与养老院护士长离职意愿相关的个体因素。

Individual factors associated with intentions to leave among directors of nursing in nursing homes.

机构信息

Department of Health Policy and Management, School of Rural Public Health, Texas A&M Health Science Center, College Station, USA.

出版信息

Health Care Manage Rev. 2010 Jul-Sep;35(3):246-55. doi: 10.1097/HMR.0b013e3181dc826d.

DOI:10.1097/HMR.0b013e3181dc826d

PMID:20551772

Abstract

BACKGROUND

Although the importance of nurse leadership stability and participation in decision making in nursing homes is well established, scarce literature exists on determinants of intent to leave among directors of nursing (DONs) in nursing homes.

PURPOSE

: The purpose of this study was to examine factors associated with DON intent to leave in nursing homes.

METHODOLOGY

We examined potential factors associated with DON intent to leave at three levels: individual DON characteristics, facility, and county-level market factors. A survey of nurse supervisors in Texas nursing homes, the 2003 Texas Nursing Facility Medicaid Cost Report, and the Area Resource File were merged. We only included respondents who identified themselves as DONs in this study (572 observations). We examined bivariate differences in individual DON characteristics on the basis of facility ownership (for-profit versus not-for-profit homes) and geographic location (urban versus rural location). We constructed three alternative logit models to explore the relationships between DON intent to leave and DON, facility, and market characteristics.

FINDINGS

DONs working in for-profit homes were more inclined to leave, less satisfied with their job, and had lower levels of perceived empowerment in terms of autonomy. Educational level and intention to leave were significantly higher for DONs working in urban areas. Job satisfaction was significantly and inversely associated with intent to leave in all three models. Higher perceived salary competitiveness and level of empowerment were associated with reduced odds of intending to leave. Higher educational levels were associated with higher odds of intentions to leave.

PRACTICE IMPLICATIONS

Nursing homes should focus on improving DON job satisfaction, empowerment in decision making, and salary competitiveness when designing retention strategies for DONs.

摘要

背景

尽管护士领导的稳定性和参与养老院决策的重要性已得到充分证实，但关于养老院注册护士（DON）离职意愿的决定因素的文献却很少。

目的

本研究旨在探讨与养老院 DON 离职意愿相关的因素。

方法

我们研究了与 DON 离职意愿相关的潜在因素，这些因素分为三个层次：个人 DON 特征、机构和县级市场因素。我们合并了德克萨斯州养老院的护士主管调查、2003 年德克萨斯州养老院医疗补助费用报告和区域资源文件。我们仅将自称为 DON 的受访者纳入本研究（572 个观测值）。我们根据机构所有权（营利性与非营利性机构）和地理位置（城市与农村），对个人 DON 特征进行了简单的差异分析。我们构建了三个替代逻辑模型，以探讨 DON 离职意愿与 DON、机构和市场特征之间的关系。