护士组织承诺对医院磁性水平影响的机制研究

目的 探究护士组织承诺、心理韧性对医院磁性水平的影响,为临床护理人力资源管理提供依据.方法 采用护士心理韧性量表、中国职工组织承诺量表、医院磁性要素量表对新疆地区4所三甲综合医院的3047名临床护士开展调查,并建立三者之间的关系模型.结果 护士心理韧性得分64.93士15.73,护士组织承诺得分81.53±16.66,护士感知医院磁性水平得分97.31土21.38.护士心理韧性与组织承诺、护士感知医院磁性水平呈正相关(r=0.492、0.483,均P＜0.01),护士组织承诺与感知医院磁性水平呈正相关(r=0.561,P＜0.01),组织承诺是心理韧性与医院磁性环境的中介变量,中介效应占总效应的55.40％.结论 护士心理韧性、组织承诺处于中等水平,护士感知医院磁性水平处于中等偏低水平,组织承诺在心理韧性与工作环境间起中介作用.医院管理者应重视护士组织承诺的建立和维护,稳定护士队伍,提高护士满意度,从而提高护理质量.     

护士组织支持感对其感情承诺的影响研究

目的：探讨护士组织支持感对其感情承诺的影响。方法：采用便利抽样法选取天津市3所三级甲等医院的346名在职护士作为研究对象,并采用组织支持感量表和感情承诺量表进行调查。结果：护士感情承诺总分为（3.26±0.55）分,护士组织支持感及其各维度与感情承诺均呈正相关（r=0.537～0.628,P＜0.01）;分层回归分析显示,控制人口学资料后,关心利益、价值认同、工作支持共可解释感情承诺总变异的32.1%。结论：医院和护理管理者应采取针对性的策略改善护士的组织支持感,以提高其感情承诺水平。     

接纳与承诺疗法对食管癌术后患者负性情绪及生活质量的影响

目的 探讨接纳与承诺疗法(acceptance and commitment therapy,ACT)对食管癌术后患者负性情绪及生活质量的影响.方法 选取2019年4月—2020年3月收治的100例食管癌术后患者为研究对象,采用随机数字表法将其分为对照组和观察组,各50例.对照组采用常规护理方法,观察组在常规护理的基础...     

Patients' commitment to their primary physician and why it matters

PURPOSE The patient-physician relationship is the cornerstone of health care service delivery. The objectives of this study were to assess the contribution of relationship commitment along with trust to patient-physician relationships and to evaluate the association of commitment and trust with adherence to medical advice and healthy eating behaviors.METHODS To test the proposed model, we developed a questionnaire that included both existing scales and a scale constructed specifically for the study; the questions addressed trust, commitment, adherence to physicians’ medical recommendations, and healthy eating behavior. The questionnaire was given to adult patients in the waiting rooms of 4 large clinics in central Texas.RESULTS A total of 1,008 patients returned questionnaires; 869 patients’ questionnaires were complete and used in the analysis. A 3-stage least squares analysis that tested a system of 4 equations which included relationship commitment yielded a systemwide R² of 0.71 that was 0.09 higher than a system of equations excluding relationship commitment. Trust and commitment were positively associated with adherence (P <.001 and P = .02, respectively). We also found positive relationships between adherence and commitment and between trust and commitment (P <.001 for each). Adherence and commitment were both associated with healthy eating behavior as well (P <.001 for each).CONCLUSIONS Patients’ trust in their physician and commitment to the relationship offer a more complete understanding of the patient-physician relationship. In addition, trust and commitment favorably influence patients’ health behaviors.     

Explaining turnover intention in Korean public community hospitals: occupational differences

OBJECTIVES: Personnel in public hospitals had relatively low job satisfaction despite of tenure employment. High turnover rates degrade hospital image and incur additional costs related to recruitment and training. The purposes of this study were to describe the occupational differences and to identify factors affecting turnover intention among public hospital personnel. METHOD: A questionnaire survey was conducted as part of Administrative Services Quality Evaluation Program by Seoul metropolitan municipality from 1 November to 1 December in 2003. The subjects were 1251 entire hospital personnel in four hospitals. The questionnaire was designed to measure job satisfaction, organizational commitment, turnover intention, and demographic characteristics. Logistic regression analysis was performed to determine factors influencing turnover intention. RESULTS: There were significant differences in job satisfaction, organizational commitment, and turnover intention according to the occupations. The turnover intention rates were highest among physicians, followed by paramedicals and nursing staffs and then administrators. The significant factors affecting turnover intention were involvement and loyalty among physicians, hospital type, satisfaction with systems and loyalty among nursing staffs, satisfaction with relationship and loyalty among administrators, and loyalty among paramedicals. CONCLUSION: There were different moderators that influence turnover intentions of hospital personnel. Loyalty had the most important effect upon turnover intention in all occupations.     

医学生自我管理能力与专业承诺关系的研究

目的:调查医学生自我管理能力和专业承诺的现状,并进一步分析二者的关系。方法:采用《大学生自我管理能力问卷》和《大学生专业承诺问卷》对蚌埠医学院600名五年制医学生进行抽样调查。结果:医学生自我管理能力得分(116.32±14.72)分,专业承诺得分(85.10±13.24)分;与自我管理能力弱的医学生比较,自我管理能力强的医学生专业承诺强的医学生百分率相对较高(P<0.01);医学生自我管理总分及大部分因子分与专业承诺总分及各因子分均呈显著正相关关系(P<0.01);逐步回归分析职业生涯管理、人际关系管理、身心管理、时间管理进入以专业承诺总分为因变量的回归方程(P<0.01)。结论:医学生自我管理能力较强、专业承诺相对较好,自我管理能力中职业生涯管理、人际关系管理、身心管理、时间管理对专业承诺有影响,职业生涯管理影响最显著,可以解释医学生24.1%的专业承诺。     

Extended Outpatient Civil Commitment and Treatment Utilization

Summary

Objective: This study considers four hypotheses regarding the impact of extended involuntary outpatient commitment orders on services utilization.

Method: All Victorian Psychiatric Case Register (VPCR) patients who had extended (180+ day) outpatient commitment orders in the nine year study period and a matched treatment compliant comparison group with extended periods of outpatient care (N = 1182), both with at least two years of post-episode experience, were evaluated. Pre/post episode utilization was compared via paired t tests with individuals as their own controls. Logistic and OLS regression as well as repeated measures ANOVA via the GLM SPSS program and post hoc t tests were used to evaluate between group and across time differences.

Results: Extended episodes of care for both groups were associated with reduced use of hospitalization and increases in outpatient services. Extended orders did not promote voluntary participation in the post-period. Outpatient services during the extended episode for those on orders were raised to the level experienced by the treatment compliant comparison group and maintained at that level via subsequent renewal of orders throughout the patients' careers. OLS regression results indicate that approximately six community care service days were required for those on orders to achieve a one-day reduction in hospital utilization following the extended episode.

Conclusion: Outpatient commitment for those on extended orders in the Victorian context enables a level of community-based services provision, unexpected in the absence of this delivery system, which provides an alternative to hospitalization.