手术室护士心理资本、工作压力源对职业生涯状况影响的调查分析
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摘要
目的调查手术室护士心理资本、工作压力源与职业生涯状况,探讨三者之间的关系,分析影响手术室护士职业生涯状况的主要预测因素,为手术室护士职业生涯教育、管理提供参考和依据。
方法采用一般资料问卷、心理资本问卷、护士工作压力源量表、职业生涯状况评价量表,方便抽取2012年5-10月山东省三所三级甲等医院234名手术室护士进行问卷调查。采用SPSS16.0对资料进行录入与分析,具体包括：描述性统计分析、参数检验(t检验、ANOVA分析)、非参数检验(X2检验、两独立样本的Mann-Whitney U检验、多独立样本的Kruskal-Wallis检验)、Pearson或Spearman相关分析以及多元线性逐步回归分析。
结果共发放调查问卷250份,回收244份,最终有效234份,有效率为95.9%,具体结果如下：
1.手术室护士心理资本总分为(100.96±11.23)分,各维度条目平均分由高至低依次为：自我效能(4.54±0.65)、希望(4.36±0.69)、韧性(4.15±0.75)、乐观(3.77±0.47)分。自我效能及希望两个维度得分较高,乐观维度得分最低。
2.手术室护士工作压力源总分为(87.64±7.08)分,各维度条目平均分由高至低依次为：护理专业及工作方面问题(2.84±0.42)、工作环境及资源问题(2.63±0.60)、时间分配和工作量问题(2.43±0.31)、管理及人际关系方面问题(2.40±0.23)、病人护理方面问题(2.37±0.20)分。
3.经正态性检验,除留职意愿外,职业生涯状况总分及其他维度得分均符合正态分布,手术室护士职业生涯状况得分为(76.78±6.52)分,职业认同、职业满意度、组织承诺维度得分分别为(28.39±4.87)、(16.94±2.71)、(26.60±2.79)分,留职意愿维度中位数为4,四分位数间距为2。
4.不同人口社会学特征的手术室护士职业生涯状况得分差异有统计学意义：>40、女性、月收入较高(1000元以上)、文化程度较高(本科及以上)、正式在编、职称较高(护士以上)手术室护士的职业生涯状况或其中维度得分高于20～30岁、男性、月收入低(<1000元)、文化程度较低(本科学历以下)、合同制、职称较低的手术室护士。
5.职业生涯状况总分与心理资本总分、自我效能、希望、韧性维度得分之间均呈正相关；职业生涯状况总分与工作压力源总分、时间分配和工作方面问题维度得分之间均呈负相关(P均<0.01)。
6.对职业生涯状况进行多元线性逐步回归分析显示,希望维度得分、心理资本总分、文化程度(与中专及以下学历的护士相比,本科及以上护士的职业生涯状况更好)及工作压力源总分(负向)是手术室护士职业生涯状况的预测变量(R2=37.6%)。
结论
1.手术室护士心理资本处于中、高等水平。护理管理者应注重采取有效措施,提升护士积极、乐观心态,整体提高护士心理健康水平。
2.手术室护士的总体工作压力源及各维度得分均呈中等水平,其中护理专业及工作方面问题为主要压力来源。我们应注重护士的专业化、分层级培训,合理安排工作量和班次,提高护士对护理专业的认识,减轻护士工作压力。
3.手术室护士职业生涯状况处于中等水平,与年龄、性别、月收入、文化程度、聘用方式、职称、心理资本及维度(乐观维度除外)得分、工作压力源及时间分配和工作方面问题维度得分显著相关。其中希望、心理资本、文化程度对手术室护士职业生涯状况有正向预测作用,工作压力源对职业生涯状况有负向预测作用,护理管理者应全面认识护士个体因素中的极心理力量,积极开发护理员工的心理资本及潜能,降低其工作压力,从而促进护士自身职业发展,提高手术室护理组织整体核心竞争力。
Objectives To investigate the psychological capital, job stressors and career condition of operating room nurses, and explore the predictors of operating room nurses career condition. Thus to provide reference and basis for the career education and management of operating room nurses.
Methods Convenience sampling was used. From May to October in2012, a total of234operating room nurses had been interviewed and analyzed in three class A tertiary hospitals of Shandong province by questionnaires on psychological capital, nurse job stressors and career condition. SPSS16.0statistical software was used for data entry and analysis, including descriptive analysis, parametric analyses (t-test. ANOVA analysis), nonparametric analyses (chi-square test. Mann-Whitney U test for comparison between two groups, Kruskal-Wallis test for comparison including more than two groups), Pearson or Spearman correlation analysis and multiple linear stepwise regression analysis.
Results A total of250questionnaires were distributed, of which244were returned and234(95.9%) were usable. Detailed informations were follows:
1.The psychological capital score of operating room nurses was100.96±11.23. From high to low, the entries average of each demension was self efficacy(4.54±0.65), hope(4.36±0.69), toughness(4.15±0.75) and optimism(3.77±0.47). The scores of self efficacy and hope were high, while the optimism dimension score was lowest.
2. The job stressors score of operating room nurses was87.64±7.08. From high to low, the entries average of each demension was nursing profession and work problem(2.84±0.42), work environment and resource problems(2.63±0.60), time allocation and workload problem(2.43±0.31), management and interpersonal problem(2.40±0.23) and patient care problem(2.37±0.20).
3. The career condition score of operating room nurses was76.78±6.52. Professional identity, job satisfaction, organizational commitment dimension scores were respectively (28.39±4.87),(16.94±2.71) and (26.60±2.79). The median and interquartile range of intention to stay was respectively4and2.
4. There were statistical differences of career condition score in different characteristics of social demography. The career condition score of the operating room nurses who were more than40years old, female, with monthly income more than￥1000, with bachelor degree or above, officially enrolled, with higher professional titles was higher than those who were20～30years old, male, with monthly income less than￥1000, with lower educational background, contractually enrolled, with lower professional titles.
5. The career condition score was positively correlated to the score of psychological capital, self efficacy, hope and toughness. And it was negatively correlated to the scores of job stressors and time allocation and workload problem dimension.
6. Multiple linear stepwise regression analysis for career condition score showed that, scores of hope dimension and psychological capital, education level(compared with nurses with technical secondary school degree or below, the career condition score of those who had bachelor degree or above was higher) and job stressors score(negatively) were predictor variables of career condition for operating room nurses, all of these could explain53.6%of the total variances.
Conclusion
1. The psychological capital score of operating room nurses was in a medium and higher level. Nurse managers should pay attention to take effective measures to improve optimistic and positive psychology of the nurses, so as to overall improve the mental health level of the nurses.
2. The scores of job stressors and the dimensions were in a medium level, nursing profession and work problem was the major source of stress. We should focus on strengthening the specialized and multilevel nurse training, arranging reasonable workload and schedules, so as to improve the recognition and relieve the working pressure of nurses.
3. The career condition score of operating room nurses was in a medium level, it was significantly correlated with age, sex, monthly income, educational level, employment way, professional title, psychological capital and the dimension scores(beside the optimistic dimension), scores of job stressors and time allocation and workload problem dimension. Scores of hope dimension and psychological capital, educational level were positive predictors, while the job stressors score was negative predictor of career condition for operating room nurses. Nurse managers should comprehensively realize the positive mental power, actively develop the psychological capital and reduce the working pressure, thereby promoting career development and organizational core competence of the operating room nurses.
方法采用一般资料问卷、心理资本问卷、护士工作压力源量表、职业生涯状况评价量表,方便抽取2012年5-10月山东省三所三级甲等医院234名手术室护士进行问卷调查。采用SPSS16.0对资料进行录入与分析,具体包括：描述性统计分析、参数检验(t检验、ANOVA分析)、非参数检验(X2检验、两独立样本的Mann-Whitney U检验、多独立样本的Kruskal-Wallis检验)、Pearson或Spearman相关分析以及多元线性逐步回归分析。
结果共发放调查问卷250份,回收244份,最终有效234份,有效率为95.9%,具体结果如下：
1.手术室护士心理资本总分为(100.96±11.23)分,各维度条目平均分由高至低依次为：自我效能(4.54±0.65)、希望(4.36±0.69)、韧性(4.15±0.75)、乐观(3.77±0.47)分。自我效能及希望两个维度得分较高,乐观维度得分最低。
2.手术室护士工作压力源总分为(87.64±7.08)分,各维度条目平均分由高至低依次为：护理专业及工作方面问题(2.84±0.42)、工作环境及资源问题(2.63±0.60)、时间分配和工作量问题(2.43±0.31)、管理及人际关系方面问题(2.40±0.23)、病人护理方面问题(2.37±0.20)分。
3.经正态性检验,除留职意愿外,职业生涯状况总分及其他维度得分均符合正态分布,手术室护士职业生涯状况得分为(76.78±6.52)分,职业认同、职业满意度、组织承诺维度得分分别为(28.39±4.87)、(16.94±2.71)、(26.60±2.79)分,留职意愿维度中位数为4,四分位数间距为2。
4.不同人口社会学特征的手术室护士职业生涯状况得分差异有统计学意义：>40、女性、月收入较高(1000元以上)、文化程度较高(本科及以上)、正式在编、职称较高(护士以上)手术室护士的职业生涯状况或其中维度得分高于20～30岁、男性、月收入低(<1000元)、文化程度较低(本科学历以下)、合同制、职称较低的手术室护士。
5.职业生涯状况总分与心理资本总分、自我效能、希望、韧性维度得分之间均呈正相关；职业生涯状况总分与工作压力源总分、时间分配和工作方面问题维度得分之间均呈负相关(P均<0.01)。
6.对职业生涯状况进行多元线性逐步回归分析显示,希望维度得分、心理资本总分、文化程度(与中专及以下学历的护士相比,本科及以上护士的职业生涯状况更好)及工作压力源总分(负向)是手术室护士职业生涯状况的预测变量(R2=37.6%)。
结论
1.手术室护士心理资本处于中、高等水平。护理管理者应注重采取有效措施,提升护士积极、乐观心态,整体提高护士心理健康水平。
2.手术室护士的总体工作压力源及各维度得分均呈中等水平,其中护理专业及工作方面问题为主要压力来源。我们应注重护士的专业化、分层级培训,合理安排工作量和班次,提高护士对护理专业的认识,减轻护士工作压力。
3.手术室护士职业生涯状况处于中等水平,与年龄、性别、月收入、文化程度、聘用方式、职称、心理资本及维度(乐观维度除外)得分、工作压力源及时间分配和工作方面问题维度得分显著相关。其中希望、心理资本、文化程度对手术室护士职业生涯状况有正向预测作用,工作压力源对职业生涯状况有负向预测作用,护理管理者应全面认识护士个体因素中的极心理力量,积极开发护理员工的心理资本及潜能,降低其工作压力,从而促进护士自身职业发展,提高手术室护理组织整体核心竞争力。
Objectives To investigate the psychological capital, job stressors and career condition of operating room nurses, and explore the predictors of operating room nurses career condition. Thus to provide reference and basis for the career education and management of operating room nurses.
Methods Convenience sampling was used. From May to October in2012, a total of234operating room nurses had been interviewed and analyzed in three class A tertiary hospitals of Shandong province by questionnaires on psychological capital, nurse job stressors and career condition. SPSS16.0statistical software was used for data entry and analysis, including descriptive analysis, parametric analyses (t-test. ANOVA analysis), nonparametric analyses (chi-square test. Mann-Whitney U test for comparison between two groups, Kruskal-Wallis test for comparison including more than two groups), Pearson or Spearman correlation analysis and multiple linear stepwise regression analysis.
Results A total of250questionnaires were distributed, of which244were returned and234(95.9%) were usable. Detailed informations were follows:
1.The psychological capital score of operating room nurses was100.96±11.23. From high to low, the entries average of each demension was self efficacy(4.54±0.65), hope(4.36±0.69), toughness(4.15±0.75) and optimism(3.77±0.47). The scores of self efficacy and hope were high, while the optimism dimension score was lowest.
2. The job stressors score of operating room nurses was87.64±7.08. From high to low, the entries average of each demension was nursing profession and work problem(2.84±0.42), work environment and resource problems(2.63±0.60), time allocation and workload problem(2.43±0.31), management and interpersonal problem(2.40±0.23) and patient care problem(2.37±0.20).
3. The career condition score of operating room nurses was76.78±6.52. Professional identity, job satisfaction, organizational commitment dimension scores were respectively (28.39±4.87),(16.94±2.71) and (26.60±2.79). The median and interquartile range of intention to stay was respectively4and2.
4. There were statistical differences of career condition score in different characteristics of social demography. The career condition score of the operating room nurses who were more than40years old, female, with monthly income more than￥1000, with bachelor degree or above, officially enrolled, with higher professional titles was higher than those who were20～30years old, male, with monthly income less than￥1000, with lower educational background, contractually enrolled, with lower professional titles.
5. The career condition score was positively correlated to the score of psychological capital, self efficacy, hope and toughness. And it was negatively correlated to the scores of job stressors and time allocation and workload problem dimension.
6. Multiple linear stepwise regression analysis for career condition score showed that, scores of hope dimension and psychological capital, education level(compared with nurses with technical secondary school degree or below, the career condition score of those who had bachelor degree or above was higher) and job stressors score(negatively) were predictor variables of career condition for operating room nurses, all of these could explain53.6%of the total variances.
Conclusion
1. The psychological capital score of operating room nurses was in a medium and higher level. Nurse managers should pay attention to take effective measures to improve optimistic and positive psychology of the nurses, so as to overall improve the mental health level of the nurses.
2. The scores of job stressors and the dimensions were in a medium level, nursing profession and work problem was the major source of stress. We should focus on strengthening the specialized and multilevel nurse training, arranging reasonable workload and schedules, so as to improve the recognition and relieve the working pressure of nurses.
3. The career condition score of operating room nurses was in a medium level, it was significantly correlated with age, sex, monthly income, educational level, employment way, professional title, psychological capital and the dimension scores(beside the optimistic dimension), scores of job stressors and time allocation and workload problem dimension. Scores of hope dimension and psychological capital, educational level were positive predictors, while the job stressors score was negative predictor of career condition for operating room nurses. Nurse managers should comprehensively realize the positive mental power, actively develop the psychological capital and reduce the working pressure, thereby promoting career development and organizational core competence of the operating room nurses.
引文
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