嘉兴地区护士职业疲溃、工作满意度和离职意愿的研究
|
摘要
背景：护士短缺已成为一个世界性的问题,据报道,美国护士短缺越来越严重,预测到2020年美国护理服务的需求将超过供应几乎30%；英国也在经历护士的严重短缺,加拿大、德国,甚至新西兰等国家,都在遭受护士短缺的问题。国内由卫生部统计信息中心提供的2003-2007年我国卫生发展情况简报中指出我国每千人口注册护士已由1.00人增加到1.12人,2007年我国病房护士与床位之比平均为0.38：1,但尚未达到国家卫生部1978年护士配备标准。嘉兴地区也不例外,截至2007年底嘉兴市共有注册护士数5583人,每千人口护士数1.66人,病房护士与床位之比约为0.34：1,护理人力资源仍然不足。护士的短缺在一定程度上影响护理质量和患者满意度,制约了护理专业的进一步发展。探索造成护士离职的原因,降低护士的离职率,稳定护理队伍,是目前护理管理领域关注的重点。目的：调查浙江省嘉兴地区二级甲等及以上医院护士的健康功能、职业疲溃感、工作满意度以及离职意愿现状,并分析其健康功能、职业疲溃、工作满意度以及离职意愿的相关性,探索影响护士工作满意度和离职意愿的因素。
方法：对嘉兴地区11所二级甲等及以上医院2220名注册护士进行问卷调查,回收有效问卷2010份,问卷包括护士的一般资料调查表、SF-8健康功能量表、Maslach职业疲溃感量表、Warr工作满意度量表和Michael离职意愿量表。采用SPSS15.0统计软件对资料进行描述性分析、两样本t检验、单因素方差分析、Pearson相关分析、二分类Logistic回归分析及多重线性逐步回归分析。结果：
嘉兴地区护士的健康功能得分74.41±11.51,有86.4%的护士有不同程度的颈肩痛或腰痛,50.1%的护士认为由于健康原因在一定程度上影响了社交活动；79.8%的护士有情绪困扰；61.5%的护士认为由于身体或情绪上的原因而在不同程度上影响了日常工作、学习或活动；64.7%的护士有不同程度的睡眠障碍问题(入睡困难、早醒或多醒等)。护士职业疲溃情绪衰竭得分为22.08±11.47,工作冷漠感得分6.81±5.71,低成就感得分为29.64±10.30。护士情绪衰竭和工作冷漠感2个维度处于中等水平,成就感得分较低。
护士的工作满意度总分为48.40±7.88,其中工作状态得分为30.31±5.94,工作中的人际关系为18.08±2.65,均呈一般水平；护士对同事关系满意的比例为78.5%；对直接领导满意为71.5%；对领导和下属关系满意的比例为53.6%；但对收入满意的比例仅为13.4%。职业疲溃、健康功能和护士从事夜班情况等因素与满意度密切相关,能解释工作满意度总体变异度的38.8%(R2=0.388),其中情绪衰竭是影响工作满意度的最重要因素,能解释总变异的28.5%,其次是健康功能和低成就感(分别是6.4%和1.9%)
护士离职意愿得分为14.74±3.24,指标值为61.42%,得分最高的是离职意愿Ⅲ(获得外部工作可能性),其指标值达到69.5%,其次是离职意愿Ⅰ(辞职可能性)和离职意愿Ⅱ(寻找其它工作的动机)。有11.4%的护士经常考虑辞去目前的工作,19.4%的护士经常在寻找不同性质的工作。护士的职业疲溃、工作满意度、健康功能和个人特征包括所在科室、年龄、工作年限、学历、任职方式、月薪收入与离职意愿密切相关,能够解释离职意愿总体变异度的30.3%(R2=0.303)。其中情绪衰竭对离职意愿的影响最大,能解释总变异的15.7%,其次是工作年限和满意度(分别是7.3%和4.9%)。护士认为离职最主要的可能原因是工作风险太高,其次是报酬太低、工作条件不如意和健康原因等。
结论：
嘉兴地区护士健康功能不佳,护士处于中度的情绪疲溃和工作冷漠状态,从工作中感受到的成就感普遍处于低水平,工作满意度处于一般水平。职业疲溃、健康功能、从事夜班情况是影响护士工作满意度的重要因素。护士的离职意愿处于较高水平,护理队伍处于相对不稳定状态；影响护士离职意愿的因素包括护士个人特征和职业特征、职业疲溃感、工作满意度和健康功能；职业疲溃程度越严重,离职意愿越强烈；工作满意度越低,离职意愿越高；护士的健康功能也是影响离职意愿的一个重要变量；针对护士的工作满意度和离职意愿现状及其影响因素,应采取有效的对策,如加强护理人力配置；提高护士经济和社会待遇；重视编外合同护士队伍建设；建立安全保障机制,控制护理风险；逐步实现护士按职上岗制度；大力培养专科护士,提供专业实践发展机会,充分发挥护士的积极性；重视护士的身心健康,以达到提高护士工作满意度,减少离职率,稳定护士队伍,确保护理质量和护理安全的最终目标。
Background:Shortage of nurse is a worldwide problem. It was reported that there is an increasingly serious shortage of registered nurses in USA, predicted the demand for nursing services will exceed the supply by nearly 30% in 2020; UK is also experiencing a serious shortage of nurses. Canada, Germany, and even New Zealand and other developed countries, are suffering the same issue. In China, National statistical report from the Ministry of Health offered by the Center for Health Development in China 2003-2007 briefing pointed out that registered nurses per thousand population rose from 1.00 people to 1.12 in mainland China, by 2007 the average ratio of nurses and beds was 0.38:1, however, have not yet reached the standard of the Ministry of Health in 1978.
Nursing resources are insufficient in Jiaxing area too. By the end of 2007 the total number of registered nurses was 5583,1.66 nurses per thousand people, the ratio of nurses and beds was about 0.34:1. The shortage of nurses to a certain extent affects the quality of care and patient satisfaction, restricts the further development of the nursing profession. What is the reason caused nurses to leave? The current focus for nursing administrators is to improve nurse satisfaction and reduce nurse turnover. It is expected that based on this study, strageties for further intervention might be proposed so as to improve physical and mental health, alleviate the nursing burnout, enhance the job satisfactionand reduce nurse turnover.
Objectives:To investigate the status of nurses'health functioning, burnout, job satisfaction and intent to leave in GradeⅡLevelⅠhospitals in Jiaxing area, and analyze the relationship among job satisfaction, burnout and intent to leave, and to analyze factors influencing job satisfaction and intent to leave.
Methods:A total of 2010 nurses from 11 GradeⅡLevelⅠhospitals were investigated by questionnaire which including Medical Outcomes Study Short From(SF-8), Maslach Burnout Inventory(MBI), Warr Job Satisfaction Scale of nurses and Michael Intent to leave Questionnaire(ILQ). The Statistical Package for Social Sciences (SPSS15.0) software was used to analyse the data, including descriptive analysis, t-test, one way ANOVA, Pearson correlation analysis, Binary logistic regression analysis and multiple linear stepwise regression analysis.
Results:
The findings showed that nurses health functioning score was 74.41±11.51, With 86.4% nurses reporting varied degrees of body pain,50.1% had affected social activities,79.8% reported different levels of emotional distress that affected their daily work, study or activities, 64.7% of nurses have different levels of sleep disorder problems (difficulty falling asleep, early awakening or more awake, etc).
The emotional exhaustion score of nurses was 22.08±11.47, depersonalization was 6.81±5.71, reduced personal accomplishment was 29.64±10.30. It showed moderate levels of Emotional Exhaustion and Depersonalization, and low levels of Personal Accomplishment.
The results also showed that the total score of job satisfaction was 48.40±7.88, with working condition subscore as 30.31±5.94, Work relationships 18.08±2.65.78.5% of nurses satisfied with relationship of colleagues,71.5% satisfied with their direct supervisor,53.6% satisfied with the relationship between leadership and subordinate, however only 13.4% satisfied with nursing income. About 39% of the variance in job satisfaction could be explained by the set of independent variables including burnout, health functioning and personal characteristics of nurses(R2=0.388). Emotional exhaustion had the strongest impact on job satisfaction, which explained 28.5% of the variance, followed by health function and low sense of accomplishment (6.4% and 1.9% in respectively).
The total score of intent to leave was 14.74±3.24, the value of index was 61.42%; The highest scores were intent to leaveⅢ(possibility of receiving other job), the index value reached 69.5%, followed by intent to leaveⅠ(possibility of resign) andⅡ(motivation of searching for other job opportunity). About 11.4% of the nurses often considered resigned from current job,19.4% of the nurses were seeking other job opportuneities. About 30% of the variance in intent to leave could be explained by the set of independent variables including burnout, job satisfaction health functioning and personal characteristics of nurses(R2=0.303). Emotional exhaustion had the strongest impact on intent to leave, which explained 15.7% of the variance, followed by work experience and job satisfaction (7.3% and 4.9% respectively). The main reason of considering leaving nursing job was the high working risk, followed by low pay, unsatisfied working conditions and health reasons and so on.
Conclusions:Health functioning among nursing staff in Jiaxing area was low, burnout and depersonalization was in the moderate, Nurses perception of achievement from work was generally at a low level, Job satisfaction was at a medium level. The important influencing factors were burnout, health functioning and shift work. The intent to leave rate was on a relatively high level, thus nursing team was in an unstable state; Factors affecting intent to leave rate including personal and professional characteristics, burnout, job satisfaction and health functioning. The higher job burnout, the higher turnover rate. The lower job satisfaction, the higher turnover rate; Health functioning of nurses was also an important variable affecting intent to leave.
The possible top four reasons for nurses leaving were high working risks, low rewards, unsatisfactory working conditions and health reasons. For the nursing staff job satisfaction, intent to leave rate status and influencing factors, effective intervenetions should be taken, such as strengthening the nursing manpower allocation; improving the economic and social treatment of nurses; emphasizing supernumerary nurse team-building; establishing security mechanisms to control nursing risks; training specialist nurses, providing professional development opportunities for practice, bringing into full play the enthusiasm of the work of nurses; emphasizing physical and mental health of nurses to improve nursing job satisfaction, so as to reduce turnover rate, stable nursing team, ensure nursing quality and safety of care.
方法：对嘉兴地区11所二级甲等及以上医院2220名注册护士进行问卷调查,回收有效问卷2010份,问卷包括护士的一般资料调查表、SF-8健康功能量表、Maslach职业疲溃感量表、Warr工作满意度量表和Michael离职意愿量表。采用SPSS15.0统计软件对资料进行描述性分析、两样本t检验、单因素方差分析、Pearson相关分析、二分类Logistic回归分析及多重线性逐步回归分析。结果：
嘉兴地区护士的健康功能得分74.41±11.51,有86.4%的护士有不同程度的颈肩痛或腰痛,50.1%的护士认为由于健康原因在一定程度上影响了社交活动；79.8%的护士有情绪困扰；61.5%的护士认为由于身体或情绪上的原因而在不同程度上影响了日常工作、学习或活动；64.7%的护士有不同程度的睡眠障碍问题(入睡困难、早醒或多醒等)。护士职业疲溃情绪衰竭得分为22.08±11.47,工作冷漠感得分6.81±5.71,低成就感得分为29.64±10.30。护士情绪衰竭和工作冷漠感2个维度处于中等水平,成就感得分较低。
护士的工作满意度总分为48.40±7.88,其中工作状态得分为30.31±5.94,工作中的人际关系为18.08±2.65,均呈一般水平；护士对同事关系满意的比例为78.5%；对直接领导满意为71.5%；对领导和下属关系满意的比例为53.6%；但对收入满意的比例仅为13.4%。职业疲溃、健康功能和护士从事夜班情况等因素与满意度密切相关,能解释工作满意度总体变异度的38.8%(R2=0.388),其中情绪衰竭是影响工作满意度的最重要因素,能解释总变异的28.5%,其次是健康功能和低成就感(分别是6.4%和1.9%)
护士离职意愿得分为14.74±3.24,指标值为61.42%,得分最高的是离职意愿Ⅲ(获得外部工作可能性),其指标值达到69.5%,其次是离职意愿Ⅰ(辞职可能性)和离职意愿Ⅱ(寻找其它工作的动机)。有11.4%的护士经常考虑辞去目前的工作,19.4%的护士经常在寻找不同性质的工作。护士的职业疲溃、工作满意度、健康功能和个人特征包括所在科室、年龄、工作年限、学历、任职方式、月薪收入与离职意愿密切相关,能够解释离职意愿总体变异度的30.3%(R2=0.303)。其中情绪衰竭对离职意愿的影响最大,能解释总变异的15.7%,其次是工作年限和满意度(分别是7.3%和4.9%)。护士认为离职最主要的可能原因是工作风险太高,其次是报酬太低、工作条件不如意和健康原因等。
结论：
嘉兴地区护士健康功能不佳,护士处于中度的情绪疲溃和工作冷漠状态,从工作中感受到的成就感普遍处于低水平,工作满意度处于一般水平。职业疲溃、健康功能、从事夜班情况是影响护士工作满意度的重要因素。护士的离职意愿处于较高水平,护理队伍处于相对不稳定状态；影响护士离职意愿的因素包括护士个人特征和职业特征、职业疲溃感、工作满意度和健康功能；职业疲溃程度越严重,离职意愿越强烈；工作满意度越低,离职意愿越高；护士的健康功能也是影响离职意愿的一个重要变量；针对护士的工作满意度和离职意愿现状及其影响因素,应采取有效的对策,如加强护理人力配置；提高护士经济和社会待遇；重视编外合同护士队伍建设；建立安全保障机制,控制护理风险；逐步实现护士按职上岗制度；大力培养专科护士,提供专业实践发展机会,充分发挥护士的积极性；重视护士的身心健康,以达到提高护士工作满意度,减少离职率,稳定护士队伍,确保护理质量和护理安全的最终目标。
Background:Shortage of nurse is a worldwide problem. It was reported that there is an increasingly serious shortage of registered nurses in USA, predicted the demand for nursing services will exceed the supply by nearly 30% in 2020; UK is also experiencing a serious shortage of nurses. Canada, Germany, and even New Zealand and other developed countries, are suffering the same issue. In China, National statistical report from the Ministry of Health offered by the Center for Health Development in China 2003-2007 briefing pointed out that registered nurses per thousand population rose from 1.00 people to 1.12 in mainland China, by 2007 the average ratio of nurses and beds was 0.38:1, however, have not yet reached the standard of the Ministry of Health in 1978.
Nursing resources are insufficient in Jiaxing area too. By the end of 2007 the total number of registered nurses was 5583,1.66 nurses per thousand people, the ratio of nurses and beds was about 0.34:1. The shortage of nurses to a certain extent affects the quality of care and patient satisfaction, restricts the further development of the nursing profession. What is the reason caused nurses to leave? The current focus for nursing administrators is to improve nurse satisfaction and reduce nurse turnover. It is expected that based on this study, strageties for further intervention might be proposed so as to improve physical and mental health, alleviate the nursing burnout, enhance the job satisfactionand reduce nurse turnover.
Objectives:To investigate the status of nurses'health functioning, burnout, job satisfaction and intent to leave in GradeⅡLevelⅠhospitals in Jiaxing area, and analyze the relationship among job satisfaction, burnout and intent to leave, and to analyze factors influencing job satisfaction and intent to leave.
Methods:A total of 2010 nurses from 11 GradeⅡLevelⅠhospitals were investigated by questionnaire which including Medical Outcomes Study Short From(SF-8), Maslach Burnout Inventory(MBI), Warr Job Satisfaction Scale of nurses and Michael Intent to leave Questionnaire(ILQ). The Statistical Package for Social Sciences (SPSS15.0) software was used to analyse the data, including descriptive analysis, t-test, one way ANOVA, Pearson correlation analysis, Binary logistic regression analysis and multiple linear stepwise regression analysis.
Results:
The findings showed that nurses health functioning score was 74.41±11.51, With 86.4% nurses reporting varied degrees of body pain,50.1% had affected social activities,79.8% reported different levels of emotional distress that affected their daily work, study or activities, 64.7% of nurses have different levels of sleep disorder problems (difficulty falling asleep, early awakening or more awake, etc).
The emotional exhaustion score of nurses was 22.08±11.47, depersonalization was 6.81±5.71, reduced personal accomplishment was 29.64±10.30. It showed moderate levels of Emotional Exhaustion and Depersonalization, and low levels of Personal Accomplishment.
The results also showed that the total score of job satisfaction was 48.40±7.88, with working condition subscore as 30.31±5.94, Work relationships 18.08±2.65.78.5% of nurses satisfied with relationship of colleagues,71.5% satisfied with their direct supervisor,53.6% satisfied with the relationship between leadership and subordinate, however only 13.4% satisfied with nursing income. About 39% of the variance in job satisfaction could be explained by the set of independent variables including burnout, health functioning and personal characteristics of nurses(R2=0.388). Emotional exhaustion had the strongest impact on job satisfaction, which explained 28.5% of the variance, followed by health function and low sense of accomplishment (6.4% and 1.9% in respectively).
The total score of intent to leave was 14.74±3.24, the value of index was 61.42%; The highest scores were intent to leaveⅢ(possibility of receiving other job), the index value reached 69.5%, followed by intent to leaveⅠ(possibility of resign) andⅡ(motivation of searching for other job opportunity). About 11.4% of the nurses often considered resigned from current job,19.4% of the nurses were seeking other job opportuneities. About 30% of the variance in intent to leave could be explained by the set of independent variables including burnout, job satisfaction health functioning and personal characteristics of nurses(R2=0.303). Emotional exhaustion had the strongest impact on intent to leave, which explained 15.7% of the variance, followed by work experience and job satisfaction (7.3% and 4.9% respectively). The main reason of considering leaving nursing job was the high working risk, followed by low pay, unsatisfied working conditions and health reasons and so on.
Conclusions:Health functioning among nursing staff in Jiaxing area was low, burnout and depersonalization was in the moderate, Nurses perception of achievement from work was generally at a low level, Job satisfaction was at a medium level. The important influencing factors were burnout, health functioning and shift work. The intent to leave rate was on a relatively high level, thus nursing team was in an unstable state; Factors affecting intent to leave rate including personal and professional characteristics, burnout, job satisfaction and health functioning. The higher job burnout, the higher turnover rate. The lower job satisfaction, the higher turnover rate; Health functioning of nurses was also an important variable affecting intent to leave.
The possible top four reasons for nurses leaving were high working risks, low rewards, unsatisfactory working conditions and health reasons. For the nursing staff job satisfaction, intent to leave rate status and influencing factors, effective intervenetions should be taken, such as strengthening the nursing manpower allocation; improving the economic and social treatment of nurses; emphasizing supernumerary nurse team-building; establishing security mechanisms to control nursing risks; training specialist nurses, providing professional development opportunities for practice, bringing into full play the enthusiasm of the work of nurses; emphasizing physical and mental health of nurses to improve nursing job satisfaction, so as to reduce turnover rate, stable nursing team, ensure nursing quality and safety of care.
引文
[1]迟俊涛,于鲁欣,娄凤兰.护士工作满意度相关理论及影响因素的研究进展.解放军护理杂志,2006,23(5)：64-65.
[2]唐湘铧.合同护士工作满意度与离职意愿调查分析及管理对策.现代护理,2007,7(6)：108-110.
[3]黄金,李乐之,彭丹等.三级医院聘用制护士工作满意度与离职意愿的现状调查.中华护理杂志,2008,43(6)：527-530.
[4]Guler C, Nimet S, Gencalp GK, et al. Quality of life and job satisfaction of nurses. Journal of Nursing Care Quality,2003,18(2):151-158.
[5]Curtis E. A. Job satisfaction:a survey of nurses in the Republic of Ireland. International Nursing Review,2007,54,92-99.
[6]唐吉荣,张雪岚,陈毅怡.影响护士工作满意度的相关因素分析.护理研究,2007,21(6B)：1532-1533.
[7]Andrews DR, Dziegielewski SF. The Nurse manager:job satisfaction, the nursing shortage and retention. Journal of Nursing Management,2005,13 (4):286-95.
[8]Shields MA, Ward M. Improving nurse retention in the National Health Service in England:the impact of job satisfaction on intentions to quit. Journal Of Health Economics,2001,20 (5):677-701.
[9]Finlayson M, Aiken L, Nakarada-Kordic I. New Zealand nurses' reports on hospital care:an international comparison. Nursing Praxis in New Zealand,2007,23(1):17-28.
[10]Hasselhorn HM, Tackenberg P, Peter R, et al. Effort-reward imbalance among nurses in stable countries and in countries in transition. International Journal of Occupational and Environmental Health,2004,10 (4):401-408.
[11]Beecroft PC, Dorey F, Wenten M. Turnover intention in new graduate nurses:a multivariate analysis. Journal of Advanced Nursing,2008,62(1):41-52.
[12]Aiken LH, Clarke SP, Sloane DM et al.Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. The Journal Of The American Medical Association,2002,288 (16):1987-1993.
[13]Aiken LH, Clarke SP, Sloane DM et al. Effects of Hospital Care Environment on Patient Mortality and Nurse Outcomes. The Journal Of nursing administration,2008, 38 (5):223-229.
[14]卫生部.中国护理事业发展规划纲要(2005-2010年).中国医院,2005,9(9)：26-28.
[15]卫生部统计信息中心,2003-2007年我国卫生情况发展简报.http//www.moh.gov.cn.2007.
[16]郭燕红.贯彻实施《护士条例》保障护士合法权益全面履行护士义务.中华护理杂志,2008,43(5)：390-391.
[17]嘉兴市卫生信息统计资料,嘉兴市卫生局医政处,2007.
[18]中华人民共和国国务院令第517号.《护士条例》.中华护理杂志,2008,43(3)：198-200.
[19]Ingersoll GL, Olsan T, Drew-Cates J, et al. Nurses' job satisfaction, organizational commitment, and career intent. The Journal of Nursing Administration, 2002,32(5):250-263.
[20]Murrells T, Robinson T, Griffiths P. Job satisfaction trends during Nurses' early career. BMC Nursing,2008,7 (7):1-13.
[21]周荣慧,郭秀花,马岩.北京市综合性医院护士工作满意度及相关因素研究.中国护理管理杂志,2007,7(5)：22-25.
[22]叶文琴.上海市护理人力资源配置现状与对策.上海护理,2007,7(1)：5-7.
[23]Aiken LH, Clarke SP, Sloane DM. Hospital staffing, organization, and quality of care. Cross-national findings. International Journal for Quality in Health,2002, 14 (1):5-13.
[24]McNeese-Smith DK. descriptions of job satisfaction and dissatisfaction. Journal of Advanced Nursing,1999,29 (6):1332-1341.
[25]Sellgren SF, Ekvall G, Tomson G. Leadership behaviour of nurse managers in relation to job satisfaction and work climate. Journal Of Nursing Management,2008,16(5):578-587.
[26]Lu H, While AE, Barriball KL. A model of job satisfaction of nurses:a reflection of nurses'working lives in Mainland China. Journal of Advanced Nursing,2007,58(5): 468-479.
[27]Ogresta J, Rusac S, Zorec L. Relation Between Burnout Syndrome and Job Satisfaction Among Mental Health Workers. Croatian Medical Journal,2008,49(3): 364-374.
[28]Kilfedder CJ, Power KG, Wells TJ. burnout in psychiatric nursing. Journal Of Advanced Nursing,2001,34 (3):383-96.
[29]Lee H, Song R, Cho YS,et al. A comprehensive model for predicting burnout in Korean nurses. Journal of Advanced Nursing,2003,44(5):534-45.
[30]李小妹,刘彦君.护士工作压力源及工怍疲溃感的调查研究.中华护理杂志,2000,35(11)：645-649.
[31]郑建萍,段丽丽.护理人员工作疲溃认知水平与疲溃程度的调查研究.中国实用护理杂志,2007,23(1B)：59-60.
[32]Larrabee JH, Janney MA, Ostrow CL, et al. Predicting registered nurse job satisfaction and intent to leave. The Journal of Nursing Administration, 2003,33(5):271-83.
[33]Jork IT, Samdal GB, Hansen BS, et al. Job satisfaction in a Norwegian population of nurses:a questionnaire survey. International Journal of Nursing Studies, 2007,44(5):747-757.
[34]柯彩霞,林爱华,刘琼慧等.临床护士离职意愿影响因素的研究.护理管理杂志,2009,9(7)：6-7.
[35]Felton JS.Burnout as a clinical entity—its importance in health care workers. Occup Med,1998,48 (4):237-250.
[36]Madeleine Estryn-Be'har, Beatrice I. J. M. Van der Hei jden, et al, The Impact of Social Work Environment, Teamwork Characteristics, Burnout, and Personal Factors Upon Intent to Leave Among European Nurses. Medical Care,2007,45(10):939-950.
[37]Lin F, John W, Mcveigh C. Burnout among hospital nurses in China.Journal of Nursing Management,2009,17:294-301.
[38]何贵蓉,李小妹,顾炜,等.护理工作压力源及压力程度的研究现状.护理学杂志,2001,16(11)：700-701.
[39]郑建萍,段丽丽.护士职业性疲溃预防不力的现状分析及对策.中国护理管理杂志,2007,7(6)：30-31.
[40]赵慧华,吴燕.护士流失的相关因素分析与对策.上海护理,2004,4(5)：56-57.
[41]刘霞.锦州市三级甲等医院护士离职相关因素调查.中国护理管理杂志,2008,8(12)：37-39.
[42]杨桂华,杨海新,朱海燕,等.三级医院病房护士离职原因的调查研究.中国护理管理杂志,2007,7(9)：15-17.
[43]Shaver KH, Lacey LM..Job and career satisfaction among staff nurses:effects of job setting and environment. Journal of Nursing Administration, 2003,33 (3):166-72. [44] Freudenberger H. J. The High Cost of High Achievement, Double day, New York,1980.
[45]Maslach C, Jackson SE. The measurement of experienced burnout. Journal of Occupational Behavior,1981,2:99-113.
[46]Maslach C, Jackson S. E. Maslach Burnout Inventory Manual. Consulting Psychologists Press Inc, Palo Alto, CA.1996.
[47]Hudek-Knezevic J, Krapic N, Rajter L. The relation between emotional control, perceived stress at work and professional burnout in hospital nurses. Psihologijske teme,2005,14:41-54.
[48]Patrick K, Lavery JF. Burnout in nursing. A Quarterly Publication Of The Royal Australian Nursing Federation. Australian Journal of Advanced Nursing,2007,24(3): 43-48.
[49]Stephen P. Robbins.组织行为学(第九版).北京：清华大学出版社,2003：76-80.
[50]Kettinger Geiger JW, Davit JS. Self-image and job satisfaction in varied settings. Nursing Management,1988,19(12):50-56,58.
[51]Cavanagh SJ. Nursing turnover:Literature review and methodological critique. Journal of advanced nursing,1989,14:587-596.
[52]Cavanagh SJ. Job satisfaction of nursing staff working in hospitals. Journal of advanced nursing,1992,22:158-159.
[53]Bedeian AG, Armenakis AA. A Path-analytic study of the Consequences of Role Conflict and Ambiguity.Academy of Management Journal,1981,24(2):417-424.
[54]郑春芳,朱海利.515名临床护士离职意愿的调查分析.中国护理管理,2007,7(4)：28-31.
[55]Brewer CS, Kovner CT, Greene W, et al. Predictors of RNs' intent to work and work decisions 1 year later in a U.S. national sample. International Journal of Nursing Studies,2009,46(7):940-956.
[56]Alfonso S, Fred H. Analyzing job mobility with job turnover intention:an international comparative study. Journal of Economic Issue,2004,38(1):130-137.
[57]The WHOQOL Group. What is quality of life? World Health Forum.1996; 17(48):354-356.
[58]Ferrens CE. Quality of life:conceptual issues. Seminal Oncology Nursing. 1990,6(4):248.
[59]Ware JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36): Conceptual framework and item selection. Medical Care,1992,30(6):473-83.
[60]Turner-Bowker DM.Bayliss MS, Ware JE, et al. Usefulness of the SF-8 health for comparing the impact of mingraine and other conditions. Quality Life Resarch,2003, 12 (8):1003-1012.
[61]陈晓敏,邢文华,朱建华.医学结局研究简短量表在冠心病患者健康相关生活质量测定上的应用.中国行为医学科学,2004,13(6)：696-697.
[62]Ware JE, Kosinski M, Dewey JE,et al. How to score and interpret single-item health status measures:A manual for users of the SF-8 TM health survey. Lincoln: Quality Metric, Inc.2001.
[63]李健.护士职业紧张与身心健康及离职意愿的前瞻性研究.上海：上海复旦大学研究生院博士后论文,2008：23,47.
[64]Maslach C. Underrstanding burnout:definitional issues in analyzing a complex phenomenon. In:Paine WS, ed. Job stress and burnout. research theory and intervention perspectives,1992:29-40.
[65]Beckstead JW. Confirmatory factor analysis ofthe Maslach Burnout Inventory among Flofids nurse. International Journal of Nursing Study,2002,39:785-792.
[66]陆虹.用因子分析测量“护士工作满意度量表”的结构效度.护士进修杂志,2007,22(11)，975-977.
[67]Miehaels CE, Speetor PE. Causes of employee turnover:A test of the Mobley, Griffeth, Hand, and Meglion model. Journel of Applied Psychology,1982, (62): 237—240.
[68]李栋荣,李经远.矩阵式组织结构下角色冲突、组织承诺、离职意愿关联性研究,国立交通大学管理科学研究所硕士论文.台湾,2000.
[69]Matsuoka H, Suzuki S. Perceived health, and its correlation with depression and subjective symptoms of nurses and care workers. Sangyo Eiseigaku Zasshi,2008, 50(2):49-57.
[70]方藕环,董静波,陈国员等.慈溪市护士心理健康状况调查及分析.护理与康复,2008,7(10)：735-736.
[71]姚文英,邹志方,黄志红等.医院护士职业压力与身心健康调查.护理研究,2006,20(4A)：870-872.
[72]Matsumoto M, Kamata S, Naoe H et al. Investigation of the actual conditions of hospital nurses working on three rotating shifts:questionnaire results of shift work schedules, feelings of sleep and fatigue, and depression. Seishin Shinkeigaku Zasshi. 1996,98(1):11-26.
[73]Gold DR, Rogacz S, Bock N,et al. Rotating shift work, sleep, and accidents related to sleepiness in hospital nurses. Am J Public Health,1992,82 (7):1011-1014.
[74]孙晓颖.国内外护士职业压力研究.国际护理学杂志,2006,25(1)：4-7.
[75]左月燃,武巍,唐咪咪,等.社会心理因素对护士健康影响与对策.中国健康教育,1994,10(12)：19-21.
[76]Schernhammer ES, Laden F, Speizer FE, et al. Night-shift work and risk of colorectal cancer in the nurses' health study. Journa of the National Cancer Institute, 2003,95 (11):825-828.
[77]张清华,刘小华.不同科室临床护士身心健康状况的调查研究.护理管理杂志,2007,7(6)：18-20.
[78]骆宏,叶志弘,秦建芬.杭州地区护士职业倦怠状况调查.中国临床心理学杂志,2007,15(6)：600-602.
[79]UpenieksV V. The interrelationship of organizational caracteristics of magnet hospitals. nursing leadership and nursing job satiafaction. Health Care Management.2003,22(2):83-98.
[80]何淑贞.太原市城区二级以上综合医院护士工作满意度调查分析.山西：山西医科大学硕士论文,2006：33
[81]唐素琼.运用人本管理激励理论营造护理人员成长的良好环境.中华现代护理学杂志,2008,5(3)：239-240.
[82]钟紫凤,叶锋,邵乐文.不同日常生活自理能力分级护理成本核算的研究.中华护理杂志,2009,44(3)：215-217.
[83]浙江省卫生厅内部资料,2007.
[84]曹颖,于艳秋.护士工作满意度相关因素分析.中华医院管理杂志,2000,16(7)：437-439.
[85]杜萍,叶文琴.上海市护理人力资源配置现状伦理分析.中国医学伦理学,2008,21(6)：137-138.
[86]Kirkby MP, Dost P, Holdwick CC, et al. Improving staffing with a resource management plan. The Journal of Nursing administration,1998,28(11):25-29.
[87]Simpson K. Job satisfaction or dissatisfaction reported by registered nurses. Nursing administration quarterly.1985, Spring:64-66.
[88]Cesim D. Determining the levelof job satisfaction of nurses working at Turkish military forces hospitals. Military Medical,2002,167 (5):402-405.
[89]施雁,高秋韵.上海护理质量监控体系的建立与运作.中国护理管理,2007,7(11)：8-10.
[90]Fochsen G, Sjogren K, Josephson M, et al. Factors contributing to the decision to leave Nursing care:a study among Swedish Nursing personnel. Journal of Nursing Management,2005,13 (4):338-344.
[91]李爱文,李春霞,谢春雷等.护士工作疲溃感的调查研究.齐齐哈尔医学院院报,2007,28(23)：2897-2899.
[92]柯彩霞.临床护士离职意愿及其与工作满意度、组织承诺关系的研究.广州：中山大学硕士论文,2008：16.
[93]Parker PA, Kulik JA. Burnout, self-and supervisor-related job performance and absenteeism among nurses. Journal of Behavior Medical,1995,18:581-599.
[94]Song R, Daly B. J, Rudy E. B, et al. Nurses job satisfaction, absenteeism, and turnover after implementing a special care unit practice model. Research in Nursing and Health,1997,20:443-452.
[95]Leiter MP, Harvie P, Frizzell C. The correspondence of patient satisfaction and nurse burnout. Social Science Medical,1998,47 (10):1611-1617.
[96]吴林静,姜冬九.长沙市临床护士工作满意度和离职意愿的相关性研究.护理管理杂志,2008,8(3)：1-3.
[97]刘永安,王芳.影响员工离职意向的因素研究.企业经济,2006,(6)：42-44.
[98]李永鑫,李艺敏.护士倦怠与自尊、健康和离职意向的相关性研究.中华护理杂志,2007,42(5)：392-395.
[99]Simon M, Tackenberg P, Nienhaus A, et al. Back or neck-pain-related disability of nursing staff in hospitals, nursing homes and home care in seven countries--results from the European NEXT-Study. International Journal of Nursing Studies,2008,45 (1): 24-34.
[100]vander Heijden BI, Demerouti E, Bakker AB, et al. Work-home interference among nurses:reciprocal relationships with job demands and health. Journal of Advanced Nursing,2008,62 (5):572-584.
[101]应文娟,黄华兰,李一鸣,等.综合医院护士群体职业应激对身心健康的影响研究.护理研究,2004,18(1)：10-12.
[102]王庆玲.北京市合同护士工作满意度及应对方式调查.护士进修杂志,2007,22(23)：2175-2176.
[103]易巧云,朱海利,任小红等.临床护士离职意愿影响因素研究.中国行为医学科学,2007,16(8)：745-747.
[104]Pfaff J. Factors related to job satisfaction/dissatisfaction of registed nurse in long term facilities. Nursing Management,1998,18(8):51-55.
[105]Gage H.英国护士离职的原因.Nursing Times,2001,97(7):35-37.
[106]乐凌,夏佳芬,李宛珍,等.宁波市市级医院护理人力资源的现状调查及管理对策.护理与康复,2008,7(12)：898-900.
[107]陈先梅,吴庆芳.护士职业倦怠、离职意愿相关因素研究.护理实践与研究,2008,5(5B)：72-73
[108]刘逸文,李继平,吴小玲.护士离职原因及组织保持力的相关性研究进展.中华护理杂志,2008,43(4)：351-353
[109]浙江省实施《中国护理事业发展规划纲要(2005-2010年)方案》.http//zjwsrcw. com,2006.
[110]朱京慈,李涛,沈世琴.国外临床护理专家发展现状及对我国护理的启迪.护理管理杂志,2001,11(1)：10—12.
[111]马慧,姜安丽.文献研究临床专科护士的发展及启示.护理研究,2007,21(4C)：1099-1101.
[112]Valada V U. The interrelationship of organizational characteristics of magnet hospitals, nursing leadership, and nursing job satisfaction. Health Care Management, 2003,22(2):83-98.
[113]吴华琨,林明色,杨仲毅.护士按职上岗的优点.现代医院,2006,6(7)：117-118.
[114]Ewers P, Bradahaw T, McGovern J, et al. Does training in psychosocial interventions reduce burnout rate in forensic nurse? Nursing Advance,2002,32 (12): 648
[115]谢文,张振路,郑志惠等.护士工作疲溃感与工作压力源及应对方式的相关研究.中国行为医学科学,2005,14(5)：462-463.
[1]中华人民共和国国务院令第517号,护士条例.2008,5.
[2]Stephen P. Robbins.组织行为学(第九版).北京：清华大学出版社,2003：76-80.
[3]Kettinger Geiger JW, Davit JS. Self-image and job satisfaction in varied settings. Nursing Management,1988,19(12):50-56.
[4]Cavanagh SJ. Nursing turnover:Literature review and methodological critique. Journal of advanced nursing,1989,14:587-596.
[5]Cavanagh SJ. Job satisfaction of nursing staff working in hospitals. Journal of advanced nursing,1992,22:158-159.
[6]吴菁,刘晓虹,陶红.护士工作满意度的研究进展.中华护理杂志,2006,41(6)：548-550.
[7]Andrews DR, Dziegielewski SF. The nurse manager:job satisfaction, the nursing shortage and retention. Journal of Nursing Management,2005,13 (4):286-95.
[8]Mueller CW, McCloskey JC. Nurse'job satisfaction:Aproposed measure.Nursing Research,1990,39(2):113—117.
[9]陆虹.用因子分析测量“护士工作满意度量表”的结构效度.护士进修杂志,2007,22(11),975-977.
[10]曹颖,于艳秋.护士工作满意度相关因素分析。中华医院管理杂志,2000,16(7)：437-439.
[11]Guler C, NimetS, Gencalp GK. Quality of life and job satisfaction of nurses. Journal of Nursing Care Quality,2003,18 (2):151-158.
[12]唐吉荣,张雪岚,陈毅怡.影响护士工作满意度的相关因素分析.护理研究.2007,21(6B)：1532-1533.
[13]Ingersoll GL, Olsan T, Drew-Cates J, et al. Nurses' job satisfaction, organizational commitment, and career intent. Journal of Nursing Administration,2002,32(5):250-63.
[14]Murrells T, Robinson T, Griffiths P. Job satisfaction trends during nurses' early career. BMC Nursing.2008,7:7.
[15]周荣慧、郭秀花、马岩.北京市综合性医院护士工作满意度及相关因素研究.中国护理管理杂志,2007,7(5)：22-25.
[16]Aiken LH, Clarke SP, Sloane DM. Hospital staffing, organization, and quality of care. Cross-national findings. International Journal for Quality in Health,2002,14 (1):5-13.
[17]McNeese-Smith DK. descriptions of job satisfaction and dissatisfaction. Journal Of Advanced Nursing,1999,29 (6):1332-41.
[18]Sellgren SF, Ekvall G, Tomson G. Leadership behaviour of nurse managers in relation to job satisfaction and work climate. Journal Of Nursing Management,2008,16(5):578-87.
[19]Freudenberger H. J. The High Cost of High Achievement, Double day, New York,1980.
[20]Maslach C, Jackson SE. The measurement of experienced burnout. Journal of Occupational Behavior,1981,2:99-113.
[21]Maslach C, Jackson S. E. Maslach Burnout Inventory Manual. Consulting Psychologists Press Inc, Palo Alto, CA.1996.
[22]Hudek-Knezevic J, Krapic N, Rajter L. The relation between emotional control, perceived stress at work and professional burnout in hospital nurses. Psihologijske teme,2005,14:41-54.
[23]Patrick K, L avery JF. Burnout in nursing. A Quarterly Publication Of The Royal Australian Nursing Federation. Australian Journal of Advanced Nursing,2007,24.(3):43-48.
[24]Beckstead JW. Confirmatory factor analysis ofthe Maslach Burnout Inventory among Flofids nurse. International Journal of Nursing Studies,2002,39:785-792.
[25]Madeleine Estryn-Be'har, Beatrice I. J. M. Van der Heijden, et al, The Impact of Social Work Environment, Teamwork Characteristics, Burnout, and Personal Factors Upon Intent to Leave Among European Nurses. Medical Care,2007,45(10):939-950.
[26]Ogresta J, Rusac S, Zorec L. Relation Between Burnout Syndrome and Job Satisfaction Among Mental Health Workers. Croatian Medical Journal, 2008,49(3):364-374.
[27]Kilfedder CJ, Power KG, Wells TJ. burnout in psychiatric nursing. Journal Of Advanced Nursing,2001,34 (3):383-96.
[28]Lee H, Song R, Cho YS,et al. A comprehensive model for predicting burnout in Korean nurses. Journal of Advanced Nursing,2003,44(5):534-45.
[29]李小妹,刘彦君.护士工作压力源及工怍疲溃感的调查研究.中华护理杂志,2000,35(11)：645-649.
[30]郑建萍,段丽丽.护理人员工作疲溃认知水平与疲溃程度的调查研究.中国实用护理杂志,2007,23(1B)：59-60.
[31]Stordeur S, Vandenberghe C, D'hoore W. Predictors of nurses' professional burnout:a study in a university hospital. Rech Soins Infirm, 1999, (59):57-67.
[32]Bedeian AG, Armenakis AA. A Path-analytic study of the Consequences of Role Conflict and Ambiguity. Academy of Management Journal, 1981,24(2):417-424.
[33]郑春芳,朱海利.515名临床护士离职意愿的调查分析.中国护理管理,2007,7(4)：28-31.
[34]Brewer CS, Kovner CT, Greene W et al. Predictors of RNs'intent to work and work decisions 1 year later in a U.S. national sample. International Journal of Nursing Studies,2009,46(7):940-956.
[35]Alfonso S, Fred H. Analyzing job mobility withjob turnover intention: an international comparative study. Journal of Economic Issue,2004,38(1):130-137.
[36]唐湘铧.合同护士工作满意度与离职意愿调查分析及管理对策.现代护理,2007,7(6)：108-110.
[37]刘霞.锦州市三级甲等医院护士离职相关因素调查.中国护理管理杂志,2008,8(12)：37-39.
[38]Holmas TH. Keeping Nurses at work:a duration analysis. Health Economic,2002,11(6):493-503.
[39]杨桂华,杨海新,朱海燕,等.三级医院病房护士离职原因的调查研究.中国护理管理杂志,2007,7(9)：15-17.
[40]Barron D, West E. Leaving nursing:an event-history analysis of nurses'careers. Journal of Health Service Research Policy,2005,10(3): 150-157.
[41]Lynn MR, Redman RW. Faces of the nursing shortage:influences on staff nurses'intentions to leave their positions or nursing. Journal of Nursing Administration,2005,35(5):264-70.
[42]Hasselhorn HM, Tackenberg P, Peter R; Next-Study Group. Effort-reward imbalance among nurses in stable countries and in countries in transition. International Journal of Occupational Environment Health, 2004,10 (4):401-408.
[43]LarrabeeJH; Janney MA; Ostrow CL;etc. Predicting registered nurse job satisfaction and intent to leave. The Journal Of Nursing Administration, 2003,33(5):271-83.
[44]Jork IT, Samdal GB, Hansen BS, et al. Job satisfaction in a Norwegian population of nurses:a questionnaire survey. International Journal of Nursing Studies,2007,44(5):747-57.
[45]易巧云,朱海利,任小红等.临床护理人员离职意愿影响因素研究.中国行为医学科学,2007,16(8)：745-747.
[46]黄金,李乐之,彭丹等.三级医院聘用制护士工作满意度与离职意愿的现状调查.中华护理杂志,2008,43(6)：527-530.
[47]Shields MA, Ward M. Improving nurse retention in the National Health Service in England:the impact of job satisfaction on intentions to quit. Journal Of Health Economics,2001,20 (5):677-701.
[48]Felton JS. Burnout as a clinical entity—its importance in health care workers. Occupational Medical,1998,48 (4):237-250.
[49]何贵蓉,李小妹,顾炜,等.护理工作压力源及压力程度的研究现状.护理学杂志,2001,16(11)：700-701.
[50]郑建萍,段丽丽.护士职业性疲溃预防不力的现状分析及对策.中国护理管理杂志,2007,7(6)：30-31.
[51]Shaver KH, Lacey LM. Job and career satisfaction among staff nurses: effects of job setting and environment. Journal of Nursing Administration,2003,33(3):166-72.
[52]Aiken LH, Clarke SP, Sloane DM et al. Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. The Journal Of The American Medical Association,2002,288 (16):1987-1993.
[53]McConnell CR. Staff turnover:occasional friend, frequent foe, and continuing frustration. Health Care Management.1999,18(1):1-13.
[54]Tai TW, Bame SI, Robinson CD. Review of nursing turnover research, 1977-1996. Social Science Medical,1998,47(12):1905-1924.
[55]Patricia W. S, Cathy M K, Elaine L. L, et al. Nurse Working Conditions, Organizational Climate, and Intent to Leave in ICUs:An Instrumental Variable Approach. Health Services Research,2007,42 (3):1085-1104.
[56]刘逸文,李继平,吴小玲.护士离职原因及组织保持力的相关性研究进展.中华护理杂志,2008,43(4)：351-353
[57]马从莎,叶志弘.同事支持与护士工作满意度的相关性研究.护士进修杂志,2007,22(16)：1447-1450.
[58]乔世娜,叶志弘.护士长支持对护士工作压力影响的研究.护理与康复,2007,6(12)：795-799.
[59]吴林静,姜冬九.长沙市临床护士工作满意度和离职意愿的相关性研究.护理管理杂志,2008,8(3)：1-3.
[60]Spence Laschinger HK, Leiter MP. The impact of nursing work environments on patient safety outcomes:the mediating role of burnout/engagement. Journal of Nursing Administration,2006,36:259-67.
[61]Ewers P, Bradshaw T, McGovem J, et al. Does training in psychosocial interventions reduce burnout rates in forensic nurses? Journal of Nursing Administration,2002,32(12):648—654.
[62]谢文,张振路,郑志惠,等.护士工作疲溃感与工作压力源及应对方式的相关研究.中国行为医学科学,2005,14(5)：462—463,474.
[2]唐湘铧.合同护士工作满意度与离职意愿调查分析及管理对策.现代护理,2007,7(6)：108-110.
[3]黄金,李乐之,彭丹等.三级医院聘用制护士工作满意度与离职意愿的现状调查.中华护理杂志,2008,43(6)：527-530.
[4]Guler C, Nimet S, Gencalp GK, et al. Quality of life and job satisfaction of nurses. Journal of Nursing Care Quality,2003,18(2):151-158.
[5]Curtis E. A. Job satisfaction:a survey of nurses in the Republic of Ireland. International Nursing Review,2007,54,92-99.
[6]唐吉荣,张雪岚,陈毅怡.影响护士工作满意度的相关因素分析.护理研究,2007,21(6B)：1532-1533.
[7]Andrews DR, Dziegielewski SF. The Nurse manager:job satisfaction, the nursing shortage and retention. Journal of Nursing Management,2005,13 (4):286-95.
[8]Shields MA, Ward M. Improving nurse retention in the National Health Service in England:the impact of job satisfaction on intentions to quit. Journal Of Health Economics,2001,20 (5):677-701.
[9]Finlayson M, Aiken L, Nakarada-Kordic I. New Zealand nurses' reports on hospital care:an international comparison. Nursing Praxis in New Zealand,2007,23(1):17-28.
[10]Hasselhorn HM, Tackenberg P, Peter R, et al. Effort-reward imbalance among nurses in stable countries and in countries in transition. International Journal of Occupational and Environmental Health,2004,10 (4):401-408.
[11]Beecroft PC, Dorey F, Wenten M. Turnover intention in new graduate nurses:a multivariate analysis. Journal of Advanced Nursing,2008,62(1):41-52.
[12]Aiken LH, Clarke SP, Sloane DM et al.Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. The Journal Of The American Medical Association,2002,288 (16):1987-1993.
[13]Aiken LH, Clarke SP, Sloane DM et al. Effects of Hospital Care Environment on Patient Mortality and Nurse Outcomes. The Journal Of nursing administration,2008, 38 (5):223-229.
[14]卫生部.中国护理事业发展规划纲要(2005-2010年).中国医院,2005,9(9)：26-28.
[15]卫生部统计信息中心,2003-2007年我国卫生情况发展简报.http//www.moh.gov.cn.2007.
[16]郭燕红.贯彻实施《护士条例》保障护士合法权益全面履行护士义务.中华护理杂志,2008,43(5)：390-391.
[17]嘉兴市卫生信息统计资料,嘉兴市卫生局医政处,2007.
[18]中华人民共和国国务院令第517号.《护士条例》.中华护理杂志,2008,43(3)：198-200.
[19]Ingersoll GL, Olsan T, Drew-Cates J, et al. Nurses' job satisfaction, organizational commitment, and career intent. The Journal of Nursing Administration, 2002,32(5):250-263.
[20]Murrells T, Robinson T, Griffiths P. Job satisfaction trends during Nurses' early career. BMC Nursing,2008,7 (7):1-13.
[21]周荣慧,郭秀花,马岩.北京市综合性医院护士工作满意度及相关因素研究.中国护理管理杂志,2007,7(5)：22-25.
[22]叶文琴.上海市护理人力资源配置现状与对策.上海护理,2007,7(1)：5-7.
[23]Aiken LH, Clarke SP, Sloane DM. Hospital staffing, organization, and quality of care. Cross-national findings. International Journal for Quality in Health,2002, 14 (1):5-13.
[24]McNeese-Smith DK. descriptions of job satisfaction and dissatisfaction. Journal of Advanced Nursing,1999,29 (6):1332-1341.
[25]Sellgren SF, Ekvall G, Tomson G. Leadership behaviour of nurse managers in relation to job satisfaction and work climate. Journal Of Nursing Management,2008,16(5):578-587.
[26]Lu H, While AE, Barriball KL. A model of job satisfaction of nurses:a reflection of nurses'working lives in Mainland China. Journal of Advanced Nursing,2007,58(5): 468-479.
[27]Ogresta J, Rusac S, Zorec L. Relation Between Burnout Syndrome and Job Satisfaction Among Mental Health Workers. Croatian Medical Journal,2008,49(3): 364-374.
[28]Kilfedder CJ, Power KG, Wells TJ. burnout in psychiatric nursing. Journal Of Advanced Nursing,2001,34 (3):383-96.
[29]Lee H, Song R, Cho YS,et al. A comprehensive model for predicting burnout in Korean nurses. Journal of Advanced Nursing,2003,44(5):534-45.
[30]李小妹,刘彦君.护士工作压力源及工怍疲溃感的调查研究.中华护理杂志,2000,35(11)：645-649.
[31]郑建萍,段丽丽.护理人员工作疲溃认知水平与疲溃程度的调查研究.中国实用护理杂志,2007,23(1B)：59-60.
[32]Larrabee JH, Janney MA, Ostrow CL, et al. Predicting registered nurse job satisfaction and intent to leave. The Journal of Nursing Administration, 2003,33(5):271-83.
[33]Jork IT, Samdal GB, Hansen BS, et al. Job satisfaction in a Norwegian population of nurses:a questionnaire survey. International Journal of Nursing Studies, 2007,44(5):747-757.
[34]柯彩霞,林爱华,刘琼慧等.临床护士离职意愿影响因素的研究.护理管理杂志,2009,9(7)：6-7.
[35]Felton JS.Burnout as a clinical entity—its importance in health care workers. Occup Med,1998,48 (4):237-250.
[36]Madeleine Estryn-Be'har, Beatrice I. J. M. Van der Hei jden, et al, The Impact of Social Work Environment, Teamwork Characteristics, Burnout, and Personal Factors Upon Intent to Leave Among European Nurses. Medical Care,2007,45(10):939-950.
[37]Lin F, John W, Mcveigh C. Burnout among hospital nurses in China.Journal of Nursing Management,2009,17:294-301.
[38]何贵蓉,李小妹,顾炜,等.护理工作压力源及压力程度的研究现状.护理学杂志,2001,16(11)：700-701.
[39]郑建萍,段丽丽.护士职业性疲溃预防不力的现状分析及对策.中国护理管理杂志,2007,7(6)：30-31.
[40]赵慧华,吴燕.护士流失的相关因素分析与对策.上海护理,2004,4(5)：56-57.
[41]刘霞.锦州市三级甲等医院护士离职相关因素调查.中国护理管理杂志,2008,8(12)：37-39.
[42]杨桂华,杨海新,朱海燕,等.三级医院病房护士离职原因的调查研究.中国护理管理杂志,2007,7(9)：15-17.
[43]Shaver KH, Lacey LM..Job and career satisfaction among staff nurses:effects of job setting and environment. Journal of Nursing Administration, 2003,33 (3):166-72. [44] Freudenberger H. J. The High Cost of High Achievement, Double day, New York,1980.
[45]Maslach C, Jackson SE. The measurement of experienced burnout. Journal of Occupational Behavior,1981,2:99-113.
[46]Maslach C, Jackson S. E. Maslach Burnout Inventory Manual. Consulting Psychologists Press Inc, Palo Alto, CA.1996.
[47]Hudek-Knezevic J, Krapic N, Rajter L. The relation between emotional control, perceived stress at work and professional burnout in hospital nurses. Psihologijske teme,2005,14:41-54.
[48]Patrick K, Lavery JF. Burnout in nursing. A Quarterly Publication Of The Royal Australian Nursing Federation. Australian Journal of Advanced Nursing,2007,24(3): 43-48.
[49]Stephen P. Robbins.组织行为学(第九版).北京：清华大学出版社,2003：76-80.
[50]Kettinger Geiger JW, Davit JS. Self-image and job satisfaction in varied settings. Nursing Management,1988,19(12):50-56,58.
[51]Cavanagh SJ. Nursing turnover:Literature review and methodological critique. Journal of advanced nursing,1989,14:587-596.
[52]Cavanagh SJ. Job satisfaction of nursing staff working in hospitals. Journal of advanced nursing,1992,22:158-159.
[53]Bedeian AG, Armenakis AA. A Path-analytic study of the Consequences of Role Conflict and Ambiguity.Academy of Management Journal,1981,24(2):417-424.
[54]郑春芳,朱海利.515名临床护士离职意愿的调查分析.中国护理管理,2007,7(4)：28-31.
[55]Brewer CS, Kovner CT, Greene W, et al. Predictors of RNs' intent to work and work decisions 1 year later in a U.S. national sample. International Journal of Nursing Studies,2009,46(7):940-956.
[56]Alfonso S, Fred H. Analyzing job mobility with job turnover intention:an international comparative study. Journal of Economic Issue,2004,38(1):130-137.
[57]The WHOQOL Group. What is quality of life? World Health Forum.1996; 17(48):354-356.
[58]Ferrens CE. Quality of life:conceptual issues. Seminal Oncology Nursing. 1990,6(4):248.
[59]Ware JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36): Conceptual framework and item selection. Medical Care,1992,30(6):473-83.
[60]Turner-Bowker DM.Bayliss MS, Ware JE, et al. Usefulness of the SF-8 health for comparing the impact of mingraine and other conditions. Quality Life Resarch,2003, 12 (8):1003-1012.
[61]陈晓敏,邢文华,朱建华.医学结局研究简短量表在冠心病患者健康相关生活质量测定上的应用.中国行为医学科学,2004,13(6)：696-697.
[62]Ware JE, Kosinski M, Dewey JE,et al. How to score and interpret single-item health status measures:A manual for users of the SF-8 TM health survey. Lincoln: Quality Metric, Inc.2001.
[63]李健.护士职业紧张与身心健康及离职意愿的前瞻性研究.上海：上海复旦大学研究生院博士后论文,2008：23,47.
[64]Maslach C. Underrstanding burnout:definitional issues in analyzing a complex phenomenon. In:Paine WS, ed. Job stress and burnout. research theory and intervention perspectives,1992:29-40.
[65]Beckstead JW. Confirmatory factor analysis ofthe Maslach Burnout Inventory among Flofids nurse. International Journal of Nursing Study,2002,39:785-792.
[66]陆虹.用因子分析测量“护士工作满意度量表”的结构效度.护士进修杂志,2007,22(11)，975-977.
[67]Miehaels CE, Speetor PE. Causes of employee turnover:A test of the Mobley, Griffeth, Hand, and Meglion model. Journel of Applied Psychology,1982, (62): 237—240.
[68]李栋荣,李经远.矩阵式组织结构下角色冲突、组织承诺、离职意愿关联性研究,国立交通大学管理科学研究所硕士论文.台湾,2000.
[69]Matsuoka H, Suzuki S. Perceived health, and its correlation with depression and subjective symptoms of nurses and care workers. Sangyo Eiseigaku Zasshi,2008, 50(2):49-57.
[70]方藕环,董静波,陈国员等.慈溪市护士心理健康状况调查及分析.护理与康复,2008,7(10)：735-736.
[71]姚文英,邹志方,黄志红等.医院护士职业压力与身心健康调查.护理研究,2006,20(4A)：870-872.
[72]Matsumoto M, Kamata S, Naoe H et al. Investigation of the actual conditions of hospital nurses working on three rotating shifts:questionnaire results of shift work schedules, feelings of sleep and fatigue, and depression. Seishin Shinkeigaku Zasshi. 1996,98(1):11-26.
[73]Gold DR, Rogacz S, Bock N,et al. Rotating shift work, sleep, and accidents related to sleepiness in hospital nurses. Am J Public Health,1992,82 (7):1011-1014.
[74]孙晓颖.国内外护士职业压力研究.国际护理学杂志,2006,25(1)：4-7.
[75]左月燃,武巍,唐咪咪,等.社会心理因素对护士健康影响与对策.中国健康教育,1994,10(12)：19-21.
[76]Schernhammer ES, Laden F, Speizer FE, et al. Night-shift work and risk of colorectal cancer in the nurses' health study. Journa of the National Cancer Institute, 2003,95 (11):825-828.
[77]张清华,刘小华.不同科室临床护士身心健康状况的调查研究.护理管理杂志,2007,7(6)：18-20.
[78]骆宏,叶志弘,秦建芬.杭州地区护士职业倦怠状况调查.中国临床心理学杂志,2007,15(6)：600-602.
[79]UpenieksV V. The interrelationship of organizational caracteristics of magnet hospitals. nursing leadership and nursing job satiafaction. Health Care Management.2003,22(2):83-98.
[80]何淑贞.太原市城区二级以上综合医院护士工作满意度调查分析.山西：山西医科大学硕士论文,2006：33
[81]唐素琼.运用人本管理激励理论营造护理人员成长的良好环境.中华现代护理学杂志,2008,5(3)：239-240.
[82]钟紫凤,叶锋,邵乐文.不同日常生活自理能力分级护理成本核算的研究.中华护理杂志,2009,44(3)：215-217.
[83]浙江省卫生厅内部资料,2007.
[84]曹颖,于艳秋.护士工作满意度相关因素分析.中华医院管理杂志,2000,16(7)：437-439.
[85]杜萍,叶文琴.上海市护理人力资源配置现状伦理分析.中国医学伦理学,2008,21(6)：137-138.
[86]Kirkby MP, Dost P, Holdwick CC, et al. Improving staffing with a resource management plan. The Journal of Nursing administration,1998,28(11):25-29.
[87]Simpson K. Job satisfaction or dissatisfaction reported by registered nurses. Nursing administration quarterly.1985, Spring:64-66.
[88]Cesim D. Determining the levelof job satisfaction of nurses working at Turkish military forces hospitals. Military Medical,2002,167 (5):402-405.
[89]施雁,高秋韵.上海护理质量监控体系的建立与运作.中国护理管理,2007,7(11)：8-10.
[90]Fochsen G, Sjogren K, Josephson M, et al. Factors contributing to the decision to leave Nursing care:a study among Swedish Nursing personnel. Journal of Nursing Management,2005,13 (4):338-344.
[91]李爱文,李春霞,谢春雷等.护士工作疲溃感的调查研究.齐齐哈尔医学院院报,2007,28(23)：2897-2899.
[92]柯彩霞.临床护士离职意愿及其与工作满意度、组织承诺关系的研究.广州：中山大学硕士论文,2008：16.
[93]Parker PA, Kulik JA. Burnout, self-and supervisor-related job performance and absenteeism among nurses. Journal of Behavior Medical,1995,18:581-599.
[94]Song R, Daly B. J, Rudy E. B, et al. Nurses job satisfaction, absenteeism, and turnover after implementing a special care unit practice model. Research in Nursing and Health,1997,20:443-452.
[95]Leiter MP, Harvie P, Frizzell C. The correspondence of patient satisfaction and nurse burnout. Social Science Medical,1998,47 (10):1611-1617.
[96]吴林静,姜冬九.长沙市临床护士工作满意度和离职意愿的相关性研究.护理管理杂志,2008,8(3)：1-3.
[97]刘永安,王芳.影响员工离职意向的因素研究.企业经济,2006,(6)：42-44.
[98]李永鑫,李艺敏.护士倦怠与自尊、健康和离职意向的相关性研究.中华护理杂志,2007,42(5)：392-395.
[99]Simon M, Tackenberg P, Nienhaus A, et al. Back or neck-pain-related disability of nursing staff in hospitals, nursing homes and home care in seven countries--results from the European NEXT-Study. International Journal of Nursing Studies,2008,45 (1): 24-34.
[100]vander Heijden BI, Demerouti E, Bakker AB, et al. Work-home interference among nurses:reciprocal relationships with job demands and health. Journal of Advanced Nursing,2008,62 (5):572-584.
[101]应文娟,黄华兰,李一鸣,等.综合医院护士群体职业应激对身心健康的影响研究.护理研究,2004,18(1)：10-12.
[102]王庆玲.北京市合同护士工作满意度及应对方式调查.护士进修杂志,2007,22(23)：2175-2176.
[103]易巧云,朱海利,任小红等.临床护士离职意愿影响因素研究.中国行为医学科学,2007,16(8)：745-747.
[104]Pfaff J. Factors related to job satisfaction/dissatisfaction of registed nurse in long term facilities. Nursing Management,1998,18(8):51-55.
[105]Gage H.英国护士离职的原因.Nursing Times,2001,97(7):35-37.
[106]乐凌,夏佳芬,李宛珍,等.宁波市市级医院护理人力资源的现状调查及管理对策.护理与康复,2008,7(12)：898-900.
[107]陈先梅,吴庆芳.护士职业倦怠、离职意愿相关因素研究.护理实践与研究,2008,5(5B)：72-73
[108]刘逸文,李继平,吴小玲.护士离职原因及组织保持力的相关性研究进展.中华护理杂志,2008,43(4)：351-353
[109]浙江省实施《中国护理事业发展规划纲要(2005-2010年)方案》.http//zjwsrcw. com,2006.
[110]朱京慈,李涛,沈世琴.国外临床护理专家发展现状及对我国护理的启迪.护理管理杂志,2001,11(1)：10—12.
[111]马慧,姜安丽.文献研究临床专科护士的发展及启示.护理研究,2007,21(4C)：1099-1101.
[112]Valada V U. The interrelationship of organizational characteristics of magnet hospitals, nursing leadership, and nursing job satisfaction. Health Care Management, 2003,22(2):83-98.
[113]吴华琨,林明色,杨仲毅.护士按职上岗的优点.现代医院,2006,6(7)：117-118.
[114]Ewers P, Bradahaw T, McGovern J, et al. Does training in psychosocial interventions reduce burnout rate in forensic nurse? Nursing Advance,2002,32 (12): 648
[115]谢文,张振路,郑志惠等.护士工作疲溃感与工作压力源及应对方式的相关研究.中国行为医学科学,2005,14(5)：462-463.
[1]中华人民共和国国务院令第517号,护士条例.2008,5.
[2]Stephen P. Robbins.组织行为学(第九版).北京：清华大学出版社,2003：76-80.
[3]Kettinger Geiger JW, Davit JS. Self-image and job satisfaction in varied settings. Nursing Management,1988,19(12):50-56.
[4]Cavanagh SJ. Nursing turnover:Literature review and methodological critique. Journal of advanced nursing,1989,14:587-596.
[5]Cavanagh SJ. Job satisfaction of nursing staff working in hospitals. Journal of advanced nursing,1992,22:158-159.
[6]吴菁,刘晓虹,陶红.护士工作满意度的研究进展.中华护理杂志,2006,41(6)：548-550.
[7]Andrews DR, Dziegielewski SF. The nurse manager:job satisfaction, the nursing shortage and retention. Journal of Nursing Management,2005,13 (4):286-95.
[8]Mueller CW, McCloskey JC. Nurse'job satisfaction:Aproposed measure.Nursing Research,1990,39(2):113—117.
[9]陆虹.用因子分析测量“护士工作满意度量表”的结构效度.护士进修杂志,2007,22(11),975-977.
[10]曹颖,于艳秋.护士工作满意度相关因素分析。中华医院管理杂志,2000,16(7)：437-439.
[11]Guler C, NimetS, Gencalp GK. Quality of life and job satisfaction of nurses. Journal of Nursing Care Quality,2003,18 (2):151-158.
[12]唐吉荣,张雪岚,陈毅怡.影响护士工作满意度的相关因素分析.护理研究.2007,21(6B)：1532-1533.
[13]Ingersoll GL, Olsan T, Drew-Cates J, et al. Nurses' job satisfaction, organizational commitment, and career intent. Journal of Nursing Administration,2002,32(5):250-63.
[14]Murrells T, Robinson T, Griffiths P. Job satisfaction trends during nurses' early career. BMC Nursing.2008,7:7.
[15]周荣慧、郭秀花、马岩.北京市综合性医院护士工作满意度及相关因素研究.中国护理管理杂志,2007,7(5)：22-25.
[16]Aiken LH, Clarke SP, Sloane DM. Hospital staffing, organization, and quality of care. Cross-national findings. International Journal for Quality in Health,2002,14 (1):5-13.
[17]McNeese-Smith DK. descriptions of job satisfaction and dissatisfaction. Journal Of Advanced Nursing,1999,29 (6):1332-41.
[18]Sellgren SF, Ekvall G, Tomson G. Leadership behaviour of nurse managers in relation to job satisfaction and work climate. Journal Of Nursing Management,2008,16(5):578-87.
[19]Freudenberger H. J. The High Cost of High Achievement, Double day, New York,1980.
[20]Maslach C, Jackson SE. The measurement of experienced burnout. Journal of Occupational Behavior,1981,2:99-113.
[21]Maslach C, Jackson S. E. Maslach Burnout Inventory Manual. Consulting Psychologists Press Inc, Palo Alto, CA.1996.
[22]Hudek-Knezevic J, Krapic N, Rajter L. The relation between emotional control, perceived stress at work and professional burnout in hospital nurses. Psihologijske teme,2005,14:41-54.
[23]Patrick K, L avery JF. Burnout in nursing. A Quarterly Publication Of The Royal Australian Nursing Federation. Australian Journal of Advanced Nursing,2007,24.(3):43-48.
[24]Beckstead JW. Confirmatory factor analysis ofthe Maslach Burnout Inventory among Flofids nurse. International Journal of Nursing Studies,2002,39:785-792.
[25]Madeleine Estryn-Be'har, Beatrice I. J. M. Van der Heijden, et al, The Impact of Social Work Environment, Teamwork Characteristics, Burnout, and Personal Factors Upon Intent to Leave Among European Nurses. Medical Care,2007,45(10):939-950.
[26]Ogresta J, Rusac S, Zorec L. Relation Between Burnout Syndrome and Job Satisfaction Among Mental Health Workers. Croatian Medical Journal, 2008,49(3):364-374.
[27]Kilfedder CJ, Power KG, Wells TJ. burnout in psychiatric nursing. Journal Of Advanced Nursing,2001,34 (3):383-96.
[28]Lee H, Song R, Cho YS,et al. A comprehensive model for predicting burnout in Korean nurses. Journal of Advanced Nursing,2003,44(5):534-45.
[29]李小妹,刘彦君.护士工作压力源及工怍疲溃感的调查研究.中华护理杂志,2000,35(11)：645-649.
[30]郑建萍,段丽丽.护理人员工作疲溃认知水平与疲溃程度的调查研究.中国实用护理杂志,2007,23(1B)：59-60.
[31]Stordeur S, Vandenberghe C, D'hoore W. Predictors of nurses' professional burnout:a study in a university hospital. Rech Soins Infirm, 1999, (59):57-67.
[32]Bedeian AG, Armenakis AA. A Path-analytic study of the Consequences of Role Conflict and Ambiguity. Academy of Management Journal, 1981,24(2):417-424.
[33]郑春芳,朱海利.515名临床护士离职意愿的调查分析.中国护理管理,2007,7(4)：28-31.
[34]Brewer CS, Kovner CT, Greene W et al. Predictors of RNs'intent to work and work decisions 1 year later in a U.S. national sample. International Journal of Nursing Studies,2009,46(7):940-956.
[35]Alfonso S, Fred H. Analyzing job mobility withjob turnover intention: an international comparative study. Journal of Economic Issue,2004,38(1):130-137.
[36]唐湘铧.合同护士工作满意度与离职意愿调查分析及管理对策.现代护理,2007,7(6)：108-110.
[37]刘霞.锦州市三级甲等医院护士离职相关因素调查.中国护理管理杂志,2008,8(12)：37-39.
[38]Holmas TH. Keeping Nurses at work:a duration analysis. Health Economic,2002,11(6):493-503.
[39]杨桂华,杨海新,朱海燕,等.三级医院病房护士离职原因的调查研究.中国护理管理杂志,2007,7(9)：15-17.
[40]Barron D, West E. Leaving nursing:an event-history analysis of nurses'careers. Journal of Health Service Research Policy,2005,10(3): 150-157.
[41]Lynn MR, Redman RW. Faces of the nursing shortage:influences on staff nurses'intentions to leave their positions or nursing. Journal of Nursing Administration,2005,35(5):264-70.
[42]Hasselhorn HM, Tackenberg P, Peter R; Next-Study Group. Effort-reward imbalance among nurses in stable countries and in countries in transition. International Journal of Occupational Environment Health, 2004,10 (4):401-408.
[43]LarrabeeJH; Janney MA; Ostrow CL;etc. Predicting registered nurse job satisfaction and intent to leave. The Journal Of Nursing Administration, 2003,33(5):271-83.
[44]Jork IT, Samdal GB, Hansen BS, et al. Job satisfaction in a Norwegian population of nurses:a questionnaire survey. International Journal of Nursing Studies,2007,44(5):747-57.
[45]易巧云,朱海利,任小红等.临床护理人员离职意愿影响因素研究.中国行为医学科学,2007,16(8)：745-747.
[46]黄金,李乐之,彭丹等.三级医院聘用制护士工作满意度与离职意愿的现状调查.中华护理杂志,2008,43(6)：527-530.
[47]Shields MA, Ward M. Improving nurse retention in the National Health Service in England:the impact of job satisfaction on intentions to quit. Journal Of Health Economics,2001,20 (5):677-701.
[48]Felton JS. Burnout as a clinical entity—its importance in health care workers. Occupational Medical,1998,48 (4):237-250.
[49]何贵蓉,李小妹,顾炜,等.护理工作压力源及压力程度的研究现状.护理学杂志,2001,16(11)：700-701.
[50]郑建萍,段丽丽.护士职业性疲溃预防不力的现状分析及对策.中国护理管理杂志,2007,7(6)：30-31.
[51]Shaver KH, Lacey LM. Job and career satisfaction among staff nurses: effects of job setting and environment. Journal of Nursing Administration,2003,33(3):166-72.
[52]Aiken LH, Clarke SP, Sloane DM et al. Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. The Journal Of The American Medical Association,2002,288 (16):1987-1993.
[53]McConnell CR. Staff turnover:occasional friend, frequent foe, and continuing frustration. Health Care Management.1999,18(1):1-13.
[54]Tai TW, Bame SI, Robinson CD. Review of nursing turnover research, 1977-1996. Social Science Medical,1998,47(12):1905-1924.
[55]Patricia W. S, Cathy M K, Elaine L. L, et al. Nurse Working Conditions, Organizational Climate, and Intent to Leave in ICUs:An Instrumental Variable Approach. Health Services Research,2007,42 (3):1085-1104.
[56]刘逸文,李继平,吴小玲.护士离职原因及组织保持力的相关性研究进展.中华护理杂志,2008,43(4)：351-353
[57]马从莎,叶志弘.同事支持与护士工作满意度的相关性研究.护士进修杂志,2007,22(16)：1447-1450.
[58]乔世娜,叶志弘.护士长支持对护士工作压力影响的研究.护理与康复,2007,6(12)：795-799.
[59]吴林静,姜冬九.长沙市临床护士工作满意度和离职意愿的相关性研究.护理管理杂志,2008,8(3)：1-3.
[60]Spence Laschinger HK, Leiter MP. The impact of nursing work environments on patient safety outcomes:the mediating role of burnout/engagement. Journal of Nursing Administration,2006,36:259-67.
[61]Ewers P, Bradshaw T, McGovem J, et al. Does training in psychosocial interventions reduce burnout rates in forensic nurses? Journal of Nursing Administration,2002,32(12):648—654.
[62]谢文,张振路,郑志惠,等.护士工作疲溃感与工作压力源及应对方式的相关研究.中国行为医学科学,2005,14(5)：462—463,474.