护士职业认同在执业环境及安全行为间的中介效应研究

doi:10.3761/j.issn.0254-1769.2023.21.010

摘要/Abstract

摘要： 目的探讨护士职业认同在执业环境与安全行为间的中介效应，旨在为管理者制订科学、合理、规范的护士安全行为干预措施提供参考依据。方法采用便利抽样法，于2022年5月—6月，选取北京市5所三级甲等综合医院的1 381名护士作为调查对象，采用一般资料调查表、护士安全行为量表、护士执业环境测评量表（修订版）及护士职业认同评定量表进行调查。采用结构方程模型检验护士职业认同在执业环境及安全行为间的中介效应。结果最终1 303名护士参与调查。护士安全行为量表、护士执业环境测评量表（修订版）和护士职业认同评定量表总分依次为59.0（56.0，60.0）、3 441.0（3 066.0，3 586.0）、131.0（115.0，150.0）分，均处于中等偏上水平。护士安全行为量表与护士职业认同评定量表、护士执业环境测评量表（修订版）总分呈显著正相关（r=0.516、0.421，P<0.01），与各维度得分呈正相关（P<0.01）。护士执业环境、职业认同可直接正向影响其安全行为水平；护士职业认同在执业环境和安全行为之间起部分中介作用，中介效应为0.184，占总效应的46.11%。结论护士职业认同是执业环境及安全行为的中介变量，护理管理者应注重护士职业认同感的培养，优化临床护士工作环境，从而提高护士安全行为，保障患者安全。

关键词: 护士, 安全行为, 职业认同, 执业环境, 中介效应

Abstract:

Objective To explore the mediating effect of nurse professional identity between the practice environment and safety behavior，in order to provide references and bases for managers to formulate scientific，reasonable and standardized interventions for nurse safety behavior. Methods A total of 1381 nurses from 5 tertiary general hospitals in Beijing were adopted for investigation from May to June 2022 by convenience sampling method. They were investigated with general information questionnaire，Nurse Safety Behavior Questionnaire，Nursing Practice Environment Assessment Scale and Nurse Professional Identity Assessment Scale. The structural equation model was used to analyze the mediating effect of nurse professional identity between practice environment and safety behavior. Results Finally，1303 nurses participated in the survey.The total scores of nurse safety behavior scale，nursing practice environment assessment scale and nurse professional identity scale were 59.0（56.0，60.0） points，3 441.0（3 066.0，3 586.0） points，131.0（115.0，150.0） points，which were all above the medium level. Nurse safety behavior was significantly positively correlated with nurse professional identity and the nurse practicing environment assessment（r=0.516，0.421，P<0.01），and was significantly positively correlated with the scores of all dimensions（P<0.01）. The practice environment and professional identity can directly and positively affect the level of nurse safety behavior. The mediating test shows that nurse professional identity plays a partial mediating effect between the practice environment and safety behavior，and the mediating effect is 0.184，accounting for 46.11% of the total effect. Conclusion In this study，nurse professional identity is a mediator between the practice environment and safety behavior. Nursing managers should pay attention to the cultivation of nurses’ professional identity and optimize the working environment of clinical nurses，so as to improve nurse safety behavior and ensure the safety of patients.

Key words: Nurse, Safety Behavior, Professional Identity, Practice Environment, Mediating Effect

谢丹, 陈洁, 魏永婷, 郑一宁. 护士职业认同在执业环境及安全行为间的中介效应研究[J]. 中华护理杂志, 2023, 58(21): 2630-2636.

XIE Dan, CHEN Jie, WEI Yongting, ZHENG Yining. The mediating effect of nurse professional identity between practice environment and safety behavior[J]. Chinese Journal of Nursing, 2023, 58(21): 2630-2636.

图/表 5

表1 调查对象的一般资料（n=1 303）

Table 1 General information of surveyed patients（n=1 303）

表2 The scores of Nurse Safety Behavior Scale，Nursing Practice Environment Assessment Scale and Nurse Professional Identity Scale[n=1 303，分，M（P25，P75）]

Table 2

表3 护士安全行为、职业认同与执业环境的相关性分析（r值）

Table 3 The correlation analysis between nurse safety behavior,professional identity and practice environment（r value）

图1 护士职业认同在执业环境及安全行为间的中介效应模型

Figure 1 The mediating effect model of nurse professional identity and practice environment on safety behavior

表4 护士执业环境、职业认同对安全行为的影响效应

Table 4 Effect of nurse professional identity and practice environment on safety behavior

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