Pan S, Dunkin J, Muus K J, Harris R, Geller J M
Rural Health Research Center, University of North Dakota, Grand Forks 58202, USA.
J Rural Health. 1995 Spring;11(2):106-13. doi: 10.1111/j.1748-0361.1995.tb00403.x.
This study examined the net effects of individual and community factors on the likelihood of registered nurses leaving current jobs using a logit analysis. Based on data from a survey of 2,509 rural nurses, four separate models were estimated and compared: one for nurses in rural settings as a whole and the other three for nurses in hospitals, skilled nursing facilities, and community/public health agencies. Results of the general model indicated that nurses' marital status, age, position, income, job satisfaction, and satisfaction with the community were significant determinants of the likelihood of leaving current jobs. Job satisfaction was the most significant factor, followed by satisfaction with the community. Findings from the models for three different employment settings were similar to those of the general model. However, the significance of factors and their strength of effect on nurses' decisions to leave or stay in their current jobs differed across the three types of facilities. Based on these findings rural nursing administrators and policy-makers should give priority to retention strategies that focus on improving the job environment. The development of different strategies for different groups of nurses (i.e., by age or marital status) and different types of facilities should increase the benefit/cost ratio. In addition, programs that involve rural health care agencies in community and economic development should be further explored as an avenue to increased nurse retention in rural areas.
本研究采用逻辑回归分析，考察了个体因素和社区因素对注册护士离职可能性的综合影响。基于对2509名乡村护士的调查数据，我们估计并比较了四个不同的模型：一个是针对全体乡村护士的模型，另外三个分别针对医院、专业护理机构以及社区/公共卫生机构的护士。总体模型的结果表明，护士的婚姻状况、年龄、职位、收入、工作满意度以及对社区的满意度是离职可能性的重要决定因素。工作满意度是最显著的因素，其次是对社区的满意度。三种不同就业环境模型的结果与总体模型相似。然而，这些因素的显著性及其对护士离职或留任决定的影响强度在三种机构类型中有所不同。基于这些发现，乡村护理管理人员和政策制定者应优先考虑以改善工作环境为重点的留用策略。针对不同护士群体（如按年龄或婚姻状况划分）和不同类型机构制定不同策略，应能提高效益成本比。此外，应进一步探索让乡村医疗保健机构参与社区和经济发展的项目，以此作为提高乡村地区护士留用率的途径。
