我国医院病区护理工作环境现状及相关因素的多水平模型分析

目的了解我国医院病区的护理工作环境现状,探讨病区护理工作环境评价的影响因素。方法采用一般资料调查表和护理工作环境量表,对181家医院771个病区的9 698名护士进行调查,对病区护理工作环境的影响因素进行单因素和多因素分析。结果 771个病区中,41.4%被评价为护理工作环境好,42.1%被评价为差。评价护理工作环境差的病区中护士较年轻、工作年限短;男护士对病区护理工作环境评价差的比例较女护士大;学历越高对病区护理工作环境的评价越差,但护士因素均未进入多因素回归方程。三级医院病区较二级医院病区的护理工作环境差(P<0.001);直辖市医院的病区护理工作环境相对省会城市、其他城市地区医院的病区差(P≤0.001);东部地区医院的病区护理工作环境较中部、西部、东北部地区医院的病区差(P<0.001);中部、西部地区医院病区的护理工作环境较东北部地区医院的病区差(P=0.005);多因素分析显示,病区所在医院等级、地点、地区板块和病区类型是影响病区护理工作环境的主要因素。结论目前病区护理工作环境不太理想,管理层应对护理工作环境引起足够重视,采取积极措施加以改进。

Multilevel model analysis on present situation and related factors of nursing work environment in hospital wards in China

Objective To study the present situation of nursing work environment in wards of domestic hospitals and research related factors of evaluation on nursing work environment in wards. Method Investigate 9 698 nurses from 771 wards of 181 domestic hospitals by general information questionnaire and nursing work environment scale. Analyze related factors of nursing work environment by single and multiple factor analysis. Result Among 771 wards, 41.40/00 are evaluated to have nice nursing work environment and 42. 1 ~//00 have poor environment. Nurses give poor evaluations tend to be young and have shorter working years. Higher rate of male nurses give poor evaluation than female nurses. Nurses with higher ed- ucation level give poorer evaluation. But nurse factor is not in multi--regression equation. Wards in tertiary hospital have poorer nursing work environment than secondary hospital （P〈0. 001）. Wards in hospitals of municipality city have poorer nursing work environment than hospitals of provincial capital and other cities （P≤0. 001）. Wards in hospitals of east parts of China have poorer nursing work environment than hospitals of middle, west and northeast part of China （P〈0. 001 ）. Wards in hospitals of middle and west part of China have poorer nursing work environment than hospitals of northeast part of China （P = 0. 005）. Multiple factor analysis shows that hospitals level, location, district and ward style are the main factors influencing nursing work environment. Conclusion Present nursing work environment of wards is not satisfying. Managers should pay attention to nursing work environment and take corresponding measures.