Abstract:

Objective To describe the work status of nurses in secondary and tertiary hospitals in Guangdong province in China,and to analyze the differences between secondary and tertiary hospitals. Methods A total of 4,163 nurses from 36 secondary and tertiary hospitals were investigated with questionnaires on the demographic characteristics,nursing work environments,care left undone,burnout,job satisfaction and intention to stay. Results The overall score of nursing work environments was 3.03（2.74,3.61）;the score：for the subscale of staffing and resources adequacy and nurse participating in hospital affairs were the lowest,which were 3.00（2.50,3.50） and 3.00（2.56,3.56）,respectively. Perception of nurses in tertiary hospitals on nursing work environments was significantly worse than that of nurses in secondary hospitals for both overall scale and 5 subscales（all P<0.001）. The average number of care left undone reported by nurses was 6.0（1.0,11.0）,with a significantly higher number of those reported by nurses in tertiary hospitals than those in secondary hospitals （P=0.036）. Nurses in the secondary and tertiary hospitals experienced a moderate level of emotional exhaustion and depersonalization,and a high level of reduced personal accomplishment. Furthermore,61.42% of nurses were satisfied with their work and 79.87% had the intention to stay. Compared to nurses in secondary hospitals,the level of burnout among nurses in tertiary hospitals was at a higher level（P<0.001 both for emotional exhaustion and depersonalization）,and the proportion of nurses who were satisfied with their work and willing to stay was lower（all P<0.050）. Conclusion In Guangdong province,attention should be paid to further improvement of the work environment. Due to heavy workload and low job satisfaction of nurses,this situation was more prominent in tertiary hospitals than it in secondary hospitals.

Key words: Nursing Work Environments, Care Left Undone, Nursing Outcomes, Nursing Administration Research

摘要：

目的 调查广东省二、三级综合医院护士工作状况并分析其差异,为不同级别医院护理人力资源管理提供实证支持。方法 采用问卷调查法,于2018年收集广东省36所二、三级综合医院4 163名护士的一般资料、护理工作环境、护理工作受限水平、护士工作疲溃感、工作满意度及留职意愿。结果 护士对护理工作环境总体评分为3.03（2.74,3.61）分,其中对“人力物力充足性”以及“护士参与医院事务程度”维度评分最低,分别为3.00（2.50,3.50）、3.00（2.56,3.56）分;三级医院护士对护理工作环境总体及各维度评分均低于二级医院护士（均P<0.001）。护士报告护理工作受限项目为6.0（1.0,11.0）项,三级医院护士报告护理工作受限的项目数明显高于二级医院护士（P=0.036）。护士工作结局方面,二、三级医院护士的情感耗竭、去人格化的水平均为中度,个人成就感缺失的水平为高度,对工作表示满意的护士占61.42%,有留职意愿护士比例为79.87%;与二级医院相比,三级医院护士工作疲溃感程度较高（情感耗竭、去人格化维度均P<0.001）,对工作满意及有留职意愿护士比例较低（均P<0.05）。 结论 广东省二、三级医院护理工作环境仍有改善空间,护士工作负担较大、工作疲溃感程度较高、对工作满意度较低,其中三级医院问题更为突出。

关键词: 护理工作环境, 护理工作受限, 护士工作结局, 护理管理研究