Dublin City University Business School, Dublin, Ireland.
J Health Organ Manag. 2013;27(3):330-49. doi: 10.1108/JHOM-10-2012-0192.
Against a backdrop of increased work intensification within maternity hospitals, the purpose of this paper is to examine the role of work engagement in the quality of care delivered to patients and in general health of the midwives delivering care, as reported by midwives and nurses.
DESIGN/METHODOLOGY/APPROACH: Quantitative questionnaires consisting of standardised measures were distributed to midwives in two large maternity hospitals. These questionnaires assessed levels of work engagement, supervisor and colleague support, general health and quality of care.
Structural equation modelling analysis revealed a best-fit model that demonstrated work engagement to be a significant partial mediator between organisational and supervisor support and quality of care, and as a significant predictor of self-reported general health. Together, supervisor support, social support and organisational resources, mediated by work engagement, explained 38 per cent of the variance in quality of care at the unit level and 23 per cent of variance in general health among midwives (chi2(67) = 113; p < 0.01, CFI = 0.961, RMSEA = 0.06).
RESEARCH LIMITATIONS/IMPLICATIONS: The study is limited in that it uses self-report measures of quality of care and lacks objective indicators of patient outcomes. The cross-sectional design also does not allow for causal inferences to be drawn from the data.
This study provides evidence for the links between individual levels of work engagement and both health and self-reports of unit level quality of care. The results support the importance of health services organisations and managers deploying organisational resources to foster employee work engagement. The results also highlight the significant role of the immediate nurse manager and suggest training and development for such roles is a valuable investment.
ORIGINALITY/VALUE: These results are the first to link work engagement and performance in health care contexts and point to the value of work engagement for both unit performance and for individual employee well-being in health organisations.
在产科医院工作强度不断加大的背景下，本文旨在考察工作投入在护士报告的患者护理质量和护理人员一般健康状况中的作用。
设计/方法/途径：向两家大型产科医院的护士发放了包含标准化测量的定量问卷。这些问卷评估了工作投入、主管和同事支持、一般健康状况和护理质量的水平。
结构方程模型分析显示，一个最佳拟合模型表明，工作投入在组织和主管支持与护理质量之间是一个重要的部分中介，也是自我报告一般健康状况的一个重要预测因素。主管支持、社会支持和组织资源通过工作投入共同解释了单位层面护理质量 38%的方差和护士一般健康状况 23%的方差（卡方(67) = 113；p < 0.01，CFI = 0.961，RMSEA = 0.06）。
研究局限性/影响：该研究的局限性在于它使用了护理质量的自我报告测量方法，缺乏患者结果的客观指标。横断面设计也不允许根据数据得出因果推论。
本研究为个体工作投入水平与健康和自我报告的单位护理质量之间的联系提供了证据。研究结果支持卫生服务组织和管理人员部署组织资源以促进员工工作投入的重要性。研究结果还强调了直接护士长的重要作用，并表明对这些角色进行培训和发展是一项有价值的投资。
原创性/价值：这些结果首次将工作投入和绩效联系起来，并指出工作投入对单位绩效和卫生组织中个体员工福祉的重要性。
