某专科医院护理工作环境调查中不良得分条目情况分析

目的　通过深入分析不良得分调查条目的具体情景，持续改进医院护理管理。方法　采用横断面研究，对2020年7月9日至22日广州市胸科医院护士进行问卷调查，应参加护士441人，反馈问卷调查结果249人。依据≤25岁、>25～30岁、>30～35岁、>35～40岁、>40～45岁、>45～50岁、≥50岁7个年龄段和护士、护师、主管护师、高级护师（包括副主任护师与主任护师）4个职称类别进行护士人群分类，对护理工作环境量表（PES-NWI）问卷调查中Likert 4级计分平均分值≤2.50的不良得分条目分别计算其“非常不同意、不同意、同意、非常同意”Likert 4级分布频数、百分比及均数±标准差（x±s）。结果　（1）在11类护士人群、PES-NWI的4个维度31个条目形成的341个（11×31）人群条目集（以下简称“群目”）中，有24个得分平均值≤2.50的不良得分群目，占群目总数的7.04%（24/341）；得分不良群目涉及PES-NWT的“护士参与医院事务”维度的6个条目和“充足的人力和物力”维度的2个条目。（2）7个年龄段护士人群得分不良群目18个，占其群目总数（7×31）的8.29%（18/217），得分不良群目涉及PES-NWT的“护士参与医院事务”维度的6个条目和“充足的人力和物力”维度的2个条目。（3）4个职称类别护士人群得分不良群目6个，占其群目总数（4×31）的4.84%（6/124），得分不良群目涉及PES-NWT的“护士参与医院事务”维度的3个条目和“充足的人力和物力”维度的3个条目。（4）年龄由小到大7个年龄段护士人群得分不良群目分别涉及0、1、5、4、3、2、3个条目，职位由低到高4个护士人群得分不良群目分别涉及0、2、3、1个条目。结论　护士年龄对护理工作环境的感知比职称类别敏感，护士在医院中的地位与护理人员数量是否充足则最受关注。

Analysis of poor-scoring items in the nursing work environment survey in a specialized hospital

Objective　To improve the hospital nursing management by analyzing the poor-scoringsurvey items. Methods　In thecross-sectional study, a questionnaire survey was conducted among nurses inGuangzhou Chest Hospital from July 9 to 22, 2020; 441 nurses should participatein the survey, and 249 nurses actually gave feedback on the questionnaireresults. The nurses were classified according to 7 age groups of ≤25 years old, >25-30 years old, >30-35years old, >35-40 years old, >40-45 years old, >45-50 years old, and ≥50 years old, or 4 professional title levels ofnurse, registered nurse, supervisor nurse, and senior nurse (including deputychief nurse and chief nurse). Poor-scoring items with a Likert 4-point averagescore ≤2.50 in the PracticeEnvironment Scale of the Nursing Work Index (PES-NWI) survey were selected. Thedistribution frequencies, percentages, and their mean±standard deviation (x±s) of "strongly disagreed", "disagreed","agreed", and "strongly agreed" on Likert 4 levels werecalculated. Results　(1) There were 341(11 × 31) population item sets (hereinafter referred to as "groups")formed by 11 types of nurse populations and 31 items in 4 dimensions ofPES-NWI. There were 24 poor-scoring groups with an average score of ≤2.50, accounting for 7.04% of the total numberof groups. The poor-scoring groups involved 6 items in the dimension of"nurses' participation in hospital affairs" and 2 items in thedimension of "adequate human and material resources" of PES-NWT. (2)There were 18 poor-scoring groups in the nurses of 7 age groups, accounting for8.29% of the total number of groups (7 × 31). The poor-scoring groups involved6 items in the dimension of "nurses' participation in hospitalaffairs" and 2 items in the dimension of "adequate human and materialresources" of PES-NWT. (3) There were 6 poor-scoring groups in the nursesof 4 professional title levels, accounting for 4.84% of the total number ofgroups (4 × 31). The poor-scoring groups involved 3 items in the dimension of"nurses' participation in hospital affairs" and 3 items in thedimension of "adequate human and material resources" of PES-NWT. (4)The poor-scoring groups of the 7 age groups involved 0, 1, 5, 4, 3, 2, and 3items from the youngest to the oldest. The poor-scoring groups of the 4professional title level groups involved 0, 2, 3, and 1 items respectively fromlowest to highest. Conclusion　The nurses' age ismore sensitive to the perception of nursing work environment than the level ofprofessional titles, and the nurses' status in hospital and the adequacy of thenumber of nursing staff are the most concerned.