医院护工管理存在问题与对策

  目的  了解中国三级公立医院接受护工服务住院患者的满意度及其影响因素，为优化我国医院护工管理，更好地满足社会需求提供参考。  方法  采用随机抽样方法于2019年3月18 — 31日在中国31个省（自治区、直辖市）和新疆生产建设兵团的144家三级公立医院抽取调查当日及次日出院的23 767例住院患者进行问卷调查，分析其中6 211例接受护工服务住院患者的护工服务满意度；采用分层随机抽样方法在东、中、西部地区样本医院中各随机抽取2～3家医院，利用滚雪球抽样方法进一步抽取50例接受过护工服务的住院患者，采用一对一半结构化访谈提纲就患者对护工服务满意度的影响因素进行深入访谈，并采用扎根理论分析方法对访谈结果进行分析。  结果  6 211例接受护工服务的住院患者中，5 968例对护工服务满意，对护工服务的满意率为96.09 %。扎根理论分析结果显示，影响住院患者对护工服务满意度的重要因素有与护工个体特点有关的护工素质、态度和价值，与医院和护工管理公司相关的护工来源和护工管理以及与社会环境相关的市场体系和护工地位等；其中，护工个体为医院和护工公司以及护工市场提供了人员基础，医院和护工公司为护工服务提供了直接保障，社会为护工服务提供了间接保障，三者相辅相成，互相影响，共同影响着护工服务的质量和患者对护工服务的满意度情况。  结论  中国三级公立医院接受护工服务住院患者满意度有待提高；护工个体、医院和护工管理公司以及社会环境互相作用，共同影响着住院患者对护工服务的满意度。

Toward a deep insight into employee participation in employer-supported volunteering in Iranian organizations: a grounded theory

  Objective  To examine the satisfaction to nursing worker service and its influencing factors among inpatients in public tertiary hospitals in China and to provide evidences for improving the management on informal nursing care in hospitals.  Methods  With random sampling, we conducted questionnaire surveys among 23 767 inpatients about to be discharged at 144 public tertiary hospitals in 31 province-level regions across China during March 18 – 31, 2019 and the information collected from 6 211 inpatients receiving nursing worker service during their hospitalizations were analyzed. Using stratified random sampling, we selected 2 or 3 hospitals in the eastern, western and the central regions to recruit inpatients (n = 50) having nursing worker service in the sampled hospitals and perform face-to-face semi-structured interviews with the selected inpatients; ‘grounded theory’ based analysis was adopted in analyses on relevant information from the interviewees.  Results  Of the 6 211 respondents, 5 968 (96.09%) reported satisfaction to the service provided by nursing workers during hospitalization. The results of ‘grounded theory’ analysis revealed that main influencing factors for inpatients′ satisfaction to nursing workers′ service included nursing workers′ general quality, service attitude, usefulness of the service, sponsor or introducer of nursing worker, management manner of nursing service, environment of nursing service market, and social recognition on nursing service. Nursing workers are human resource for nursing service-related hospitals, corporations, and markets; hospitals and corporations provide direct support and the society provides indirect support to nursing workers′ service; the three aspects mentioned above are interacted each other and have integrated influence on nursing workers′ service quality and inpatients′ satisfaction to the service provided by the nursing workers.  Conclusion  The satisfaction to nursing worker service among inpatients in public tertiary hospitals in China needs to be improved. Nursing workers, hospitals/corporations and social environment exert an interactive impact on inpatients′ satisfaction to services provided by nursing workers.