【作者】 孙玫；

【导师】 唐四元；

【作者基本信息】 中南大学 ， 护理学， 2012， 博士

【摘要】 目的验证职业决策自我效能量表对护理学研究生被试的适用性。了解我国护理学硕士研究生的一般人口学资料,择业认知,职业决策自我效能,领悟社会支持,职业承诺,内-外控心理源,特质焦虑。探讨职业决策效能与可能的相关因素领悟社会支持,职业承诺,内-外控心理源,特质焦虑的关系研究,建立我国护理学硕士职业决策自我效能与各种影响因素的结构方程模型,探讨各影响因素的作用机制及贡献系数。根据研究结果提供一套简单而行之有效的提高我国护理学硕士的职业决策自我效能的干预方案,为护理学高等教育及护理用人单位提供护理才培养及人力资源管理的理论及现实依据。了解护理硕士研究生职业选择和职业决策过程中的全方位感触,在深入挖掘量性研究结果中护理学研究生对择业的认知、专业承诺等对其职业决策的深层次影响的同时全方位深入了解护理学硕士研究生对于职业选择的自身经历及择业观、人生观、价值观念、信念、态度、职业心理发展过程等等,从另一视角探讨护理学硕士研究生的职业发展问题。方法在回顾文献和理论学习的基础上构建护理硕士研究生职业决策效能及影响因素理论方程模型；采用横断面调查研究设计,于2011年10月～2012年1月期间以我国全日制护理学硕士研究生为调查对象,采取分层随机抽样方法最终确定自愿参与该项调查分布在我国东北、华北、西北、华东、中南、西南各个地区19所护理院校的的565名研究对象。资料收集工具包括研究者自行设计的护理学硕士一般情况问卷、大学生职业决策自我效能量表、大学生专业承诺问卷、硕士研究生内外心理控制源量表、领悟社会支持评定量表及特质焦虑量表；采用Epidate软件进行数据录入,使用SPSS13.0、Amos7.0进行统计学分析。统计学方法包括统计描述、t检验、卡方检验、方差分析、Kruskal-WallisH检验、Pearson相关分析、验证性因素分析、多元线性回归分析、结构方程分析等进行结构方程模型的拟合。采用质性研究中现象学研究法,于2011年10月～2011年12月间,采用方便抽样和目的抽样方法在我国多个护理院校参与过本课题量性研究部分的学生中选取访谈对象18名,其中男性2名,女性16名,描述其择业经历及对职业选择的观念、态度、心理变化过程等。以半结构式访谈、观察为主收集资料,应用NVIvo8.0版,以Colaizzi内容分析法对资料进行分析和整理。结果本研究共发放调查问卷565份,回收有效问卷545份,问卷有效回收率为94.6%。总样本CDMSE、PCQ、I-E量表,PSSS和T-AI的Cronbach a系数分别为0.963、0.917、0.758、0.911和0.897。多元线性回归分析显示,年级、地区、学位类型、导师帮助、特质焦虑、专业承诺、社会支持、心里控制源是护理硕士职业决策效能的影响因素。结构方程模型分析显示存在以下主要路径：社会支持到专业承诺(路径系数=0.223)、内控制源到社会支持(路径系数=0.473)、外控制源到社会支持(路径系数=-0.123)、社会支持到特质焦虑(路径系数=-0.633)、内控制源到特质焦虑(路径系数=-0.076)、外控制源到特质焦虑(路径系数=0.698)、专业承诺到特质焦虑(路径系数=-0.428)、专业承诺到职业决策自我效能(路径系数=0.261)、特质焦虑到职业决策自我效能(路径系数=-0.569)、内控制源对职业决策自我效能(路径系数=0.341),特质焦虑对职业决策效能的效应最大(总效应值为-0.569,且均为直接效应)；外控型心理控制源及社会支持对职业决策效能的效应均为间接效应(效应值分别为-0.441,0.418)。内控型心理控制源和专业承诺对职业决策效能的效应分别为0.412(直接效应为0.341,间接效应为0.071)、0.505(直接效应为0.261,间接效应为0.244)。对访谈资料进行分析结果,护理学硕士研究生择业观因人而异,受到个人因素、家庭、社会生活经历、教育背景等因素影响,择业观反映在以下主要相关范畴,研究结果详细描述和讨论了这些范畴和主题。分别是就业动机和择业意愿、专业认知、职业认知、职业期望、择业挑战及优势、择业过程中已获得支持及进一步需求。结论本研究采用的大学生职业决策自我效能量表,领悟社会支持量表、特质焦虑量表、大学生专业承诺量表及多维度心理控制源量表等研究工具具有有良好的信效度,可以较好的适用于研究生被试测评工作。护理学硕士研究生职业决策效能整体处于中等水平,但个体间水平层次不齐,离散度大,职业决策困难问题突出。影响护理学硕士研究生职业决策自我效能的因素众多,包括院校所在地区、导师帮助、就业指导、领悟社会支持、特质焦虑、专业承诺及心理控制源等。采用结构方程模型方法,构建出一个护理学硕士研究生职业决策效能影响因素模型,各项拟合指数良好,能指导护理教育及护理管理相关领域针对提高专业承诺、提供社会支持、引导自我归因方式、关注其焦虑情绪等提出对策,提高护理研究生职业决策效能。护理学硕士择业动机强烈,择业意愿多元化、复杂化,并呈现出与现实状况相符合的理性回归。研究结果启发护理教育者及护理管理者对护理研究生择业观中的消极感受应引起高度关注,警防其成为高等护理人才流失的伏笔。更多还原

【Abstract】 OBJECTIVES1. To test the applicability of Career Decision-Making Self-Efficacy (CDMSE) Scale in Master’ nursing students.2. To describe the social-demographic characteristics, perception of career choice, CDMSE, perceived social support, career commitment, internal and external locus of control, trait anxiety in Master’nursing students.3. To analyze the structural relationship between CDMSE and possible related factors including perceived social support, career commitment, internal and external locus of control and trait anxiety by structural equation modeling and identify how these influencing factors effect career decision-making self-efficacy and their contributions to the model.4. To establish an effective set of feasible intervention for improving CDMSE of Chinese Master’s nursing students and provide theoretical and practical evidence for tertiary nursing higher education and nursing constitutions in terms of training nursing talent and human resource management.5. To explore Master’s nursing students’ full perceptions of career choice and career decision-making process completely; to get an in-depth understanding of Master’s nursing students’experiences in career choice, career value, philosophy of life, values, belief, attitude and psychological professional development process in qualitative research when analyzing the factors such as perception of career choice and career commitment that influence career decision-making of Master’s nursing students by digging deep into quantitative research results; to consider Master’s nursing students’ professional development from a novel perspective.METHODS1. A model of Master’s nursing students’CDMSE was tested using the structural equation modeling based on literature review and related theories.2. A descriptive cross-sectional study was conducted in the whole China with fulltime Master’s nursing students between October2011and January2012. A total number of565Masters’nursing students were recruited from19colleges or universities in Northeast China, North China, Northwest China, East China, South Central China, Southwest China using a multistage cluster stratified random sampling method. Data collecting instruments included social-demographic questionnaire designed by researcher, CDMSE Scale, Professional Commitment Questionnaire (PCQ) Internal-External Locus of Control Scale (I-E LOCS), Perceived Social Support Scale (PSSS) and Trait Anxiety Inventory (TAI). Software epidate was used for data input. SPSS13.0and Amos7.0was used for data analysis. Descriptive analysis, t-test, analysis of variance/co-variance, Chi-square test, Kruskal-Wallis H test, Pearson correlation analysis, Confirmatory Factor Analysis, Multiple Linear Regression analysis and Structural Equation Modeling were performed to analyze data.3. A phenomenological research approach was used focusing on examining experiences of career choice and value, belief, attitude and psychological changes of career decision-making. Using convenience sampling and purpose sampling18subjects (2male,16female) from previous quantitative research were involved in this qualitative research. Data were collected through semi-structural interview and observation. Guided by Colazzi’s methodology, data consolidation and analysis was performed using NVIvo8.0.RESULTS1. Of the possible565respondents,545actually responded with the final response rate reaching94.6%.2. The Cronbach’a coefficients for CDMSE, PCQ, I-E LOCS, PSSS and TAI were0.963,0.917,0.758,0.911and0.897respectively.3. Multiple linear regression analysis results showed that CDMSE was predicated by grade, area, degree type, supervisor’s help, trait anxiety, profession commitment, social support and internal and external locus of control.4. According to structural equation modeling, main pathways were as follows:social support to profession commitment (path coefficient=0.223), internal locus of control to social support (path coefficient=0.473), external locus of control to social support (path coefficient=-0.123), social support to trait anxiety (path coefficient=-0.663), internal locus of control to trait anxiety (path coefficient=-0.076), profession commitment to CDMSE (path coefficient=0.698), profession commitment to trait anxiety (path coefficient=0.428), profession commitment to CDMSE (path coefficient=0.261), trait anxiety to CDMSE(path coefficient=0.569), internal locus of control to CDMSE (path coefficient=0.431). The effectiveness of trait anxiety to CDMSE was the biggest one with total effect value-0.569which was completely direct; Effects of external locus of control and social support on CDMSE were completely indirect with effect value-0.441and0.418respectively; Effects of internal locus of control and profession commitment on CDMSE were0.412(direct effect=0.341and indirect effect=0.071) and0.505(direct effect=0.261and indirect effect=0.224), respectively.5. Results of interview data analysis presented that career choice value varied with different subjects and was influenced by personal family background, social life experience and education background and so forth. Theme clusters emerged as the following:career motivation, profession perception, career perception, career expectation, challenge and disadvantages of career choice, obtained support and further need in the career choice process.CONCLUSIONS1. Good reliability and validity are demonstrated in terms of the measure instruments used in this study including CDMSE, PCQ, I-E LOCS, PSSS and TAI. Those instruments can be used in graduate students.2. The levels of CDMSE in Master’s nursing students are mostly moderate but it varies from one subject to another with great variation in subject population. There are many factors influencing CDMSE including area, supervisor’s help, career guidance, perceived social support, trait anxiety, profession commitment and internal and external locus of control etc.3. The goodness-of-fit index indicates that that structural equation model of CDMSE fits very well and it can be beneficial to nursing education, nursing management and related fields in terms of maximizing CDMSE with many interventions including raising the level of profession commitment, providing social support, conducting internal attribution and focusing on anxiety etc.4. Master’s nursing students have strong career choice motivations and their career choices are diverse and complex and suggest reasonable match to the realistic society. This research results can enlighten nursing educators and nursing leaders on the concern about negative perceptions of Master’s nursing students in career choice value in case that it would be potential risks to nursing talent retention.更多还原