Jasseron C, Estryn-Behar M, Le Nezet O, Rahhali I
Unité PRESST-NEXT, Coordination Centrale du Service de Santé au Travail de l'AP-HP, Hôtel Dieu, Paris IV(eme) arrt.
Rech Soins Infirm. 2006 Jun(85):46-64.
The organization of French medical institutions is changing, and the nursing personnel can encounter difficulties of adaption to these changes. The results of 2 questionnaires of the PRESST/NEXT study relative to working conditions (respectively, the questionnaires "Q0" and "Q12"), sent in a year interval to a sample of nurses were compared.
Three samples were made up: a sample of 5376 nurses having answered the initial questionnaire (Q0); a sample of 2627 nurses having answered the questionnaire sent one year after (Q12), and working in the same establishment; a group of 208 nurses having answered the questionnaire "Qex", specific to nurses who left their establishment.
Among nurses who answered the "Qex", approximately 1/5 of nurses chose to leave the profession definitively or temporarily before the retirement age; of these, almost 13% began a new work not in the healthcare sector. Seven factors are significantly related to the intention of leaving the profession: Dissatisfaction regarding professional prospects (Q0: OR = 3.1 and Q12: OR = 2.82); Difficulties assuming the family responsabilities (Q0: OR = 1.36 and Q12: OR = 2.10); Mental health disorders for nurses not followed medically (Q0: OR = 1.76 and Q12: OR = 1.47), and for nurses receiving care for this (Q0 : OR = 1.90 and Q12: OR = 1.77); Dissatisfaction concerning the psychological support available at work (Q0: OR = 1.57 and Q12: OR = 1.87); Tiredness (Q0 : OR = 1.40 and Q12: OR = 1.6); Musculo-skeletal disorders diagnosed by doctor (Q0: OR = 1.32 and Q12: OR = 1.61); Dissatisfaction concerning the use of competences (Q0: OR = 1.27 and Q12: OR = 1.97).
These results raise questions as to the benefits of new management which promotes flexibility in work and schedules, and which reduces the possibilities of support within the nursing teams. This type of management implies uncertainty for nurses as far as the technical aspects of their work are concerned, and a lack of time for the education and follow-up of patients.
法国医疗机构的组织架构正在发生变化，护理人员可能会面临适应这些变化的困难。对间隔一年发送给一组护士样本的PRESST/NEXT研究中两份关于工作条件的调查问卷（分别为“Q0”和“Q12”）的结果进行了比较。
组成了三个样本：一个由5376名回答了初始问卷（Q0）的护士组成的样本；一个由2627名回答了一年后发送的问卷（Q12）且在同一机构工作的护士组成的样本；一组由208名回答了针对离开所在机构的护士的“Qex”问卷的护士组成。
在回答“Qex”问卷的护士中，约五分之一的护士选择在退休年龄前永久或暂时离开该职业；其中，近13%开始从事非医疗保健行业的新工作。七个因素与离开该职业的意愿显著相关：对职业前景的不满（Q0：比值比=3.1，Q12：比值比=2.82）；承担家庭责任困难（Q0：比值比=1.36，Q12：比值比=2.10）；未接受医学随访的护士的心理健康障碍（Q0：比值比=1.76，Q12：比值比=1.47），以及接受此方面护理的护士（Q0：比值比=1.90，Q12：比值比=1.77）；对工作中可得心理支持的不满（Q0：比值比=1.57，Q12：比值比=1.87）；疲劳（Q0：比值比=1.40，Q12：比值比=1.6）；医生诊断的肌肉骨骼疾病（Q0：比值比=1.32，Q12：比值比=1.61）；对能力运用的不满（Q0：比值比=1.27，Q12：比值比=1.97）。
这些结果对促进工作和排班灵活性、减少护理团队内部支持可能性的新管理方式的益处提出了质疑。这种管理方式意味着就护士工作的技术方面而言存在不确定性，并且缺乏对患者进行教育和随访的时间。
