皖西地区3 300名临床护士工作环境感知对职业倦怠影响的调查研究

张瑛; 施学芝; 童雪银; 王正云; 吴姚

doi:10.16766/j.cnki.issn.1674-4152.003901

皖西地区3 300名临床护士工作环境感知对职业倦怠影响的调查研究

doi: 10.16766/j.cnki.issn.1674-4152.003901

1.
安徽医科大学附属六安医院护理部，安徽六安 237005
2.
安徽医科大学附属六安医院肿瘤科
3.
安徽医科大学附属六安医院急诊科

基金项目:

安徽省教育厅重大课题 2022AH040095

详细信息

通讯作者:
施学芝，E-mail: 2798980403@qq.com

中图分类号: R192.6
计量
- 文章访问数: 9
- HTML全文浏览量: 4
- PDF下载量: 1
- 被引次数: 0
出版历程
- 收稿日期: 2024-04-23
- 网络出版日期: 2025-03-27

A survey on the influence of work environment perception on job burnout among 3 300 clinical nurses in western Anhui Province

1.
Department of Nursing, Lu'an People's Hospital Affiliated to Anhui Medical University, Lu'an, Anhui 237005, China

摘要

摘要: 目的了解皖西地区二级及三级公立医院临床护士工作环境感知与职业倦怠现状，探讨工作环境对护士职业倦怠的影响, 为改善执业环境状况、降低护士的职业倦怠提供参考依据。方法 2023年8—9月，采用一般资料调查表、中文版护士工作环境感知量表、中文版Maslach职业倦怠量表对皖西地区18所二级医院及8所三级医院的3 300名临床护士进行问卷调查，并将测评得分进行相关性分析和分层回归分析。结果护士感知工作环境条目均分为(2.97±0.63)分，职业倦怠条目均分为(3.23±0.33)分。分层回归分析结果显示，不同性别(t=2.182，P=0.029)、特殊科室(t=2.073，P=0.038)、收入满意度(t=-2.164，P=0.030)、是否为专科护士(t=-2.163，P=0.031)、护士感知工作环境中的人力物力(t=-4.508，P＜0.001)、护理管理(t=-4.917，P＜0.001)、专业实践(t=-6.355，P＜0.001)7个维度是护士职业倦怠的影响因素。结论皖西地区护士职业倦怠总发生率为66.55%，护士感知执业环境对职业倦怠感有显著影响，管理者应立足于医院护理服务质量与组织管理，提升护士执业环境满意度，减轻护士职业倦怠水平，稳定护士队伍发展。
- 护士 /
- 工作环境感知 /
- 职业倦怠 /
- 工作满意度 /
- 护理管理
Abstract: Objective To understand the current situation of working environment perception and job burnout of clinical nurses in secondary and tertiary public hospitals in western Anhui, and to explore the influence of nurses' perceived working environment on job burnout, so as to provide reference for improving nurse practice environment and reducing job burnout. Methods From August 2023 to September 2023, 3 300 clinical nurses from 18 secondary and 8 tertiary hospitals in western Anhui were investigated by using the general data questionnaire, the Chinese version of nurses' working environment perception scale, and the Chinese version of Maslach burnout scale, and the scores were analyzed by correlation analysis and hierarchical regression analysis. Results The entries on nurses' perception of working environment scored (2.97±0.63) points, and the entries on job burnout scored (3.23±0.33) points. The results of hierarchical regression analysis showed that different gender (t=2.182, P=0.029), departments (t=2.073, P=0.038), income satisfaction (t=-2.164, P=0.030), whether nurses are specialists (t=-2.163, P=0.031), nurses' perception of human and material resources in the work environment (t=-4.508, P < 0.001), nursing management (t=-4.917, P < 0.001), and professional practice (t=-6.355, P < 0.001)were the influence factors of nurses' burnout. Conclusion The total incidence of nurse burnout in western Anhui was 66.55%, and nurses' perceived practice environment had a significant impact on the sense of burnout. Managers should base on the quality of hospital nursing service and organization management, improve nurses' satisfaction with the practice environment, reduce the level of nurse burnout, and stabilize the development of nurse team.
- Nurse /
- Work environment awareness /
- Job burnout /
- Job satisfaction /
- Nursing management

HTML全文

表 1 3 300名临床护士工作环境评分(x±s，分)

Table 1. Working environment rating of 3, 300 clinical nurses (x±s, points)

项目	条目数	总分	条目均分
工作环境感知维度	41	121.77±19.65	2.97±0.63
专业发展及参与决策	13	32.69±8.83	2.51±0.68
人力和物力	4	11.92±3.85	2.98±0.76
护理管理	5	15.42±3.62	3.08±0.72
专业实践	4	12.33±2.70	3.08±0.67
医护协作	3	9.99±2.78	3.33±0.86
临床工作制度	12	38.55±7.80	3.21±0.65

下载: 导出CSV

表 2 3 300名临床护士职业倦怠评分(x±s，分)

Table 2. Burnout scores of 3, 300 clinical nurses(x±s, points)

项目	条目数	总分	条目均分
职业倦怠维度	22	71.16±11.78	3.23±0.33
情感耗竭	9	30.73±8.58	3.41±0.40
个人成就感降低	8	24.73±6.75	3.09±0.32
去人格化	5	15.70±3.41	3.14±0.30

下载: 导出CSV

表 3 3 300名临床护士职业倦怠程度情况

Table 3. The degree of burnout of 3 300 clinical nurses

职业倦怠程度	人数	构成比(%)
无职业倦怠	1 104	33.45
轻度职业倦怠	1 848	56.00
中度职业倦怠	313	9.47
高度职业倦怠	35	1.06

下载: 导出CSV

表 4 不同特征的护士职业倦怠量表得分比较

Table 4. Comparison of burnout scale scores among nurses with different characteristics

项目	人(%)	得分[M(P₂₅, P₇₅)，分]	统计量	P值
医院等级			-1.271^a	0.204
二级医院	1 135(34.39)	70.00(61.00，77.00)
三级医院	2 165(65.61)	71.00(62.00，77.00)
性别			-2.575^a	0.010
男性	138(4.18)	67.00(58.00，77.00)
女性	3 162(95.82)	71.00(62.00，88.00)
科室			9.473^b	0.009
内科	1 040(31.52)	71.00(62.00，78.00)
外科	1 187(35.97)	70.00(62.00，77.00)
特殊科室	499(15.12)	71.00(62.00，89.00)
妇产科、儿科	574(17.39)	69.50(60.00，77.00)
收入满意度			-2.533^a	0.011
满意	1 398(42.36)	70.00(62.00，76.00)
不满意	1 902(57.64)	71.00(62.00，84.00)
职称			6.456^b	0.092
护士	487(14.76)	71.00(65.00，79.00)
护师	1 199(36.33)	70.00(62.00，77.00)
主管护师	1 413(42.82)	70.00(61.00，77.00)
副高及以上	201(6.09)	71.00(66.00，76.00)
是否为专科护士			-2.904^a	0.004
否	2 653(80.39)	71.00(62.00，76.00)
是	647(19.61)	70.00(62.00，83.00)
注：^a为Z值，^b为H值。

下载: 导出CSV

表 5 护士感知执业环境与职业倦怠的相关性(r值)

Table 5. Correlation between nurses' perceived practice environment and job burnout (r value)

项目	专业发展及参与决策	人力和物力	护理管理	专业实践	医护协作	临床工作制度	工作环境感知
情感耗竭	-0.365^a	-0.389^a	-0.345^a	-0.257^a	-0.305^a	-0.317^a	-0.383^a
去人格化	-0.227^a	-0.239^a	-0.231^a	-0.177^a	-0.218^a	-0.230^a	-0.255^a
个人成就感降低	0.290^a	0.302^a	0.275^a	0.289^a	0.275^a	0.308^a	0.332^a
职业倦怠	-0.086^a	-0.097^a	-0.085^a	-0.006	-0.056^a	-0.044^a	-0.075^a
注：^aP＜0.01。

下载: 导出CSV

表 6 皖西地区3 300名护士职业倦怠的影响因素分层回归分析

Table 6. Hierarchical regression analysis of influencing factors of job burnout among 3 300 nurses in western Anhui province

变量	B	SE	β	t值	P值
第一层
性别	1.415	0.489	0.584	2.424	0.015
特殊科室	1.058	0.624	0.482	2.194	0.028
收入满意度	-1.204	0.485	-0.043	-2.481	0.013
是否为专科护士	-1.102	0.587	-0.040	-2.251	0.024
第二层
性别	1.066	0.481	0.040	2.182	0.029
特殊科室	0.997	0.487	0.036	2.073	0.038
收入满意度	-1.047	0.483	-0.038	-2.164	0.030
是否为专科护士	-1.045	0.484	-0.037	-2.163	0.031
专业发展及参与决策	-0.027	0.058	-0.018	-0.470	0.639
人力和物力	-0.396	0.088	-0.111	-4.508	＜0.001
护理管理	-0.544	0.111	-0.143	-4.917	＜0.001
专业实践	-0.901	0.142	-0.176	-6.355	＜0.001
医护协作	-0.107	0.170	-0.018	-0.630	0.529
临床工作制度	0.006	0.069	0.004	-0.092	0.926
注：自变量赋值方法如下，男性=0，女性=1; 内科=(1，0，0)，急诊、手术室、ICU=(0，1，0)，妇产、儿科=(0，0，1); 收入不满意=0，满意=1; 是否为专科护士，否=0，是=1。

下载: 导出CSV

参考文献(24)

[1]	国家护理专业质控中心. 2020年国家医疗服务与质量安全报告-护理专业分册[M]. 北京: 科学技术文献出版社, 2022. National Nursing Professional Quality Control Center. 2020 National Health Service and Quality Safety Report-Nursing professional volume[M]. Beijing: Sci Tech Document Press, 2022.
[2]	李东, 梁玉艳, 杨日兴, 等. 健康的执业环境对改善护士工作适应性的作用研究[J]. 卫生职业教育, 2023, 41(15): 158-160. Li D, LIANG Y Y, YANG R X, et al. Effect of healthy practice environment on improving nurses'job adaptability[J]. Health Vocational Educ, 2023, 41(15): 158-160.
[3]	DE AlMEIDA H, ORGAMBÍDEZ A. Workplace empowerment and job satisfaction in portuguese nurses: an explicative model[J]. Health Care Manag (Frederick), 2019, 38(3): 220-227. doi: 10.1097/HCM.0000000000000265
[4]	EDÚ-VALSANIA S, LAGUÍA A, MORIANO J A. Burnout: a review of theory and measurement[J]. Int J Environ Res Public Health, 2022, 19(3): 1780-1807. doi: 10.3390/ijerph19031780
[5]	YALIN Z, JIANJUN J, CHUANMEI Z, et al. Status and related factors of burnout among palliative nurses in China: a cross-sectional study[J]. BMC Nurs, 2022, 21(1): 313-323. doi: 10.1186/s12912-022-01083-x
[6]	APIRADEE N, OMANONG W, KULWADEE A, et al. The relationship between nurse burnout, missed nursing care, and care quality following COVID-19 pandemic[J]. J Clin Nurs, 2023, 32(15-16): 5076-5083. doi: 10.1111/jocn.16761
[7]	黄鑫, 尚文涵, 安磊, 等. 188所三级甲等公立综合医院护士执业环境与离职率的相关性研究[J]中华护理杂志, 2023, 58(15): 1858-1864. HUANG X, SHANG W H, AN L, et al. A study on the correlation between nurse practice environment and turnover rate in 188 Grade-A public general hospitals[J]Chinese Journal of Nursing, 2023, 58(15): 1858-1864.
[8]	潘俐, 袁响林, 杨中策, 等. 云南省全科专业规培及实习医师心理健康状况调查分析[J]. 中华全科医学, 2023, 21(9): 1556-1558, 1630. doi: 10.16766/j.cnki.issn.1674-4152.003169 PAN L, YUAN X L, YANG Z C, et al. Investigation and analysis of general practice training and Mental health status of practicing physicians in Yunnan Province[J]. Chinese Journal of General Practice, 2023, 21(9): 1556-1558, 1630. doi: 10.16766/j.cnki.issn.1674-4152.003169
[9]	潘莘莘, 苏翔逸, 柳琼, 等. 组织信任对临床护士差序氛围感知和工作满意度间的中介与调节效应[J]. 中华全科医学, 2023, 21(5): 891-895. doi: 10.16766/j.cnki.issn.1674-4152.003008 PAN X X, SU X Yi, LIU Q, et al. The mediating and moderating effects of organizational trust on clinical nurses'perception of differential atmosphere and job satisfaction[J]. Chinese Journal of General Practice, 2023, 21(5): 891-895. doi: 10.16766/j.cnki.issn.1674-4152.003008
[10]	CHOI J, BAKKEN S, LARSON E, et al. Perceived nursing work environment of critical care nurses[J]. Nurs Res, 2004, 53(6): 370-378. doi: 10.1097/00006199-200411000-00005
[11]	陈雪蕾, 林平, 赵振娟. 中文版护士工作环境感知量表的开发[J]. 中国护理管理, 2011, 11(4): 28-31. CHEN X L, LIN P, ZHAO Z J. Development of the Chinese version of nurses'work environment Perception scale[J]. Chinese Nursing Management, 2011, 11(4): 28-31.
[12]	MASLACH C, JACKSON S E. The measurement of experienced burnout[J]. J Organiza Behavi, 1981, 2(2): 99-113. http://91.190.232.206:8080/predmet/inostr/law/Measurementburnout.pdf
[13]	冯莺, 骆宏, 叶志弘. MBI在护工作研究中的测试[J]. 中国心理卫生杂志, 2004, 18(7): 477-479. FENG Y, LUO H, YE Z H. Testing of MBI in nursing work research[J]. Chin Mental Health J, 2004, 18(7): 477-479.
[14]	叶志弘, 骆去, 姜安丽. 杭州地区护士群体职业倦怠常模与诊断标准的研究[J]. 中华护理杂志, 2008, 43(3): 207-209. YE Z H, LUO G, J A L. Study on occupational fatigue norms and diagnostic criteria of nurses in Hangzhou area[J]. Chinese Journal of Nursing, 2008, 43(3): 207-209.
[15]	梁姚, 田凌云, 杨秋红, 等. 应对方式在重症医学科护士社会支持和职业倦怠间的中介作用[J]. 中国护理管理, 2022, 22(1): 106-110. LIANG Y, TIAN L Y, YANG Q H, et al. The mediating effect of coping style on social support and job burnout among nurses in intensive care department[J]. Chinese Nursing Management, 2022, 22(1): 106-110.
[16]	田红森. 青岛地区男护士执业环境现状及其影响因素的研究[D]. 青岛: 青岛大学, 2023. TIAN H S. A study on the status quo and influencing factors of the practicing environment of male nurses in Qingdao[D]. Qingdao: Qingdao University, 2023.
[17]	汪晖, 张梦霞, 谌永鸿, 等. 湖北省18所三级甲等医院护士工作环境感知现状及影响因素研究[J]. 护理管理杂志, 2019, 19(11): 768-772. WANG H, ZHANG M X, CHEN Y H, et al. Research on the status quo and influencing factors of nurses'working environment perception in 18 Grade A hospitals in Hubei Province[J]. Nurs Manag, 2019, 19(11): 768-772.
[18]	何洪, 余健, 孟悦, 等. 西藏自治区三级综合医院护士执业环境的调查及影响因素分析[J]. 中国护理管理, 2021, 21(9): 1377-1381. HE H, YU J, MENG Y, et al. Investigation and influencing factors of nurse practice environment in tertiary general hospitals in Tibet Autonomous Region[J]. Chinese Nursing Management, 2021, 21(9): 1377-1381.
[19]	张月, 杨惠云, 曹怡, 等. 护士长领导风格对护士工作环境感知的影响[J]. 护理学杂志, 2021, 36(22): 1-4. ZHANG Y, YANG H Y, CAO Y, et al. The effect of head nurses'leadership style on nurses'perception of working environment[J]. Journal of Nursing, 2021, 36(22): 1-4.
[20]	汪池, 吕小红, 鲍娟, 等. 安徽省男性护士执业环境、职业倦怠感和职业认同感相关性分析[J]. 职业与健康, 2023, 39(15): 2021-2025. WANG C, LYU X H, BAO J, et al. Correlation analysis of professional environment, job burnout and professional identity of male nurses in Anhui Province[J]. Occupation and Health, 2023, 39(15): 2021-2025.
[21]	俞文兰, 孙道远. 新型冠状病毒肺炎救治一线女护士心理健康风险及干预对策[J]. 职业卫生与应急救援, 2020, 38(2): 106-108. YU W L, SUN D Y. Mental health risks and intervention measures of frontline female nurses in the treatment of novel coronavirus pneumonia[J]. Occupa Health and Emer Rescue, 2020, 38(2): 106-108.
[22]	孙莹, 林牡丹, 刘春梅, 等. 正念减压训练对急诊科护士职业倦怠和生活质量的影响[J]. 护理研究, 2023, 37(16): 3007-3011. SUN Y, LIN M D, LIU C M, et al. Effects of Mindfulness-based stress reduction training on burnout and quality of life of nurses in emergency department[J]. Nursing Research, 2023, 37(16): 3007-3011.
[23]	王颖, 沙丽艳, 刘洋. 工作环境报警疲劳和情绪劳动对ICU护士职业倦怠的影响研究[J]. 中国护理管理, 2022, 22(9): 1405-1410. WANG Y, SHA L Y, LIU Y. Study on the influence of work environment alarm fatigue and emotional labor on job burnout in ICU nurses[J]. Chinese Nursing Management, 2022, 22(9): 1405-1410.
[24]	BOAMAH S A, SPENCE LASCHINGER H K, WONG C, et al. Effect of transform national leadership on job satisfaction and patient safety outcomes[J]. Nurs Outlook, 2018, 66(2): 180-189. http://www.onacademic.com/detail/journal_1000040127141610_c571.html