Lyons Kevin J, Lapin Jennifer, Young Barbara
Center for Collaborative Research, Thomas Jefferson University, College of Health Professions, Philadelphia, Pennsylvania 19107, USA.
J Allied Health. 2003 Spring;32(1):10-7.
There have been numerous changes in the health care system, including cost-containment efforts, the increased growth of managed care, and shortages of many health professionals. It is important to assess the impact these changes are having on the quality of health care delivery and the way various health professionals view their jobs. To accomplish this assessment, a sample of experienced nursing and allied health professionals were asked to provide their assessment of positive and negative changes in the health system over a 5-year period. They also were asked to indicate their level of satisfaction with their profession, their current job, and various aspects of that job. A Health Care Environment Survey was mailed to six groups of graduates of a mid-Atlantic college of health professions. Three of the groups had been in practice for 5 years, and three of the groups had been in practice for 10 years. The survey asked respondents to assess the magnitude of certain changes in the health system over the previous 5 years and to provide an assessment of their satisfaction with their current job. A total of 1,610 surveys were mailed, and 787 were returned for a rate of 49%. Nursing and allied health professionals who responded to the survey reported that there have been many more negative than positive changes in the health care system, including less job security, efficiency, and time available to spend with individual patients and increases in workload, paperwork, and control of health care by insurance companies. Even with these negative changes, nurses and allied health professionals report a high level of satisfaction with their jobs. In investigating the aspects of their jobs that were most related to satisfaction, having a feeling of worthwhile accomplishment from their job, opportunities for personal and professional growth, recognition and satisfaction with their workload were found to be the best predictors of job satisfaction.
医疗保健系统发生了诸多变化,包括成本控制措施、管理式医疗的增长以及许多医疗专业人员的短缺。评估这些变化对医疗保健服务质量以及各类医疗专业人员对其工作的看法所产生的影响非常重要。为了完成这项评估,我们抽取了一批经验丰富的护士和专职医疗人员样本,要求他们对医疗系统在5年期间的积极和消极变化进行评估。他们还被要求表明对自己职业、当前工作以及该工作各个方面的满意度。一份《医疗保健环境调查问卷》被邮寄给一所大西洋中部健康职业学院的六组毕业生。其中三组已经从业5年,另外三组已经从业10年。该调查问卷要求受访者评估过去5年医疗系统中某些变化的程度,并对他们当前工作的满意度进行评估。总共邮寄了1610份调查问卷,回收了787份,回收率为49%。对调查问卷做出回应的护士和专职医疗人员报告称,医疗保健系统中的消极变化比积极变化多得多,包括工作安全感降低、效率下降、与个体患者相处的时间减少,以及工作量、文书工作和保险公司对医疗保健的控制增加。即便存在这些消极变化,护士和专职医疗人员对他们的工作仍报告了较高的满意度。在调查与满意度最相关的工作方面时,从工作中获得有价值的成就感、个人和职业成长的机会、认可以及对工作量的满意度被发现是工作满意度的最佳预测指标。