Concerns, satisfaction, and retention of Canadian community health nurses

This study of Canadian community health nurses (N = 1,044) compared the work-related concerns, job satisfaction, and factors influencing the retention of public health, home care, and community care access center (CCAC) nurses. Community health nurses identified similar work-related issues as being of greatest concern to them, but there were significant differences among the 3 groups of nurses in the magnitude of these concerns. There were also significant differences among the 3 groups for satisfaction with their jobs and their immediate supervisors, with CCAC nurses being the least satisfied except for the greater dissatisfaction of home care nurses with their pay and benefits. For the retention factors, the differences were primarily in the areas of job features and supportive work relationships. There are both similarities and differences among public health, home care, and CCAC nurses. Initiatives to address community health nurses' concerns, improve their job satisfaction, and increase their retention will require interventions tailored to the specific community health care setting.     

Job Satisfaction of Rural Public and Home Health Nurses

Abstract Based on Vroom's expectancy theory, this study was conducted to identify differences in job satisfaction between nurses working in public health settings, and staff nurses and administrators working in both settings. Questionnaires containing an adaptation of a job satisfaction scale were mailed to all 258 registered nurses practicing in public health and home health settings (response rate 57%) in a rural midwestern state. Respondents were asked to rate their satisfaction with various dimensions of their jobs, as well as how important each aspect was to them. Although both groups of nurses reported low satisfaction with salary, public health nurses were significantly less satisfied with their salaries than were home health nurses (F = 32.96, P≤0.001); home health nurses, however, were significantly less satisfied with benefits/rewards (F = 11.85, P≤0.001), task requirements (F = 8.37, P≤0.05), and professional status (F = 5.30, P≤0.05). Although administrators did not differ significantly from staff nurses on job satisfaction, they did perceive organizational climate (F = 4.50, P≤0.05) to be an important feature of satisfaction. These differences may be partially explained by divergent salaries, roles, and responsibilities between public health and home health nurses.     

Prestige: Key to Job Satisfaction for Community Health Nurses

By examining and predicting dimensions of job satisfaction of community-based nurses, this study sought to provide information for recruiting and retaining community nurses. Data were collected from a sample of 104 community health, school health, and home health nurses. Prestige had the highest positive correlation with and was the single significant predictor of job satisfaction. Three other subscales, autonomy, social interaction, and organizational requirements, correlated with job satisfaction as moderately positive. Weak positive relationships were found with years of work, years on the job, age, and years of education. Pay was not associated with job satisfaction for these nurses.     

The Changing Spirit of Rural Community Nursing: Documentation Burden

Abstract Rural community and public health nursing are characterized by an impressive commitment of nurses to their communities and a connectedness of people to one another. Home care as an integral part of long-term and acute care for the older adult population has emerged as a vital practice area in community health nursing. The purpose of this ethnographic field study was to describe rural home care for frail older adults from the perspective of those providing and receiving care. More than 250 interviews were conducted with home care providers, recipients and their families, and other community members. The setting included eight culturally and geographically diverse counties in rural Colorado. One major theme is presented: the perceived change in the spirit of rural community nursing due to the overwhelming documentation required for home care reimbursement. Oppressive paperwork requirements impeded practice and resulted in fewer home visits per day, low job satisfaction, increased nursing staff turnover, decreased quality of care, and changed the spirit of community nursing from an emphasis on caring and community service to a focus on reimbursement. The study results have timely implications for health policy formulation as the United States undergoes major health care reform.     

西安市社区护士工作压力源对工作满意度的影响研究

目的了解西安市社区护士工作压力源、工作满意度现状并探讨二者之间的关系。方法采用一般资料调查表、社区护士工作压力源量表、社区护士工作满意度量表对西安市24个社区卫生服务中心的302名社区护士进行问卷调查。结果社区护士工作压力源总分为(71.55±25.41)分,工作满意度总分为(139.88±19.33)分。职称、个人月收入、护理专业及工作方面的问题、工作量及时间分配方面的问题、管理及人际关系方面的问题是社区护士工作满意度的主要影响因素。结论管理者要注重改善社区护士工作环境、提高待遇、注重其个人发展,提高社区护士工作满意度。     

社区签约护士叙事护理体验的质性研究

目的 了解社区签约护士在运用叙事护理方法为患者实施健康管理过程中,自身护理体验、个人成长收获及职业发展需求,为社区进一步推广叙事护理及人才培养提供依据。 方法 采用现象学研究方法,对北京市2所开展签约服务工作,且由护士对患者实施叙事护理的社区卫生服务中心（站）的13名护士进行半结构式访谈。采用Colaizzi 7步分析法进行资料分析。 结果 开展叙事护理后,社区签约护士在工作体验和感受方面提炼出工作成就感增强、职业价值感凸显、叙事护理模式认同感提升、护患关系亲密感增加4个主题;在个人成长收获方面提炼出学会尊重、懂得理解、关爱彼此、自我赋能4个主题;在未来职业发展需求方面提炼出希望人员配置更合理、渴望更多的专业培训机会、期望更大的护理交流平台3个主题。 结论 通过叙事护理在签约患者中的实施,社区护士职业认同感及自我价值感明显提升。相关机构应给予护士更多学习、培训、交流的机会,以提升护士专业能力,为社区护理事业的发展提供保障。     

Job Satisfaction Assessment of Public Health Nurses

Abstract To provide empirical data for dealing with problems of low morale and high turnover in a few districts of a state public health nursing department, survey research was designed to measure the job satisfaction of the public health nurses. Questionnaires that measured satisfaction with 12 job components were received from 741 nurses for a 68 percent response rate. Top-ranked satisriers were job importance, interpersonal relations, and achievement. Lowest-ranked satisfiers were job mechanics, recognition, and salary/benefits; administrative interventions were developed to deal with these areas. High levels of job satisfaction were associated with increased educational preparation, increased age and longevity, administrative positions, and program assignment in tuberculosis or child health.     

齐齐哈尔市社区护士工作满意度影响因素的研究

目的 了解齐齐哈尔市社区护士工作满意度的影响因素.方法 利用分层系统整群抽样的方法对165名社区护士进行现场自填式问卷调查,对结果进行分析.结果 引入Logistic回归分析,工作地点、年龄、婚姻状况、职称、岗位性质、月收入和工作年限是护士工作满意度的影响因素.结论 政府应重视社区卫生护理服务,及时掌握社区护士的工作满意度情况,采取改进措施,提高社区护士工作满意度,稳定社区护理队伍,促进社区卫生服务事业的发展.     

Public Health Nursing Research Priorities: A Collaborative Delphi Study

Abstract The purpose of this study was to identify research questions and priorities in public health nursing based on the perceived needs of practicing public health nurses, and to assess whether the respondents believed that the profession should provide leadership in the study of the identified questions. Using a modified Delphi survey. 76 research priorities were ranked and produced three factors or categories of questions during the two rounds: outcomes in maternal-child and family planning, outcomes in home health services, and public health nurse recruitment, retention, job satisfaction, and image. Forty-seven (62%) of the 76 priorities were deemed appropriate for nursing to assume leadership in seeking answers. Results reveal a consensus of research priorities generated by front-line nurses consistent with year 2000 health objectives for the nation.     

Knowledge, skills and experiences for community health nursing practice: the perceptions of community nurses, administrators and educators

Nursing in Canada is committed to preparing all new graduates at the baccalaureate level for entry to nursing practice by the year 2000 This goal has major implications for community health nursing education and practice Health care reform is also expected to move care out of the hospital and into the community It was against this backdrop that the researchers mounted a study on the educational preparation needed for graduates to begin to practice community health nursing In this paper, the knowledge, professional and personal skills, and experiences that graduates need to begin community practice are reported The study was carried out within an action-research framework All major groups of stakeholders involved in community health nursing throughout the study province were involved in the project This included nurses and administrators from two public health agencies (provincial and municipal), home care nurses, home health nurses (l e non-governmental visiting nurses), community health centres, provincial health care and nursing consultants, and faculty from two universities In addition to the generation of relevant research findings for use by the educational institutions, the study was initiated to set the stage for future and ongoing interactions between the researchers and community experts to implement the findings from the project Data were collected from 118 participants by means of 27 focus groups of community nurses, administrators and educators Interviews were tape-recorded transcribed and analysed using latent content analysis and constant comparison techniques Findings indicated that qualified nurses from university programmes need a wide range of knowledge, skills and experiences to begin to practice community health nursing Detailed accounts of these requirements are outlined and the implications for practice and education put forward     

重庆主城区社区护士的工作满意度调查及影响因素分析

目的比较并分析重庆主城区不同层次社区护士对社区护理工作满意度状况及其影响因素,为社区护理管理提供依据。方法采取整群抽样的方法,自行设计问卷对重庆市主城区48所社区卫生服务中心349名社区护士进行工作满意度及相关影响因素调查,并对其工作满意度及影响因素进行单因素分析及Logistic回归分析。结果不同年龄、学历、职称及聘用类型的护士对社区护理工作满意度不同,差异均有统计学意义(P<0.05)。Logistic回归分析结果表明:工资及其他福利待遇低,评定职称体系缺乏、晋升机会少,社区护士自身知识及能力相对不足,社区护士职责、分工不明确,继续教育机会少,以及认为社区护理不重要是影响社区护士工作满意度的主要因素。结论社区护理管理者应在了解社区护士工作满意度情况的基础上,针对其不同群体差异,采取有效措施,不断完善社区护理管理制度,提高社区护士工作满意度,进一步提高社区护理质量。     

Roles and functions of community mental health nurses caring for people with schizophrenia in Taiwan

Aims and objectives. The study aimed to understand the nursing roles and functions of public health nurses and home health nurses in Taiwan and the factors that affect nursing roles and functions of nurses that provide community mental health home visiting services. Background. Although community nurses provide more psychiatric home visiting services than other psychiatric professionals, little research on their roles and functions has been conducted. Design. Nursing roles and functions were developed through use of grounded theory method of Strauss and Corbin. Methods. Data were collected using semi‐structured face‐to‐face in‐depth interviews and unstructured non‐participant observations. The constant comparative analysis continued during the open, axial and selective coding process until data saturation occurred. Participants were selected using theoretical sampling. Final sample size in this study comprised a total of 29 community nurses (18 public health nurses and 11 home health nurses) who provided community mental health home visiting. Public health nurses conducted a total of 16 (eight carers and eight clients) services and home health nurses conducted 16 (eight carers and eight clients) services. Results. Fourteen nursing roles were identified. These roles included assessor, supporter, educator, consultant, counselor, negotiator, harmoniser, collaborator, advocate, placement coordinator, resource provider, care provider, case manager and case finder. Moreover, several factors that affect nursing roles and functions in the community mental health home visiting service in Taiwan were also identified. Conclusion. This is the first study to identify the role of public health and home health nurses caring for people with schizophrenia in the community in Taiwan. Relevance to clinical practice. The recommendations based on the findings of this research can be used as a guide to improve the delivery of psychiatric home visiting services to community‐dwelling clients with schizophrenia and their carers.     

临床护士幸福进取感在工作满意度与职业认同中的中介效应

目的 探讨临床护士积极心理健康在职业认同与工作满意度中的中介效应.方法 采用幸福进取者调查问卷、工作满意度调查表及护士职业认同调查问卷对300名临床护士护士进行调查.结果 临床护士工作满意度程度为57.30％,工作满意度不同程度的临床护士的幸福进取感及职业认同感存在显著性差异（P＜0.01）,幸福进取感不满意得分为（2.31±0.26）,低满意得分为（3.68±0.42）,高满意得分为（4.59±0.38）,各维度得分比较差异有统计学意义（F=7.68,P＜0.01）;护士职业认同问卷不满意得分为（55.24 ±6.37）,低满意得分为（63.35 ±5.46）,高满意得分为（82.49 ±7.62）,各维度得分差异有统计学意义（F=9.34,P＜0.01）,幸福进取感各维度与工作满意度及职业认同感存在正相关性（r =0.226 ～0.337,P＜0.01）.结论 临床护士工作满意度不高,工作满意度及职业认同受积极心理健康的影响.     

Home Health Nurses’ Perspectives and Care Processes Related to Older Persons with Frailty and Depression: A Mixed Method Pilot Study

The objectives of this study were (1) to describe home health care (HHC) nurses’ perception of and care processes related to geriatric depression and frailty, and (2) to identify barriers to care delivery for older persons with these two conditions. Ten semi-structured interviews were conducted with HHC nurses, and 16 HHC nursing visits to 16 older patients (≥65 years) were observed. Mixed method analysis showed that HHC nurses did not routinely assess for frailty and depression. Major barriers to care delivery included insufficient training, documentation burden, limited reimbursement, and high caseload. Addressing these barriers would facilitate HHC nursing care for frail, depressed elders.     

Nurses and palliation in the community: the current discourse

A core component of community nursing practice in Australia is the provision of palliative care, however this area of practice has been minimally researched. We, therefore, undertook a broader review of the contemporary literature in community nursing; palliative nursing; and community nursing palliative care. Literature was searched electronically in OVID, CINAHL and nursing databases and manually in relevant journals. Findings revealed community and palliative care nursing to be both complex and challenging. Community and palliative nurses ideals for care are compromised by competing practice demands. Changing health systems and philosophical views, limited resources and the perceived 'visibility/invisibility' polarity are identified as major job stressors. Therapeutic use of 'self' and interpersonal communication are recognized as contributing to job satisfaction. Community nurses providing palliative care is as an under researched area yet it is a role that arguably requires critical understanding and recognition. Further research is needed into the relationship between emotional well-being and professional satisfaction for community and palliative care nurses providing palliation.     

Differences in Technology Among Subspecialties in Community Health Nursing

Interest in differentiating community health nursing from home health nursing has focused on theoretical models, concepts, and examinations of the historical origins and evolution of the roles. Although not usually included in the recent differentiation efforts, school and occupational health nursing traditionally have been considered important subspecialties of community health nursing. Utilizing an approach to technology developed by organizational researchers and focusing not on hardware and equipment, but on the characteristics of the raw materials and techniques employed, this study examined the differences among public health/community health, home health, school health, and occupational health on the three technological dimensions of uncertainty, instability, and variability. Survey data from nurses in the four areas (N = 40) were utilized. Results indicated that home health nursing differed significantly from the other groups on the dimensions of uncertainty and instability.     

Differences in technology among subspecialties in community health nursing

Interest in differentiating community health nursing from home health nursing has focused on theoretical models, concepts, and examinations of the historical origins and evolution of the roles. Although not usually included in the recent differentiation efforts, school and occupational health nursing traditionally have been considered important subspecialties of community health nursing. Utilizing an approach to technology developed by organizational researchers and focusing not on hardware and equipment, but on the characteristics of the raw materials and techniques employed, this study examined the differences among public health/community health, home health, school health, and occupational health on the three technological dimensions of uncertainty, instability, and variability. Survey data from nurses in the four areas (N = 40) were utilized. Results indicated that home health nursing differed significantly from the other groups on the dimensions of uncertainty and instability.     

Predictors of job satisfaction for rural acute care registered nurses in Canada

This study examines predictors of job satisfaction among rural acute care registered nurses. The data are from a cross-sectional national survey, which was part of a larger project, The Nature of Nursing Practice in Rural and Remote Canada. This analysis suggests that a combination of individual, workplace, and community characteristics are interrelated predictors of job satisfaction for rural acute care nurses. There were nine variables that accounted for 38% of the total variance in job satisfaction. Four variables alone (available and up-to-date equipment and supplies, satisfaction with scheduling and shifts, lower psychological job demands, and home community satisfaction) explained 33% of the variance. Recruitment and retention strategies in rural areas must acknowledge that rural nurses' work lives and community lives are inextricably intertwined. Attention to these issues will help ensure high-quality working environments and a continued commitment to quality nursing care in the rural hospital settings in Canada.