(57.43%)cases of imbalance between effort and reward among 249 female nurses in emergency department.Binary Logistic regression shows that monthly income<4 000 yuan,undergraduate,night shift,employment nature of contract workers and heavy load are risk factors leading to imbalance(P<0.05).Area under curve of multiple indexes prediction model is 0.901,cut-off point is 0.43,sensitivity is91.7%,specificity is 67.0%,positive likelihood ratio is 2.780,negative likelihood ratio is 0.120,which are better than single index.Conclusion Prediction model on imbalance between effort and reward for female nurses in emergency department has a nice prediction value.
Objective To study the prediction index on present situation of imbalance between effort and reward for female nurses in emergency department and provide reference for corresponding management measures.Method 249 emergency female nurses from 3third grade class A general hospitals in Nantong are chosen by convenient sampling using crosssectional method.Collect social demographic characteristics by general information questionnaire and investigate present situation of imbalance between effort and reward by the effort-reward imbalance scale.Analyze the influencing factors of present situation of imbalance between effort and reward for female nurses in emergency department by Logistic regression.Evaluate the prediction ability and optimal cut-off point of different indexes on imbalance between effort and reward for female nurses in emergency department by ROC curve.Result There is 143(57.43%)cases of imbalance between effort and reward among 249 female nurses in emergency department.Binary Logistic regression shows that monthly income<4 000 yuan,undergraduate,night shift,employment nature of contract workers and heavy load are risk factors leading to imbalance(P<0.05).Area under curve of multiple indexes prediction model is 0.901,cut-off point is 0.43,sensitivity is91.7%,specificity is 67.0%,positive likelihood ratio is 2.780,negative likelihood ratio is 0.120,which are better than single index.Conclusion Prediction model on imbalance between effort and reward for female nurses in emergency department has a nice prediction value.
引文
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[13]陈浩蕾,陈月新,卢韵琦,等.综合医院急诊科女护士的睡眠问题与职业紧张[J].中国心理卫生杂志,2014,28(4):253-257.
[14]Ramin C,Devore EE,Wang WK,et al.Night shift work at specific age ranges and chronic disease risk factors[J].Occup Environ Med,2015,72(2):100-107.
[15]Trousselard M,Dutheil F,Naughton G,et al.Stress among nurses working in emergency,anesthesiology and intensive care units depends on qualification:a Job Demand-Control survey[J].Int Arch Occup Environ Health,2016,89(2):221-229.
[16]刘克英,朱晓华,王丛英.三级甲等医院编内与编外护士付出-获得不平衡现状的调查[J].解放军护理杂志,2014,31(3):5-8.
[17]王家良.临床流行病学-临床科研设计、测量与评价[M].4版.上海:上海科学技术出版社,2014:320-337.
[2]罗玉越,舒晓兵,史茜.付出-回馈工作压力模型:西方国家十年来研究的回顾与评析[J].心理科学进展,2011,19(1):107-116.
[3]刘克英,张婧,周林.付出-获得不平衡对护士工作生活质量的影响[J].护理学杂志,2014,29(7):52-55.
[4]Backe EM,Seidler A,Latza U,et al.The role of psychosocial stress at work for the development of cardiovascular diseases:a systematic review[J].Int Arch Occup Environ Health,2012,85(1):67-79.
[5]王竞艳,林周,周相莲,等.ICU护士离职意愿与付出-回报、工作倦怠相关性研究[J].医院管理论坛,2015,32(12):53-56.
[6]刘克英,毛小敏,张婧.护士付出-获得不平衡状况对其工作投入的影响研究[J].护理管理杂志,2013,13(10):691-693.
[7]Adriaenssens J,De Gucht V,Maes S.Causes and consequences of occupational stress in emergency nurses,a longitudinal study[J].J Nurs Mange,2015,23(3):346-358.
[8]陈天喜,孙宏,崔秋霞,等.综合医院急诊科护士职业压力与应对的研究进展[J].护理实践与研究,2016,13(5):18-20.
[9]李秀央,郭永松,张扬.付出-获得不平衡量表中文版的信度和效度[J].中华流行病学杂志,2006,27(1):25-28.
[10]Kikuchi Y,Nakaya M,Ikeda M,et al.Job stress and temperaments in female nurses[J].Occupational Medicine-Oxford,2013,63(2):123-128.
[11]Lin PC,Chen CH,Pan SM,et al.The association between rotating shift work and increased occupational stress in nurses[J].J Occup Health,2015,57(4):307-315.
[12]Xie ZY,Wang AL,Chen B.Nurse burnout and its association with occupational stress in a cross-sectional study in Shanghai[J].J Adv Nurs,2011,67(7):1537-1546.
[13]陈浩蕾,陈月新,卢韵琦,等.综合医院急诊科女护士的睡眠问题与职业紧张[J].中国心理卫生杂志,2014,28(4):253-257.
[14]Ramin C,Devore EE,Wang WK,et al.Night shift work at specific age ranges and chronic disease risk factors[J].Occup Environ Med,2015,72(2):100-107.
[15]Trousselard M,Dutheil F,Naughton G,et al.Stress among nurses working in emergency,anesthesiology and intensive care units depends on qualification:a Job Demand-Control survey[J].Int Arch Occup Environ Health,2016,89(2):221-229.
[16]刘克英,朱晓华,王丛英.三级甲等医院编内与编外护士付出-获得不平衡现状的调查[J].解放军护理杂志,2014,31(3):5-8.
[17]王家良.临床流行病学-临床科研设计、测量与评价[M].4版.上海:上海科学技术出版社,2014:320-337.