Ogata Yasuko, Nagano Midori, Fukuda Takashi, Hashimoto Michio
Graduate School of Nursing, Chiba University.
Nihon Koshu Eisei Zasshi. 2011 Jun;58(6):409-19.
The purpose of this study was to examine how the nursing practice environment affects job retention and the turnover rate among hospital nurses. The Practice Environment Scale of the Nursing Work Index (PES-NWI) was applied to investigate the nurse working environment from the viewpoint of hospital nurses in Japan. Methods A postal mail survey was conducted using the PES-NWI questionnaire targeting 2,211 nurses who were working at 91 wards in 5 hospitals situated in the Tokyo metropolitan area from February to March in 2008. In the questionnaire, hospital nurses were asked about characteristics such as sex, age and work experience as a nurse, whether they would work at the same hospital in the next year, the 31 items of the PES-NWI and job satisfaction. Nurse managers were asked to provide staff numbers to calculate the turnover rate of each ward. Logistic regression analyses were carried out, with "intention to retain or leave the workplace next year" as the dependent variable, with composite and 5 sub-scale scores of the PES-NWI and nurse characteristics as independent variables. Correlation coefficients were calculated to investigate the relationship between nurse turnover rates and nursing practice environments.
A total of 1,067 full-time nurses (48.3%) from 5 hospitals responded. Almost all of them were men (95.9%), with an average age of 29.2 years old. They had an average of 7.0 years total work experience in hospitals and 5.8 years of experience at their current hospital. Cronbach's alpha coefficients were 0.75 for composite of the PES-NWI, and 0.77-0.85 for the sub-scales. All correlation coefficients between PES-NWI and job satisfaction were significant (P < 0.01). In the logistic regression analysis, a composite of PES-NWI, "Nurse Manager's Ability, Leadership, and Support of Nurses" and "Staffing and Resource Adequacy" among the 5 sub-scales correlated with the intention of nurses to stay on (P < 0.05). The means for turnover rate were 10.4% for nurses and 17.6% for newly hired nurses. These rates were significantly correlated to the composite and some sub-scales of the PES-NWI.
The working environment for nurses is important in retaining nurses working at hospitals. We confirmed the reliability and the validity of the PES-NWI scale based on the magnitude of the Cronbach's alpha coefficient and correlation coefficient between the PES-NWI scale and job satisfaction in this study.
本研究旨在探讨护理实践环境如何影响医院护士的工作保留率和离职率。应用护理工作指数实践环境量表（PES-NWI）从日本医院护士的角度调查护士工作环境。方法 使用PES-NWI问卷进行邮政邮件调查，目标是2008年2月至3月在东京都市区5家医院的91个病房工作的2211名护士。在问卷中，询问医院护士的性别、年龄和护士工作经验等特征，他们是否会在明年在同一家医院工作，PES-NWI的31个项目以及工作满意度。要求护士长提供员工人数以计算每个病房的离职率。进行逻辑回归分析，以“明年留在或离开工作场所的意向”作为因变量，以PES-NWI的综合和5个分量表得分以及护士特征作为自变量。计算相关系数以调查护士离职率与护理实践环境之间的关系。
5家医院共有1067名全职护士（48.3%）做出回应。几乎所有都是男性（95.9%），平均年龄29.2岁。他们在医院的总工作经验平均为7.0年，在当前医院的工作经验平均为5.8年。PES-NWI综合量表的Cronbach's alpha系数为0.75，各分量表的系数为0.77 - 0.85。PES-NWI与工作满意度之间的所有相关系数均具有统计学意义（P < 0.01）。在逻辑回归分析中，PES-NWI综合量表、5个分量表中的“护士长对护士的能力、领导和支持”以及“人员配备和资源充足性”与护士留任意向相关（P < 0.05）。护士的离职率平均为10.4%，新入职护士为17.6%。这些比率与PES-NWI的综合量表和一些分量表显著相关。
护士的工作环境对于留住医院护士很重要。在本研究中，我们根据Cronbach's alpha系数的大小以及PES-NWI量表与工作满意度之间的相关系数，证实了PES-NWI量表的信度和效度。
