长春市三级甲等医院合同制护士离职倾向及相关因素研究
|
摘要
近年来,随着医院规模的扩大和人事制度改革的不断深入,我国医院的合同制护士比例呈逐年上升趋势,她们已成为护理队伍的重要补充力量。但在实际工作生活中,与合同制护士相对应的完善的管理体系尚未形成,她们在工作、薪酬、职业发展、人际、管理制度等方面面临着许多问题,造成了合同制护士的流动性和不稳定性。这样既不利于我国护理专业的发展、护理人才的培养及医院护理工作的持续开展,更直接影响着医院护理服务质量和正规化建设水平。?
基于以上的研究背景,本论文通过使用离职倾向量表、工作满意度量表和组织承诺量表对长春市四所三级甲等医院的合同制护士进行问卷调查,以此了解长春市三级甲等医院合同制护士的离职倾向现况,分析影响合同制护士离职倾向的相关因素,探讨合同制护士流失的主、客观原因,寻找有效对策,提高护理管理质量,稳定护理队伍。研究结果显示长春市三级甲等医院合同制护士的离职倾向处于中等水平;合同制护士的工作满意度、组织承诺与离职倾向呈显著负相关;在个人特征变量中,婚姻状况对离开护理职业倾向影响的最大;工作满意度中,工作本身对总体离职倾向及离开护理职业倾向的影响最大;组织承诺中,经济承诺对总体离职倾向、离开单位倾向及离开护理职业倾向的影响最大。?
Nowadays, the widespread nursing shortage has become a global issue. With the development of society and the increase of people's demand for medical services, the shortage of nurses is increasingly prominent. The high turnover of nursing staff is one of the factors of the nursing shortage. The shortage and the loss of nurses of contract nurses in our country is very urgent. Some studies show that the turnover intention is a sensitive variable to predict turnover behavior and turnover intention is affected by several factors. The objective of this study is to analysis the related factors on turnover intention of contract nurses, explore the reasons for termination of contract nurses and trying to find the effective interventions through investigating the turnover intention level of the contract nurses of class A tertiary general hospitals in Changchun. It can stabilize the nursing profession, reduce the economic losses of contract nurses’turnover, promote healthy and growth of contract nurses and thus to improve the quality of nursing care to meet the growing health needs of the people. Methods: 424 from1 year to 20 years contract nurses of class A tertiary general hospitals?sampled from four different hospitals in Changchun were investigated by a stratified random sampling method through turnover intention scale, job satisfaction scale and Chinese organizational commitment scale. The entire figure was in put into computer. Descriptive statistics, ANOVA, SNK test, Pearson correlation analysis and multiple linear stepwise regression analysis were performed by SPSS13.0 statistic software.
Results:
1. The demographic characteristics of contract nurses 424 contract nurses surveyed come from 4 different class A tertiary general hospitals in Changchun city. Most of them are under the age of 25, that is 213 cases, accounting for 50.2%. Unmarried persons are higher than married persons, that is260 cases, accounting for 61.3%. Associate degree is prominent in the educational background of nurses, there are 290, accounting for 68.4%.?From the aspect of the length of service, the number of nurses working for from more than 1 to less than 10 years is 377 nurses, accounting for 88.9%. In professional title structure, nurse assistant and primary nurse take up a large proportion, that is 69.3% and 25.9%. Among the contract nurses, there are136 nurses in surgical, accounting for 32.1%; Internal Medicine has 115 nurses, accounting for 27.1%; Obstetrics and Gynecology has 53 nurses, accounting for 12.5%; Pediatrics has 26 nurses, accounting for 6.1%; Clinic has 29 nurses, accounting for 6.8%; Emergency has 27 nurses, accounting for 6.4%; ICU has 14 nurses, accounting for 3.3%; there are 24 nurses in the operating room, which accounted for 5.7%.
2. Turnover intention scores of contract nurses
424 contract nurses surveyed overall turnover intention score is 5.07, the value of index is 50.70%. The score of tendency to leave the unit is 2.62, the value of index is 52.40%; The score of tendency to leave the nursing profession unit is 2.46, the value of index is 49.20%.
3. Job satisfaction scores of contract nurses
The general score of job satisfaction of 424 contract nurses is 27.48, the value of index is target value of 68.70%. The scores?of every dimension are: management is 3.42, the value of index is 68.40%;workload is 3.57, the value of index is71.40% that is the most satisfied dimension; relationship with colleagues is 3.45, the value of index is 69.00%;the work itself is 3.53, the value of index is 70.60%;wages and benefits is 3.34, the value of index is66.80%; personal growth and development is 3.33, the value of index is 66.60% that is the most dissatisfied dimension; work approved is 3.38, the value of index is 67.60%; family and work balance is 3.46, the value of index is 69.20%.
4. Organizational commitment scores of contract nurses
The general score of organizational commitment of 424 contract nurses is 16.47, index value is 65.88%. The highest score among five dimensions is normative commitment, that is 3.74, index value is 74.80%; the lowest score is opportunity commitment, that is2.76, index value is 55.20 %. Other scores are ideal commitment 3.50, index value is70.00%; emotional commitment 3.49, index value is 69.80%; economic commitment 2.97, index value is 59.40%.
5. Contract nurses’influential factors of turnover intention
(1)Demographic characteristic variables and turnover intention The single factor analysis of variance and SNK test show that the scores of overall turnover intention, tendency to leave the unit and tendency to leave the nursing profession of under the age of 25 are higher than the other two groups. The scores of overall turnover intention and tendency to leave the nursing profession of single contract nurses are higher than married nurses. The scores of overall turnover intention, tendency to leave the unit of 1 to 5 years working time group are higher than other groups. The turnover intention of contract nurses from different sections?are significant statistically (P <0.01).Among them, the scores of overall turnover intention, tendency to leave the unit and tendency to leave the nursing profession of the operating room contract nurses are lower than other groups. The Pearson correlation analysis shows that age, working hours, professional title are significantly negative correlated to overall turnover intention, tendency to leave the unit and tendency to leave the nursing profession (P <0.01). Marital status is significantly negative correlated to overall turnover intention and tendency to leave the nursing profession ( P<0.01). The multiple linear stepwise regression analysis shows that marital status is the significant variable affect tendency to leave the nursing profession (P = 0.032).
(2) Job satisfaction and turnover intention The Pearson correlation analysis shows that the total job satisfaction and each dimension are significantly negative correlated to overall turnover intention, tendency to leave the unit and tendency to leave the nursing profession (P <0.01). The multiple linear stepwise regression analysis shows that overall job satisfaction, work itself and the personal growth and development are affect the overall turnover intention; Work itself is affect tendency to leave the unit (P = 0.043); Overall job satisfaction, and employee relations, work itself, personal growth and development and work approved are affect tendency to leave the nursing profession ,of which the work itself is the significant variable affect overall turnover and the tendency to leave the nursing profession.
(3) Organizational commitment and turnover intention
The Pearson correlation analysis shows that the total organizational commitment and each dimension are significantly negative correlated to overall turnover intention, tendency to leave the unit and tendency to leave the nursing profession (P <0.01). The multiple linear stepwise regression analysis shows that except emotional commitment not to enter the equation, the overall organizational commitment, normative commitment, ideal commitment, economic commitment and opportunity commitment are affect overall turnover intention and the tendency to leave nursing profession; the overall organizational commitment, normative commitment, economic commitment and opportunity commitment are affect the tendency to leave the unit ;Economic commitment is the significant variable affect the overall turnover intention, tendency to leave the unit and tendency to leave the nursing profession.
Conclusion:
1. The turnover intention score of the contract nurses are in the medium level.
2. The demographic characteristic variables of contract nurses are affect turnover intention. Among them, the influence factors of overall turnover intention and tendency to leave the nursing profession are age, marital status, working hours and professional title; the influence factors of tendency to leave the unit are age, working hours and professional title; Marital status is the significant variable affect the tendency to leave the nursing profession.
3. The job satisfaction of contract nurses are significantly negative correlated to the turnover intention, job satisfaction is one of the significant predictors of turnover intention. Among them, the influence factors of the overall turnover intention are the total job satisfaction, work itself and the personal growth and development; the influence factor of the tendency to leave the unit is the work itself; the influence ?factors of the tendency to leave the nursing profession are the total job satisfaction, employee relations, work itself, personal growth and development and work to be recognized. The work itself is the significant variable affect the overall turnover intention and the tendency to leave the nursing profession.
4. The organizational commitment of contract nurses are significantly negative correlated to the turnover intention, organizational commitment is one of the significant predictors of turnover intention. Among them, the influence factors of the overall turnover intention and the tendency to leave the nursing profession are the overall organizational commitment, normative commitment, ideal commitment, economic commitment and opportunity commitment; the influence factors of the tendency to leave the unit are the overall organizational commitment, normative commitment, economic commitment and opportunity commitment. Economic commitment is the significant variable affect the overall turnover intention, tendency to leave the unit and tendency to leave the nursing profession.
基于以上的研究背景,本论文通过使用离职倾向量表、工作满意度量表和组织承诺量表对长春市四所三级甲等医院的合同制护士进行问卷调查,以此了解长春市三级甲等医院合同制护士的离职倾向现况,分析影响合同制护士离职倾向的相关因素,探讨合同制护士流失的主、客观原因,寻找有效对策,提高护理管理质量,稳定护理队伍。研究结果显示长春市三级甲等医院合同制护士的离职倾向处于中等水平;合同制护士的工作满意度、组织承诺与离职倾向呈显著负相关;在个人特征变量中,婚姻状况对离开护理职业倾向影响的最大;工作满意度中,工作本身对总体离职倾向及离开护理职业倾向的影响最大;组织承诺中,经济承诺对总体离职倾向、离开单位倾向及离开护理职业倾向的影响最大。?
Nowadays, the widespread nursing shortage has become a global issue. With the development of society and the increase of people's demand for medical services, the shortage of nurses is increasingly prominent. The high turnover of nursing staff is one of the factors of the nursing shortage. The shortage and the loss of nurses of contract nurses in our country is very urgent. Some studies show that the turnover intention is a sensitive variable to predict turnover behavior and turnover intention is affected by several factors. The objective of this study is to analysis the related factors on turnover intention of contract nurses, explore the reasons for termination of contract nurses and trying to find the effective interventions through investigating the turnover intention level of the contract nurses of class A tertiary general hospitals in Changchun. It can stabilize the nursing profession, reduce the economic losses of contract nurses’turnover, promote healthy and growth of contract nurses and thus to improve the quality of nursing care to meet the growing health needs of the people. Methods: 424 from1 year to 20 years contract nurses of class A tertiary general hospitals?sampled from four different hospitals in Changchun were investigated by a stratified random sampling method through turnover intention scale, job satisfaction scale and Chinese organizational commitment scale. The entire figure was in put into computer. Descriptive statistics, ANOVA, SNK test, Pearson correlation analysis and multiple linear stepwise regression analysis were performed by SPSS13.0 statistic software.
Results:
1. The demographic characteristics of contract nurses 424 contract nurses surveyed come from 4 different class A tertiary general hospitals in Changchun city. Most of them are under the age of 25, that is 213 cases, accounting for 50.2%. Unmarried persons are higher than married persons, that is260 cases, accounting for 61.3%. Associate degree is prominent in the educational background of nurses, there are 290, accounting for 68.4%.?From the aspect of the length of service, the number of nurses working for from more than 1 to less than 10 years is 377 nurses, accounting for 88.9%. In professional title structure, nurse assistant and primary nurse take up a large proportion, that is 69.3% and 25.9%. Among the contract nurses, there are136 nurses in surgical, accounting for 32.1%; Internal Medicine has 115 nurses, accounting for 27.1%; Obstetrics and Gynecology has 53 nurses, accounting for 12.5%; Pediatrics has 26 nurses, accounting for 6.1%; Clinic has 29 nurses, accounting for 6.8%; Emergency has 27 nurses, accounting for 6.4%; ICU has 14 nurses, accounting for 3.3%; there are 24 nurses in the operating room, which accounted for 5.7%.
2. Turnover intention scores of contract nurses
424 contract nurses surveyed overall turnover intention score is 5.07, the value of index is 50.70%. The score of tendency to leave the unit is 2.62, the value of index is 52.40%; The score of tendency to leave the nursing profession unit is 2.46, the value of index is 49.20%.
3. Job satisfaction scores of contract nurses
The general score of job satisfaction of 424 contract nurses is 27.48, the value of index is target value of 68.70%. The scores?of every dimension are: management is 3.42, the value of index is 68.40%;workload is 3.57, the value of index is71.40% that is the most satisfied dimension; relationship with colleagues is 3.45, the value of index is 69.00%;the work itself is 3.53, the value of index is 70.60%;wages and benefits is 3.34, the value of index is66.80%; personal growth and development is 3.33, the value of index is 66.60% that is the most dissatisfied dimension; work approved is 3.38, the value of index is 67.60%; family and work balance is 3.46, the value of index is 69.20%.
4. Organizational commitment scores of contract nurses
The general score of organizational commitment of 424 contract nurses is 16.47, index value is 65.88%. The highest score among five dimensions is normative commitment, that is 3.74, index value is 74.80%; the lowest score is opportunity commitment, that is2.76, index value is 55.20 %. Other scores are ideal commitment 3.50, index value is70.00%; emotional commitment 3.49, index value is 69.80%; economic commitment 2.97, index value is 59.40%.
5. Contract nurses’influential factors of turnover intention
(1)Demographic characteristic variables and turnover intention The single factor analysis of variance and SNK test show that the scores of overall turnover intention, tendency to leave the unit and tendency to leave the nursing profession of under the age of 25 are higher than the other two groups. The scores of overall turnover intention and tendency to leave the nursing profession of single contract nurses are higher than married nurses. The scores of overall turnover intention, tendency to leave the unit of 1 to 5 years working time group are higher than other groups. The turnover intention of contract nurses from different sections?are significant statistically (P <0.01).Among them, the scores of overall turnover intention, tendency to leave the unit and tendency to leave the nursing profession of the operating room contract nurses are lower than other groups. The Pearson correlation analysis shows that age, working hours, professional title are significantly negative correlated to overall turnover intention, tendency to leave the unit and tendency to leave the nursing profession (P <0.01). Marital status is significantly negative correlated to overall turnover intention and tendency to leave the nursing profession ( P<0.01). The multiple linear stepwise regression analysis shows that marital status is the significant variable affect tendency to leave the nursing profession (P = 0.032).
(2) Job satisfaction and turnover intention The Pearson correlation analysis shows that the total job satisfaction and each dimension are significantly negative correlated to overall turnover intention, tendency to leave the unit and tendency to leave the nursing profession (P <0.01). The multiple linear stepwise regression analysis shows that overall job satisfaction, work itself and the personal growth and development are affect the overall turnover intention; Work itself is affect tendency to leave the unit (P = 0.043); Overall job satisfaction, and employee relations, work itself, personal growth and development and work approved are affect tendency to leave the nursing profession ,of which the work itself is the significant variable affect overall turnover and the tendency to leave the nursing profession.
(3) Organizational commitment and turnover intention
The Pearson correlation analysis shows that the total organizational commitment and each dimension are significantly negative correlated to overall turnover intention, tendency to leave the unit and tendency to leave the nursing profession (P <0.01). The multiple linear stepwise regression analysis shows that except emotional commitment not to enter the equation, the overall organizational commitment, normative commitment, ideal commitment, economic commitment and opportunity commitment are affect overall turnover intention and the tendency to leave nursing profession; the overall organizational commitment, normative commitment, economic commitment and opportunity commitment are affect the tendency to leave the unit ;Economic commitment is the significant variable affect the overall turnover intention, tendency to leave the unit and tendency to leave the nursing profession.
Conclusion:
1. The turnover intention score of the contract nurses are in the medium level.
2. The demographic characteristic variables of contract nurses are affect turnover intention. Among them, the influence factors of overall turnover intention and tendency to leave the nursing profession are age, marital status, working hours and professional title; the influence factors of tendency to leave the unit are age, working hours and professional title; Marital status is the significant variable affect the tendency to leave the nursing profession.
3. The job satisfaction of contract nurses are significantly negative correlated to the turnover intention, job satisfaction is one of the significant predictors of turnover intention. Among them, the influence factors of the overall turnover intention are the total job satisfaction, work itself and the personal growth and development; the influence factor of the tendency to leave the unit is the work itself; the influence ?factors of the tendency to leave the nursing profession are the total job satisfaction, employee relations, work itself, personal growth and development and work to be recognized. The work itself is the significant variable affect the overall turnover intention and the tendency to leave the nursing profession.
4. The organizational commitment of contract nurses are significantly negative correlated to the turnover intention, organizational commitment is one of the significant predictors of turnover intention. Among them, the influence factors of the overall turnover intention and the tendency to leave the nursing profession are the overall organizational commitment, normative commitment, ideal commitment, economic commitment and opportunity commitment; the influence factors of the tendency to leave the unit are the overall organizational commitment, normative commitment, economic commitment and opportunity commitment. Economic commitment is the significant variable affect the overall turnover intention, tendency to leave the unit and tendency to leave the nursing profession.
引文
[1]段功香,王蓉,张平,等.合同护士的聘用现状及对护理专业影响的调查[J].中国实用护理杂志,2007,23(8):4.
[2]赵菲,张治国,邓雪萍.合同制和临时护士人事管理现状研究[J].中国护理管理, 2008,8(10):46-49.
[3]陈静,王志稳,尚少梅,等.北京市二级及以上医院合同制护士使用情况调查[J].中国护理管理,2008, 8(8): 25-27.
[4]何淑贞,张保玲,孙莉,等.合同制护士与正式护士工作满意度比较分析[J].护理研究,2008, 22(3):772-773.
[5]张玲,李加宁,宋雁宾,等.聘用护士离职现状分析及对策[J].中华现代护理杂志, 2008,14(27):2922-2924.
[6]张萍.聘用护士离职原因调查与分析[J].临床和实验医学杂志,2009,8(1): 146-147.
[7]Jones C B. The costs of nurse turnover. Part 1. An economic perspective[J]. Nursing Administration. 2004,34(12):562-570.
[8]卫生部信息统计中心. 2006年中国卫生统计提要.[EB/ OL] .http://www.moh. gov. cn.
[9]Price J L. Reflections on the determinants of voluntary turnover[J]. International Journal of Manpower, 2001,22 (7):600-624.
[10]Carol S. Brewer, Christine T. Kovner, William Greene, Ying Cheng. Predictors of RNs’intent to work and work decisions 1 year later in a U.S. national sample [J]. International Journal of Nursing Studies,2008. Mar 28. [Epub ahead of print].
[11]Christian Vandenberghe, Kathleen Bentein, Florence Stinglhamber. Affective commitment to the organization, supervisor, and work group: Antecedents and outcomes[J]. Journal of Vocational Behavior, 2004,64: 47-71.
[12]Laureen J. Hayes, Linda O,Brien-Pallas, Christine Duffield.et al. Nurse turnover: A literature review[J].International Journal of Nursing Studies, 2006,43:237–263.
[13]Billie Coomber, K. Louise Barriball. Impact of job satisfaction components on intent to leave and turnover for hospital-based nurses: A review of the research literature[J]. International Journal of Nursing Studies, 2007,44:297-314.
[14]黄兰淳.高雄地区广播从业人员离职倾向及离职行为因素之研究[D].台湾:中山大学公共事务管理研究所, 2000.
[15]欧阳玲.工作生活质量与临床护理人员离职意愿之研讨[D].台湾:东海大学企业管理研究所,1993.
[16]Irvine, D. Evans, M. Job satisfaction and turnover among nurses: integrating research findings across studies [J]. Nursing Research, 1995, 44 (4):246-253.
[17]Locke, E.A. The Nature and Causes of Job Satisfaction. In M.D.Dunnette(Ed.), The Handbook of Industrial and Organizational Psychology. Chicago,Ⅱ:Tand Mcnally, 1976:1297-1349.
[18]Hong Lu, Alison E. While, K.Louise?Barriball. Job satisfaction among nurses:a literature review [J]. International Journal of Nursing Studies, 2005,42:211.
[19]Cavanagh S J .Nursing turnover:Literature review and methodological critique [J]. Journal of Advanced Nursing, 1989,14 :587- 596.
[20]郭播春.澳门医务护理人员之工作特性、工作满意度、离职倾向之相关研究---以某私立医院为例[D].广州:华南师范大学, 2007.
[21]约翰.W.纽斯特罗姆,基斯.戴维斯.组织行为学[M].北京:经济科学出版社, 2000:326-328.
[22]胡方,刘毅.医院合同护士工作满意度调查与分析[J].中国卫生事业管理, 2005, 6(4):217 -219.
[23]潘慧,玄英哲.护士组织承诺的研究进展[J].护理学杂志,2007,22(5):72-74.
[24]Porter LM, SteersRM, Mowday RT,et al.Organizational commitment ,job satisfaction and turnover among psychiatric technicians[J]. Appl Psychol, 1974, 59(3):603-609. [25 ]Mowday RT, Steers RM, Porter LW. The measurement of organizational commitment[J].VocatBehav,1979,14(2) :224-247.
[26]MeyerJ P, Allen NJ. A three-component conceptualization of organizational commitment[J]. Human Resource Manag Rev,1991,1(1) :61-89.
[27]凌文辁,张治灿,方俐洛.中国职工组织承诺的结构模型研究[J] .管理科学学报,2000,3 (2) :76-81.
[28]Hasselhorn, H-M., Tackenberg, P., Muller, B.H., Working conditions and intent to leave the profession among nursing staff in Europe, Report No. 2003:7.
[29]M.Flinkman, M.Laine, H.Leino-Kilpi, H.-M.Hasselhorn, S.Salantera Explaining young registered Finnish nurses’intention to leave the profession:A questionnaire survey[J]. International Journal of Nursing Studies, 2008,45:727-739.
[30]Miyuki Takase, Keiko Oba, NorikoYamashita. Generational differences in factors influencing job turnover among Japanese nurses: An exploratory comparative design[J]. International Journal of Nursing Studies, 2008[Epub ahead of print].
[31]Hong Lu, Alison E. While, K. Louise Barriball. Job satisfaction and its related factors: A questionnaire survey of hospital nurses in Mainland China[J]. International Journal of Nursing Studies, 2007,44:574-588
[32]KUEI-YUN LU, PI-LI LIN,CHIUNG-MAN WU, YA-LUNG HSIEH. The Relationships Among Turnover Intentions, Professional Commitment, and Job Satisfaction of Hospital Nurses[J]. Journal of Professional Nursing, 2002,18(4):214-219.
[33]Tzeng H M. Satisfying nurses on job factors they care about: a Taiwanese perspective[J]. Journal of Nursing Administration, 2002b, 32 (6):306-309.
[34]Hsing-Chu Chen, Cheng-I Chu, Ying-Hui Wang, Ling-Chu Lin.Turnover factors revisited: A longitudinal study of Taiwan-based staff nurses[J].International Journal of Nursing Studies, 2008,45:277-285.
[35]周萍.护士离职意愿及其相关因素的研究[D].杭州:浙江大学,2008.
[36]Larrabee J H, Janney M A, Ostrow C L.et al. Predicting registered nurse job satisfaction and intent to leave[J]. Journal of Nursing Administration, 2003,33(5):271-283.
[37]Chen Z X, TSui A S, Fath J L. Loyalty to supervisor vs. organizational commitment: Relationships to employee performance in China[J]. Journal of Occupational and Organizational Psychology, 2002,75(3):339-356.
[38]Carol S. Brewer, Christine T. Kovner, William Greene, Ying Cheng. Predictors of?RNs’intent to work and work decisions 1 year later in a U.S. national sample[J]. International Journal of Nursing Studies, 2008. Mar 28. [Epub ahead of print].
[39]朴玉粉.组织承诺对护士离职意愿的影响[J].中国护理管理, 2007,7(3):54-55.
[40]易巧云,朱海利,任小红,李桂源.临床护理人员离职意愿影响因素研究[J].中国行为医学科学,2007, l6( 8):745-747.
[41]王家良.临床流行病学(第二版)[M].上海科学技术出版社, 2001,8:155.
[42]迟俊涛,邵华,娄凤兰.护士工作满意度的研究进展[J].中国实用护理杂志, 2006,22(4):56-58.
[43]胡静超.护士工作满意度评定量表及区域性常模的研制[D].上海:第二军医大学, 2007.
[44]朱海利,陈洪华,任小红.护理人员组织承诺及相关因素研究进展[J].现代护理2006, 12(24) :3722-5722.
[45]李栋荣,李经远.矩阵式组织结构下角色冲突、组织承诺、离职意愿关系研究[D].台湾:国立交通大学管理科学研究所, 2000.
[46]? Hasselhorn,H-M. Tackenberg,P. Muller,B.H. 2003a. Working conditions and intent to leave the Profession among nursing staff in Europe. Report No.2003:7. httP://www.next-study.net/S14.8.2005.
[47]迟俊涛.聘用制护士工作满意度及其与组织承诺、离职倾向的关系研究[D].山东:山东大学, 2006
[48]Blau, G.& Lunz, M. Testing the incremental effect of professional commitment on intent to leave one,s profession beyond the effects of external, personal, and work-related variables[J]. Journal of Vocational Behavior, 1998,52:260-269.
[49]吴欣娟,张晓静,高凤菊.护理人员离职意愿与工作压力相关性研究[J],中华护理杂志,2000,35(4):197-199.
[50]刘霞.锦州市三级甲等医院护士离职相关因素调查[J].中国护理管理, 2008,8(12):37-39.
[51]Donatella Camerino, Paul Maurice Conway.et al,Age-dependent relationships between work ability thinking of quitting the job, and actual leaving among Italian nurses:A longitudinal study[J],?International Journal of Nursing Studies, 2008, 45: 1645-1659.
[52]陈维荣.合同制护士存在的问题分析与对策[J].护理研究,2007,21(11): 3079-3080.
[53]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[J].护理管理杂志,2007,7(9):15-17.
[54]宁宁,陈海霞,赵晓燕.影响合同制护士主动离职意向的相关因素分析[J].现代护理, 2007, 3(10): 888-889.
[55]Fochsen G, Sjogren K, Jose Phson M ,et a. Factors contributing to the decision to leave nursing care:a study among Swedish nursing personnel[J].Nurs Manag,2005, 13(4):338-344.
[56]Leanne S. Cowin , Maree Johnson, Rhonda G. Craven. et al. Causal modeling of self-concept, job satisfaction,and retention of nurses[J].International Journal of Nursing Studies, 2008,45:1449-1459.
[57]Zeki Yildiz, PhD , Sevgi Ayhan.et al.?The impact of nurses' motivation to work, job satisfaction, and sociodemographic characteristics on intention to quit their current job: An empirical study in Turkey[J].?Applied Nursing Research, 2009,22: 113-118.
[58]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[J].当代护士2007, 6:108-110.
[59]黄金,李乐之,彭丹.三级医院聘用制护士工作满意度与离职意愿的现状调查[J].中华护理杂志, 2008,43(6):527-529.
[60]杨爱军,焦俊花.护士压力及工作满意度对护理工作的影响[J].护理管理杂志, 2004,2(4):2.
[61]曹颖,于艳秋.护士工作满意度相关因素分析[J].中华医院管理杂志,2000, 16(7):437-439.
[62]Michael A Shields, Melanie Ward. Improving nurse retention in the National Health Service in England:the impact of job satisfaction on intentions to quit[J].Journal of Health Economics,2001,20(5):677-701.
[63]LI J ,Lambert VA. Job satisfaction among intensive care nurses from the People,s Republic of China[J]. International Nursing Review. 2008,55:34-39.
[64]柯永红.医院临时聘用护士的使用现状调查[J].南方护理学报, 2004,11(7): 18-19.
[65]Yin JCT.Yang KPA. Nursing turnover in Taiwan: a meta analysis of related factors[J].International Journal of Nursing studies,2002,39(6):573-581.
[66]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[J].护理管理杂志,2008,8(3):1-3.
[2]赵菲,张治国,邓雪萍.合同制和临时护士人事管理现状研究[J].中国护理管理, 2008,8(10):46-49.
[3]陈静,王志稳,尚少梅,等.北京市二级及以上医院合同制护士使用情况调查[J].中国护理管理,2008, 8(8): 25-27.
[4]何淑贞,张保玲,孙莉,等.合同制护士与正式护士工作满意度比较分析[J].护理研究,2008, 22(3):772-773.
[5]张玲,李加宁,宋雁宾,等.聘用护士离职现状分析及对策[J].中华现代护理杂志, 2008,14(27):2922-2924.
[6]张萍.聘用护士离职原因调查与分析[J].临床和实验医学杂志,2009,8(1): 146-147.
[7]Jones C B. The costs of nurse turnover. Part 1. An economic perspective[J]. Nursing Administration. 2004,34(12):562-570.
[8]卫生部信息统计中心. 2006年中国卫生统计提要.[EB/ OL] .http://www.moh. gov. cn.
[9]Price J L. Reflections on the determinants of voluntary turnover[J]. International Journal of Manpower, 2001,22 (7):600-624.
[10]Carol S. Brewer, Christine T. Kovner, William Greene, Ying Cheng. Predictors of RNs’intent to work and work decisions 1 year later in a U.S. national sample [J]. International Journal of Nursing Studies,2008. Mar 28. [Epub ahead of print].
[11]Christian Vandenberghe, Kathleen Bentein, Florence Stinglhamber. Affective commitment to the organization, supervisor, and work group: Antecedents and outcomes[J]. Journal of Vocational Behavior, 2004,64: 47-71.
[12]Laureen J. Hayes, Linda O,Brien-Pallas, Christine Duffield.et al. Nurse turnover: A literature review[J].International Journal of Nursing Studies, 2006,43:237–263.
[13]Billie Coomber, K. Louise Barriball. Impact of job satisfaction components on intent to leave and turnover for hospital-based nurses: A review of the research literature[J]. International Journal of Nursing Studies, 2007,44:297-314.
[14]黄兰淳.高雄地区广播从业人员离职倾向及离职行为因素之研究[D].台湾:中山大学公共事务管理研究所, 2000.
[15]欧阳玲.工作生活质量与临床护理人员离职意愿之研讨[D].台湾:东海大学企业管理研究所,1993.
[16]Irvine, D. Evans, M. Job satisfaction and turnover among nurses: integrating research findings across studies [J]. Nursing Research, 1995, 44 (4):246-253.
[17]Locke, E.A. The Nature and Causes of Job Satisfaction. In M.D.Dunnette(Ed.), The Handbook of Industrial and Organizational Psychology. Chicago,Ⅱ:Tand Mcnally, 1976:1297-1349.
[18]Hong Lu, Alison E. While, K.Louise?Barriball. Job satisfaction among nurses:a literature review [J]. International Journal of Nursing Studies, 2005,42:211.
[19]Cavanagh S J .Nursing turnover:Literature review and methodological critique [J]. Journal of Advanced Nursing, 1989,14 :587- 596.
[20]郭播春.澳门医务护理人员之工作特性、工作满意度、离职倾向之相关研究---以某私立医院为例[D].广州:华南师范大学, 2007.
[21]约翰.W.纽斯特罗姆,基斯.戴维斯.组织行为学[M].北京:经济科学出版社, 2000:326-328.
[22]胡方,刘毅.医院合同护士工作满意度调查与分析[J].中国卫生事业管理, 2005, 6(4):217 -219.
[23]潘慧,玄英哲.护士组织承诺的研究进展[J].护理学杂志,2007,22(5):72-74.
[24]Porter LM, SteersRM, Mowday RT,et al.Organizational commitment ,job satisfaction and turnover among psychiatric technicians[J]. Appl Psychol, 1974, 59(3):603-609. [25 ]Mowday RT, Steers RM, Porter LW. The measurement of organizational commitment[J].VocatBehav,1979,14(2) :224-247.
[26]MeyerJ P, Allen NJ. A three-component conceptualization of organizational commitment[J]. Human Resource Manag Rev,1991,1(1) :61-89.
[27]凌文辁,张治灿,方俐洛.中国职工组织承诺的结构模型研究[J] .管理科学学报,2000,3 (2) :76-81.
[28]Hasselhorn, H-M., Tackenberg, P., Muller, B.H., Working conditions and intent to leave the profession among nursing staff in Europe, Report No. 2003:7.
[29]M.Flinkman, M.Laine, H.Leino-Kilpi, H.-M.Hasselhorn, S.Salantera Explaining young registered Finnish nurses’intention to leave the profession:A questionnaire survey[J]. International Journal of Nursing Studies, 2008,45:727-739.
[30]Miyuki Takase, Keiko Oba, NorikoYamashita. Generational differences in factors influencing job turnover among Japanese nurses: An exploratory comparative design[J]. International Journal of Nursing Studies, 2008[Epub ahead of print].
[31]Hong Lu, Alison E. While, K. Louise Barriball. Job satisfaction and its related factors: A questionnaire survey of hospital nurses in Mainland China[J]. International Journal of Nursing Studies, 2007,44:574-588
[32]KUEI-YUN LU, PI-LI LIN,CHIUNG-MAN WU, YA-LUNG HSIEH. The Relationships Among Turnover Intentions, Professional Commitment, and Job Satisfaction of Hospital Nurses[J]. Journal of Professional Nursing, 2002,18(4):214-219.
[33]Tzeng H M. Satisfying nurses on job factors they care about: a Taiwanese perspective[J]. Journal of Nursing Administration, 2002b, 32 (6):306-309.
[34]Hsing-Chu Chen, Cheng-I Chu, Ying-Hui Wang, Ling-Chu Lin.Turnover factors revisited: A longitudinal study of Taiwan-based staff nurses[J].International Journal of Nursing Studies, 2008,45:277-285.
[35]周萍.护士离职意愿及其相关因素的研究[D].杭州:浙江大学,2008.
[36]Larrabee J H, Janney M A, Ostrow C L.et al. Predicting registered nurse job satisfaction and intent to leave[J]. Journal of Nursing Administration, 2003,33(5):271-283.
[37]Chen Z X, TSui A S, Fath J L. Loyalty to supervisor vs. organizational commitment: Relationships to employee performance in China[J]. Journal of Occupational and Organizational Psychology, 2002,75(3):339-356.
[38]Carol S. Brewer, Christine T. Kovner, William Greene, Ying Cheng. Predictors of?RNs’intent to work and work decisions 1 year later in a U.S. national sample[J]. International Journal of Nursing Studies, 2008. Mar 28. [Epub ahead of print].
[39]朴玉粉.组织承诺对护士离职意愿的影响[J].中国护理管理, 2007,7(3):54-55.
[40]易巧云,朱海利,任小红,李桂源.临床护理人员离职意愿影响因素研究[J].中国行为医学科学,2007, l6( 8):745-747.
[41]王家良.临床流行病学(第二版)[M].上海科学技术出版社, 2001,8:155.
[42]迟俊涛,邵华,娄凤兰.护士工作满意度的研究进展[J].中国实用护理杂志, 2006,22(4):56-58.
[43]胡静超.护士工作满意度评定量表及区域性常模的研制[D].上海:第二军医大学, 2007.
[44]朱海利,陈洪华,任小红.护理人员组织承诺及相关因素研究进展[J].现代护理2006, 12(24) :3722-5722.
[45]李栋荣,李经远.矩阵式组织结构下角色冲突、组织承诺、离职意愿关系研究[D].台湾:国立交通大学管理科学研究所, 2000.
[46]? Hasselhorn,H-M. Tackenberg,P. Muller,B.H. 2003a. Working conditions and intent to leave the Profession among nursing staff in Europe. Report No.2003:7. httP://www.next-study.net/S14.8.2005.
[47]迟俊涛.聘用制护士工作满意度及其与组织承诺、离职倾向的关系研究[D].山东:山东大学, 2006
[48]Blau, G.& Lunz, M. Testing the incremental effect of professional commitment on intent to leave one,s profession beyond the effects of external, personal, and work-related variables[J]. Journal of Vocational Behavior, 1998,52:260-269.
[49]吴欣娟,张晓静,高凤菊.护理人员离职意愿与工作压力相关性研究[J],中华护理杂志,2000,35(4):197-199.
[50]刘霞.锦州市三级甲等医院护士离职相关因素调查[J].中国护理管理, 2008,8(12):37-39.
[51]Donatella Camerino, Paul Maurice Conway.et al,Age-dependent relationships between work ability thinking of quitting the job, and actual leaving among Italian nurses:A longitudinal study[J],?International Journal of Nursing Studies, 2008, 45: 1645-1659.
[52]陈维荣.合同制护士存在的问题分析与对策[J].护理研究,2007,21(11): 3079-3080.
[53]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[J].护理管理杂志,2007,7(9):15-17.
[54]宁宁,陈海霞,赵晓燕.影响合同制护士主动离职意向的相关因素分析[J].现代护理, 2007, 3(10): 888-889.
[55]Fochsen G, Sjogren K, Jose Phson M ,et a. Factors contributing to the decision to leave nursing care:a study among Swedish nursing personnel[J].Nurs Manag,2005, 13(4):338-344.
[56]Leanne S. Cowin , Maree Johnson, Rhonda G. Craven. et al. Causal modeling of self-concept, job satisfaction,and retention of nurses[J].International Journal of Nursing Studies, 2008,45:1449-1459.
[57]Zeki Yildiz, PhD , Sevgi Ayhan.et al.?The impact of nurses' motivation to work, job satisfaction, and sociodemographic characteristics on intention to quit their current job: An empirical study in Turkey[J].?Applied Nursing Research, 2009,22: 113-118.
[58]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[J].当代护士2007, 6:108-110.
[59]黄金,李乐之,彭丹.三级医院聘用制护士工作满意度与离职意愿的现状调查[J].中华护理杂志, 2008,43(6):527-529.
[60]杨爱军,焦俊花.护士压力及工作满意度对护理工作的影响[J].护理管理杂志, 2004,2(4):2.
[61]曹颖,于艳秋.护士工作满意度相关因素分析[J].中华医院管理杂志,2000, 16(7):437-439.
[62]Michael A Shields, Melanie Ward. Improving nurse retention in the National Health Service in England:the impact of job satisfaction on intentions to quit[J].Journal of Health Economics,2001,20(5):677-701.
[63]LI J ,Lambert VA. Job satisfaction among intensive care nurses from the People,s Republic of China[J]. International Nursing Review. 2008,55:34-39.
[64]柯永红.医院临时聘用护士的使用现状调查[J].南方护理学报, 2004,11(7): 18-19.
[65]Yin JCT.Yang KPA. Nursing turnover in Taiwan: a meta analysis of related factors[J].International Journal of Nursing studies,2002,39(6):573-581.
[66]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[J].护理管理杂志,2008,8(3):1-3.