Estryn-Béhar Madeleine, Van der Heijden Beatrice I J M, Ogińska Halszka, Camerino Donatella, Le Nézet Olivier, Conway Paul Maurice, Fry Clementine, Hasselhorn Hans-Martin
Department of Occupational Health Hôtel Dieu, Assistance-Publique-Hôpitaux de Paris, Paris, France.
Med Care. 2007 Oct;45(10):939-50. doi: 10.1097/MLR.0b013e31806728d8.
Europe's nursing shortage calls for more effective ways to recruit and retain nurses. This contribution aims to clarify whether and how social work environment, teamwork characteristics, burnout, and personal factors are associated with nurses' intent to leave (ITL).
Our sample comprises 28,561 hospital-based nurses from 10 European countries. Different occupational levels have been taken into account: qualified registered nurses (n = 18,594), specialized nurses (n = 3957), head nurses (n = 3256), and nursing aides and ancillary staff (n = 2754).
Our outcomes indicate that ITL is quite prevalent across Europe, although we have found some differences across the countries depending on working conditions and economic situation. Quality of teamwork, interpersonal relationships, career development possibilities, uncertainty regarding treatment, and influence at work are associated with nurses' decision to leave the profession across Europe, notwithstanding some country-specific outcomes. A serious lack of quality of teamwork seems to be associated with a 5-fold risk of ITL in 7 countries. As far as personal factors are concerned, our data support the hypothesized importance of work-family conflicts, satisfaction with pay, and burnout. A high burnout score seems to be associated with 3 times the risk of ITL in 5 countries.
To prevent premature leaving, it is important to expand nurses' expertise, to improve working processes through collaboration and multidisciplinary teamwork, and to develop team training approaches and ward design facilitating teamwork.
欧洲护理人员短缺，需要更有效的方法来招募和留住护士。本研究旨在阐明社会工作环境、团队合作特征、职业倦怠和个人因素是否以及如何与护士的离职意愿相关。
我们的样本包括来自10个欧洲国家的28561名医院护士。考虑了不同的职业水平：注册护士（n = 18594）、专科护士（n = 3957）、护士长（n = 3256）以及护理助理和辅助人员（n = 2754）。
我们的结果表明，离职意愿在欧洲相当普遍，尽管我们发现各国之间因工作条件和经济状况存在一些差异。团队合作质量、人际关系、职业发展可能性、治疗不确定性以及工作中的影响力与欧洲各国护士离职的决定相关，尽管存在一些特定国家的结果。在7个国家，严重缺乏团队合作质量似乎与离职意愿风险增加5倍相关。就个人因素而言，我们的数据支持工作与家庭冲突、薪酬满意度和职业倦怠假设的重要性。在5个国家，高职业倦怠得分似乎与离职意愿风险增加3倍相关。
为防止过早离职，扩大护士专业知识、通过协作和多学科团队合作改善工作流程以及开发促进团队合作的团队培训方法和病房设计非常重要。
