【作者】 王幼芳；

【导师】 刘晓丹；

【作者基本信息】 吉林大学 ， 护理学， 2010， 硕士

【摘要】 近年来,随着医院规模的扩大和人事制度改革的不断深入,我国医院的合同制护士比例呈逐年上升趋势,她们已成为护理队伍的重要补充力量。但在实际工作生活中,与合同制护士相对应的完善的管理体系尚未形成,她们在工作、薪酬、职业发展、人际、管理制度等方面面临着许多问题,造成了合同制护士的流动性和不稳定性。这样既不利于我国护理专业的发展、护理人才的培养及医院护理工作的持续开展,更直接影响着医院护理服务质量和正规化建设水平。?基于以上的研究背景,本论文通过使用离职倾向量表、工作满意度量表和组织承诺量表对长春市四所三级甲等医院的合同制护士进行问卷调查,以此了解长春市三级甲等医院合同制护士的离职倾向现况,分析影响合同制护士离职倾向的相关因素,探讨合同制护士流失的主、客观原因,寻找有效对策,提高护理管理质量,稳定护理队伍。研究结果显示长春市三级甲等医院合同制护士的离职倾向处于中等水平;合同制护士的工作满意度、组织承诺与离职倾向呈显著负相关;在个人特征变量中,婚姻状况对离开护理职业倾向影响的最大;工作满意度中,工作本身对总体离职倾向及离开护理职业倾向的影响最大;组织承诺中,经济承诺对总体离职倾向、离开单位倾向及离开护理职业倾向的影响最大。?更多还原

【Abstract】 Nowadays, the widespread nursing shortage has become a global issue. With the development of society and the increase of people’s demand for medical services, the shortage of nurses is increasingly prominent. The high turnover of nursing staff is one of the factors of the nursing shortage. The shortage and the loss of nurses of contract nurses in our country is very urgent. Some studies show that the turnover intention is a sensitive variable to predict turnover behavior and turnover intention is affected by several factors. The objective of this study is to analysis the related factors on turnover intention of contract nurses, explore the reasons for termination of contract nurses and trying to find the effective interventions through investigating the turnover intention level of the contract nurses of class A tertiary general hospitals in Changchun. It can stabilize the nursing profession, reduce the economic losses of contract nurses’turnover, promote healthy and growth of contract nurses and thus to improve the quality of nursing care to meet the growing health needs of the people. Methods: 424 from1 year to 20 years contract nurses of class A tertiary general hospitals?sampled from four different hospitals in Changchun were investigated by a stratified random sampling method through turnover intention scale, job satisfaction scale and Chinese organizational commitment scale. The entire figure was in put into computer. Descriptive statistics, ANOVA, SNK test, Pearson correlation analysis and multiple linear stepwise regression analysis were performed by SPSS13.0 statistic software.Results:1. The demographic characteristics of contract nurses 424 contract nurses surveyed come from 4 different class A tertiary general hospitals in Changchun city. Most of them are under the age of 25, that is 213 cases, accounting for 50.2%. Unmarried persons are higher than married persons, that is260 cases, accounting for 61.3%. Associate degree is prominent in the educational background of nurses, there are 290, accounting for 68.4%.?From the aspect of the length of service, the number of nurses working for from more than 1 to less than 10 years is 377 nurses, accounting for 88.9%. In professional title structure, nurse assistant and primary nurse take up a large proportion, that is 69.3% and 25.9%. Among the contract nurses, there are136 nurses in surgical, accounting for 32.1%; Internal Medicine has 115 nurses, accounting for 27.1%; Obstetrics and Gynecology has 53 nurses, accounting for 12.5%; Pediatrics has 26 nurses, accounting for 6.1%; Clinic has 29 nurses, accounting for 6.8%; Emergency has 27 nurses, accounting for 6.4%; ICU has 14 nurses, accounting for 3.3%; there are 24 nurses in the operating room, which accounted for 5.7%.2. Turnover intention scores of contract nurses424 contract nurses surveyed overall turnover intention score is 5.07, the value of index is 50.70%. The score of tendency to leave the unit is 2.62, the value of index is 52.40%; The score of tendency to leave the nursing profession unit is 2.46, the value of index is 49.20%.3. Job satisfaction scores of contract nursesThe general score of job satisfaction of 424 contract nurses is 27.48, the value of index is target value of 68.70%. The scores?of every dimension are: management is 3.42, the value of index is 68.40%;workload is 3.57, the value of index is71.40% that is the most satisfied dimension; relationship with colleagues is 3.45, the value of index is 69.00%;the work itself is 3.53, the value of index is 70.60%;wages and benefits is 3.34, the value of index is66.80%; personal growth and development is 3.33, the value of index is 66.60% that is the most dissatisfied dimension; work approved is 3.38, the value of index is 67.60%; family and work balance is 3.46, the value of index is 69.20%.4. Organizational commitment scores of contract nurses The general score of organizational commitment of 424 contract nurses is 16.47, index value is 65.88%. The highest score among five dimensions is normative commitment, that is 3.74, index value is 74.80%; the lowest score is opportunity commitment, that is2.76, index value is 55.20 %. Other scores are ideal commitment 3.50, index value is70.00%; emotional commitment 3.49, index value is 69.80%; economic commitment 2.97, index value is 59.40%.5. Contract nurses’influential factors of turnover intention(1)Demographic characteristic variables and turnover intention The single factor analysis of variance and SNK test show that the scores of overall turnover intention, tendency to leave the unit and tendency to leave the nursing profession of under the age of 25 are higher than the other two groups. The scores of overall turnover intention and tendency to leave the nursing profession of single contract nurses are higher than married nurses. The scores of overall turnover intention, tendency to leave the unit of 1 to 5 years working time group are higher than other groups. The turnover intention of contract nurses from different sections?are significant statistically (P <0.01).Among them, the scores of overall turnover intention, tendency to leave the unit and tendency to leave the nursing profession of the operating room contract nurses are lower than other groups. The Pearson correlation analysis shows that age, working hours, professional title are significantly negative correlated to overall turnover intention, tendency to leave the unit and tendency to leave the nursing profession (P <0.01). Marital status is significantly negative correlated to overall turnover intention and tendency to leave the nursing profession ( P<0.01). The multiple linear stepwise regression analysis shows that marital status is the significant variable affect tendency to leave the nursing profession (P = 0.032).(2) Job satisfaction and turnover intention The Pearson correlation analysis shows that the total job satisfaction and each dimension are significantly negative correlated to overall turnover intention, tendency to leave the unit and tendency to leave the nursing profession (P <0.01). The multiple linear stepwise regression analysis shows that overall job satisfaction, work itself and the personal growth and development are affect the overall turnover intention; Work itself is affect tendency to leave the unit (P = 0.043); Overall job satisfaction, and employee relations, work itself, personal growth and development and work approved are affect tendency to leave the nursing profession ,of which the work itself is the significant variable affect overall turnover and the tendency to leave the nursing profession.(3) Organizational commitment and turnover intentionThe Pearson correlation analysis shows that the total organizational commitment and each dimension are significantly negative correlated to overall turnover intention, tendency to leave the unit and tendency to leave the nursing profession (P <0.01). The multiple linear stepwise regression analysis shows that except emotional commitment not to enter the equation, the overall organizational commitment, normative commitment, ideal commitment, economic commitment and opportunity commitment are affect overall turnover intention and the tendency to leave nursing profession; the overall organizational commitment, normative commitment, economic commitment and opportunity commitment are affect the tendency to leave the unit ;Economic commitment is the significant variable affect the overall turnover intention, tendency to leave the unit and tendency to leave the nursing profession.Conclusion:1. The turnover intention score of the contract nurses are in the medium level.2. The demographic characteristic variables of contract nurses are affect turnover intention. Among them, the influence factors of overall turnover intention and tendency to leave the nursing profession are age, marital status, working hours and professional title; the influence factors of tendency to leave the unit are age, working hours and professional title; Marital status is the significant variable affect the tendency to leave the nursing profession.3. The job satisfaction of contract nurses are significantly negative correlated to the turnover intention, job satisfaction is one of the significant predictors of turnover intention. Among them, the influence factors of the overall turnover intention are the total job satisfaction, work itself and the personal growth and development; the influence factor of the tendency to leave the unit is the work itself; the influence ?factors of the tendency to leave the nursing profession are the total job satisfaction, employee relations, work itself, personal growth and development and work to be recognized. The work itself is the significant variable affect the overall turnover intention and the tendency to leave the nursing profession.4. The organizational commitment of contract nurses are significantly negative correlated to the turnover intention, organizational commitment is one of the significant predictors of turnover intention. Among them, the influence factors of the overall turnover intention and the tendency to leave the nursing profession are the overall organizational commitment, normative commitment, ideal commitment, economic commitment and opportunity commitment; the influence factors of the tendency to leave the unit are the overall organizational commitment, normative commitment, economic commitment and opportunity commitment. Economic commitment is the significant variable affect the overall turnover intention, tendency to leave the unit and tendency to leave the nursing profession.更多还原