护士组织沉默现状及潜在剖面分析

doi:10.3761/j.issn.0254-1769.2023.08.004

摘要/Abstract

摘要：

目的探讨护士组织沉默的现状，并分析其潜在剖面及人群特征。方法采用便利抽样法，于2020年6月选取中国东北、华南、华中、华北、华东、西南、西北七大地区二级及以上医院的护士作为调查对象。采用一般资料调查表、员工沉默行为调查量表和同事支持量表进行问卷调查。对护士组织沉默特征进行潜在剖面分析，并通过单因素分析和Logistic回归分析识别其潜在剖面的影响因素。结果最终共纳入3 974名护士，其组织沉默分为4个潜在剖面，分别为“局外人”（15.60%）、“顺从者”（22.60%）、“中间人”（37.75%）和“主人公”（24.06%）。Logistic回归分析结果显示，护士的家庭经济负担、健康状况、职务、护士长支持得分、同事支持得分和医院等级是组织沉默潜在剖面类别的影响因素（P<0.05）。结论护士组织沉默特征存在异质性，可分为4个潜在剖面。护理管理者可根据不同潜在剖面的影响因素对护士进行个体化干预，以降低护士组织沉默水平。

关键词: 护士, 组织沉默, 潜在剖面分析, 同事支持, 护理管理研究

Abstract:

Objective To explore the current status of organizational silence among nurses，and to analyze its latent profiles and population characteristics. Methods Convenience sampling was adopted to select nurses from secondary and above hospitals in Northeast，South，Southeast，Central South，East，Southwest，and Northwest China in June 2020 by the demographic characteristics questionnaire，Employee Silence Scale（ESS） and Peer Support Scale （PSS）. A latent profile analysis（LPA） was performed on characteristics of nurses’ organizational silence，and the influencing factors of the latent profile were identified by single-factor analysis and logistic regression analysis. Results A total of 3 974 nurses were included，and their organizational silence can be divided into 4 categories，namely “outsiders”（15.60%），“followers”（22.60%），“middlers”（37.75%），and “protagonists”（24.06%）. Logistic regression analysis showed that family financial burden，health status，job title，hospital level，head nurse support and colleague support were the influencing factors of the latent profile of organizational silence（P<0.05）. Conclusion There was heterogeneity in the characteristics of organizational silence，which could be divided into 4 latent profiles. Nursing managers can conduct individualized interventions according to the influencing factors of different organizational silence profiles to reduce the level of organizational silence of nurses.

Key words: Nurses, Organizational Silence, Latent Profile Analysis, Peer Support, Nursing Administration Research

姚鑫, 文司棋, 沈媛媛, 宋梓菱, 陈燕燕, 张佩华, 黄小琼. 护士组织沉默现状及潜在剖面分析[J]. 中华护理杂志, 2023, 58(8): 921-928.

YAO Xin, WEN Siqi, SHEN Yuanyuan, SONG Ziling, CHEN Yanyan, ZHANG Peihua, HUANG Xiaoqiong. Current status and latent profile analysis of nurses’ organizational silence[J]. Chinese Journal of Nursing, 2023, 58(8): 921-928.

图/表 5

表1 调查对象的一般资料及其组织沉默潜在剖面的单因素分析[n=3 974，名（百分比，%）]

Table 1 Demographic characteristics of nurses and their single-factor analysis on the organizational silence profile [n=3 974，case（percent，%）]

表2 护士组织沉默潜在剖面模型的拟合信息

Table 2 Model fitting information for the latent profile of organizational silence of nurses

图1 护士组织沉默的潜在剖面特征

Figure 1 Characteristics of latent profile in organizational silence of nurses

表3 护士同事支持量表得分在不同潜在剖面的比较（n=3 974，分，$\bar{x}±s$）

Table 3 Comparison of scores of nurse peer support scale between different latent profiles（n=3 974，score，$\bar{x}±s$）

表4 护士组织沉默4个潜在剖面的多因素分析

Table 4 Multi-factor analysis of 4 latent profiles in organizational silence of nurses

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