安徽省护理人员建言行为潜在剖面分析

李楠楠; 宋瑰琦; 张小红; 张国文; 程圣莉; 姚红; 刘媛

doi:10.16766/j.cnki.issn.1674-4152.004231

安徽省护理人员建言行为潜在剖面分析

doi: 10.16766/j.cnki.issn.1674-4152.004231

李楠楠^{1, 2},
宋瑰琦^{2, 3, ,},
张小红⁴,
张国文⁵,
程圣莉¹,
姚红⁶,
刘媛¹

1.
中国科学技术大学附属第一医院(安徽省立医院)急诊综合一病区，安徽合肥 230001
2.
安徽医科大学护理学院，安徽合肥 230022
3.
中国科学技术大学附属第一医院(安徽省立医院)教育处
4.
中国科学技术大学附属第一医院(安徽省立医院)门诊办公室
5.
中国科学技术大学附属第一医院(安徽省立医院)抢救室
6.
中国科学技术大学附属第一医院(安徽省立医院)重症医学科

基金项目:

安徽省高等学校省级质量工程项目 2020jyxm2309

详细信息

通讯作者:
宋瑰琦，E-mail：songguiqi66@sina.com

中图分类号: R47
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出版历程
- 收稿日期: 2025-03-21

Potential profile analysis of nurses' voice behavior in Anhui Province

1.
The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230001, China

摘要

摘要: 目的探讨安徽省护理人员(护士)建言行为的潜在类别并分析其影响因素，为制定干预策略提供参考。方法采用一般资料问卷、护士建言行为量表、心理资本量表、真实型领导量表。在2022年1—2月对安徽省37所医院3 000名护士进行横断面问卷调查，采用潜在剖面分析和无序多分类logistic回归探究护士建言行为潜在类别并分析其影响因素。结果 3 000名护理人员建言行为可分为3个潜在类别：沉默型-低水平建言行为组(17.4%)，保守型-中等水平建言行为组(40.5%)，积极型-高水平建言行为组(42.1%)。相对沉默型-低水平建言行为组职称越高的护理人员倾向于积极型-高水平建言行为组概率更大(OR=-0.149, P＜0.05)。心理资本和真实型领导得分越高的护士归属于积极型-高水平建言行为组概率更大(OR=0.839, P＜0.001，OR=0.845, P＜0.001)。回归分析显示：职称、聘用方式、年龄、真实型领导水平及心理资本是护理人员建言行为潜在类别的影响因素(P＜0.05)。结论 3 000名临床护理人员建言行为分类特征明显，57.9%的护理人员在建议表达方面的表现处于中低水平。护理管理者应当依据其群体的不同特征，并结合影响因素，实施有针对性的干预措施，提高护理人员建言水平。
- 护士 /
- 建言行为 /
- 心理资本 /
- 真实型领导 /
- 潜在剖面分析
Abstract: Objective To explore the potential categories of voice behavior of nursing staff (nurses) in Anhui Province and analyze its influencing factors, to provide reference for formulating intervention strategies. Methods The general information questionnaire, nurse suggestion behavior scale, psychological capital scale and authentic leadership scale were adopted. From January to February 2022, a cross-sectional questionnaire survey was conducted among 3 000 nurses from 37 hospitals in Anhui Province. Potential profile analysis and unordered multi-class logistic regression were used to explore the potential categories of nurses' suggestion behaviors and analyze their influencing factors. Results The 3 000 nurses' voice behavior could be divided into three potential categories: silent type-low level voice behavior group (17.4%), conservative type-medium level voice behavior group (40.5%), active type-high level voice behavior group (42.1%). The higher the professional title of the nursing staff in the relatively silent type-low-level suggestion behavior group, the greater the probability in the positive type-high-level suggestion behavior group (OR=-0.149, P < 0.05). Nurses with higher scores in psychological capital and authentic leadership were more likely to belong to the positive-high-level suggestion behavior group (OR=0.839, P < 0.001, OR=0.845, P < 0.001). Regression analysis showed that professional title, employment method, age, genuine leadership level and psychological capital were the influencing factors of the potential categories of advice behavior of nursing staff (P < 0.05). Conclusion The classification characteristics of the suggestion behavior of 3 000 clinical nursing staff were obvious. 57.9% of the nursing staff showed a medium to low level in terms of suggestion expression. Nursing managers should, based on the different characteristics of their groups and in combination with influencing factors, implement targeted intervention measures to enhance the level of advice provided by nursing staff.
- Nurses /
- Voice behavior /
- Psychological capital /
- Authentic leadership /
- Potential profile analysis
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图 1 建言行为3个潜在类别题项得分均值分布

Figure 1. Distribution of mean scores across the three identified voice behavior profiles

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表 1 护士建言行为的潜在剖面模型拟合信息汇总

Table 1. Summary of model fitting information for the latent profile analysis of nurses' voice behavior

模型	Log(L)	AIC	BIC	aBIC	Entropy	LMR(p)	BLRT(p)	类别概率
模型1	-42 727.399	85 498.798	85 630.939	85 561.036	/	/	/	1
模型2	-32 882.257	65 832.515	66 036.731	65 928.700	0.969	0	0	0.539/0.461
模型3	-27 368.870	54 829.741	55 106.034	54 959.874	0.978	0	0	0.174/0.405/0.420
模型4	-25 665.524	51 447.047	51 795.416	51 611.128	0.983	0	0	0.018/0.173/0.392/0.417
模型5	-24 912.348	49 964.696	50 385.141	50 162.724	0.972	0	0	0.018/0.171/0.380/0.067/0.360
模型6	-22 479.157	45 122.314	45 614.836	45 354.290	0.977	0	0	0.022/0.152/0.317/0.079/0.365/0.066

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表 2 调查对象的一般资料和建言行为3个潜在剖面的单因素分析

Table 2. Univariable analysis of baseline characteristics and voice behavior across the three latent profiles

项目	总体	沉默型-低水平	保守型-中水平	积极型-高水平	统计值	P值
性别[例(%)]					3.530^a	0.171
女性	2 913	502(95.98)	1 230(97.62)	1 181(97.04)
男性	87	21(4.02)	30(2.38)	36(2.96)
第一学历[例(%)]					3.426^a	0.180
大专	2 220	390(74.57)	911(72.30)	919(75.51)
本科及以上	780	133(25.43)	349(27.70)	298(24.49)
婚姻[例(%)]					20.064^a	＜0.001
已婚	2 352	376(71.89)	1 026(81.43)	950(78.06)
未婚	594	134(25.62)	215(17.06)	245(20.13)
离异或丧偶	54	13(2.49)	19(1.51)	22(1.81)
职称[例(%)]					121.269^b	＜0.001
护士	478	102(19.50)	177(14.05)	199(16.35)
护师	1 143	258(49.33)	395(31.35)	490(40.26)
主管护师	1 196	158(30.21)	562(44.60)	476(39.11)
副主任护师及以上	183	5(0.96)	126(10.00)	52(4.27)
医院等级[例(%)]					6.724^b	0.151
三级医院	1 763	290(55.45)	771(61.19)	702(57.68)
二级医院	1 223	230(43.98)	485(38.49)	508(41.74)
社区或乡镇卫生院	14	3(0.57)	4(0.32)	7(0.58)
人事关系[例(%)]					90.570^b	＜0.001
正式在编	771	71(13.58)	421(33.41)	279(22.93)
合同制	1 490	295(56.41)	588(46.67)	607(49.88)
人事代理	739	157(30.02)	251(19.92)	331(27.20)
夜班频率[例(%)]					108.144^b	＜0.001
几乎很少无	878	104(19.89)	454(36.03)	320(26.29)
每月2~3次	504	56(10.71)	252(20.00)	196(16.11)
每月4~6次	1 618	363(69.41)	554(43.97)	701(57.60)
年龄分组[例(%)]					126.156^b	＜0.001
＜30岁	983	226(43.21)	344(27.30)	413(33.94)
30~40岁	1 405	263(50.29)	562(44.60)	580(47.66)
40~50岁	462	24(4.59)	257(20.40)	181(14.87)
>50岁	150	10(1.91)	97(7.70)	43(3.53)
工作年限分组[例(%)]					147.644^b	＜0.001
≤5年	736	157(30.02)	275(21.83)	304(24.98)
5~10年	836	204(39.01)	276(21.90)	356(29.25)
10~20年	914	136(26.00)	397(31.51)	381(31.31)
>20年	514	26(4.97)	312(24.76)	176(14.46)
建言行为总分(x±s，分)	45.49±8.42	2.97±0.82	4.87±0.40	3.95±0.55	2 298.490^c	＜0.001
心理资本总分(x±s，分)	68.23±13.15	2.84±1.00	4.76±0.54	3.87±0.69	1 471.890^c	＜0.001
真实型领导总分(x±s，分)	97.21±17.46	3.88±0.92	5.58±0.67	4.64±0.70	1 134.960^c	＜0.001
注：^a为χ²值，^b为Z值，^c为F值。

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表 3 护士真实型领导、建言行为、心理资本得分(x±s，n=3 000)

Table 3. Scores on measures of authentic leadership, voice behavior, and psychological capital in nurses(x±s, n=3 000)

条目	条目总分	条目均分
真实型领导总分	68.23±13.15	4.26±0.82
自我效能维度	29.07±5.55	4.85±0.92
希望维度	28.94±5.51	4.82±0.92
韧性维度	24.45±4.46	4.89±0.89
乐观维度	14.74±2.96	4.91±0.99
心理资本总分	97.21±17.46	4.86±0.87
建言行为总分	45.49±8.42	4.14±0.77
自我意识维度	17.16±3.26	4.29±0.82
关系透明维度	21.17±4.36	4.23±0.87
内化道德维度	17.15±3.27	4.29±0.82
信息平衡处理维度	12.75±2.66	4.25±0.89

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表 4 护理人员建言行为水平潜在剖面的多因素logistic回归分析

Table 4. Multinomial logistic regression to identify predictors of latent profiles in nurses' voice behavior levels

项目	类别	沉默型——积极型						保守型——积极型
项目	类别	B	SE	Waldχ²	P值	OR值	95% CI	B	SE	Waldχ²	P值	OR值	95% CI
职称	护师	-0.075	0.293	0.066	0.797	0.928	0.523~1.646	-0.052	0.210	0.061	0.805	0.949	0.629~1.434
	主管护师	-0.758	0.381	3.957	0.047	0.469	0.222~0.989	-0.508	0.274	3.440	0.064	0.602	0.352~1.029
	副主任护师及以上	-1.903	0.703	7.321	0.007	0.149	0.038~0.592	-0.965	0.367	6.925	0.008	0.381	0.186~0.782
人事关系	人事代理	0.456	0.266	2.929	0.087	1.577	0.936~2.658	0.325	0.175	3.462	0.063	1.384	0.983~1.948
	合同制	0.971	0.280	12.071	＜0.001	2.642	1.527~4.570	0.679	0.186	13.341	＜0.001	1.973	1.370~2.840
夜班频率	每月2~3次	0.129	0.272	0.225	0.635	1.138	0.667~1.940	0.148	0.167	0.788	0.375	1.159	0.836~1.607
	每月4~6次	0.391	0.219	3.177	0.075	1.478	0.962~2.271	0.335	0.150	5.026	0.025	1.399	1.043~1.875
年龄	30~40岁	-0.525	0.300	3.054	0.081	0.592	0.328~1.066	-0.301	0.228	1.737	0.188	0.740	0.473~1.158
	40~50岁	-1.583	0.563	7.903	0.005	0.205	0.068~0.619	-0.428	0.345	1.543	0.214	0.652	0.332~1.281
	>50岁	-0.762	0.784	0.944	0.331	0.467	0.100~2.170	-0.599	0.444	1.816	0.178	0.550	0.230~1.313
工作年限	6~10年	-0.098	0.329	0.089	0.766	0.907	0.476~1.727	0.009	0.243	0.001	0.970	1.009	0.626~1.626
	11~20年	0.100	0.415	0.058	0.809	1.106	0.490~2.496	0.326	0.306	1.130	0.288	1.385	0.760~2.525
	>20年	0.108	0.680	0.025	0.874	1.114	0.294~4.226	0.390	0.414	0.888	0.346	1.477	0.657~3.321
心理资本		-0.175	0.007	591.063	＜0.001	0.839	0.827~0.851	-0.097	0.005	391.732	＜0.001	0.908	0.899~0.917
真实型领导		-0.168	0.008	405.383	＜0.001	0.845	0.831~0.859	-0.104	0.007	240.966	＜0.001	0.901	0.890~0.913

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