Sichuan University.
Huazhong University of Science and Technology.
Workplace Health Saf. 2020 Jul;68(7):325-336. doi: 10.1177/2165079919900796. Epub 2020 Jan 26.
Most of the previous studies on nursing practice environment and job burnout employed conventional analyses ignoring the impact of unit-level data clusters. This study addressed this gap by examining the effects of the nursing practice environments on dimensions of occupational burnout among a sample of Chinese nurses using multilevel logistic regression models and demonstrating the superiority of employing multilevel models over conventional models within this context. A proportionate stratified sampling method was applied in this cross-sectional study that invited 1,300 registered nurses (RNs) from nine clinical units of a large, academic hospital in urban China to complete the questionnaire. Nurse-reported information was obtained using the Practice Environment Scale of the Nursing Work Index (PES-NWI) and the Maslach Burnout Inventory (MBI). A total of 1,178 valid questionnaires were returned for a response rate of 90.62%. RNs generally perceived their nursing practice environment as favorable as measured by the PES-NWI. Approximately 40% of the respondents reported experiencing emotional exhaustion and depersonalization. The multivariate models indicated that nurse burnout was significantly associated with nurse participation in hospital affairs, nursing foundations for quality of care, and adequate staffing. In addition, our results illustrated the advantage of multilevel modeling over the conventional modeling for handling hierarchical data in terms of the accuracy of the estimates and the goodness-of-fit of the model. These findings underscore the importance of measures aimed at enhancing nursing practice environments to prevent RNs from experiencing feelings of burnout and of considering multilevel analysis in future nursing research.
大多数关于护理实践环境和职业倦怠的先前研究采用了传统的分析方法，忽略了单位层面数据聚类的影响。本研究通过使用多层次逻辑回归模型，考察了护理实践环境对中国护士职业倦怠各维度的影响，填补了这一空白，并证明了在这种情况下，使用多层次模型优于传统模型的优越性。本横断面研究采用了比例分层抽样方法，邀请了中国某城市一所大型学术医院的九个临床科室的 1300 名注册护士（RN）完成问卷。使用护理工作指数（NWI）实践环境量表（PES-NWI）和马斯拉赫倦怠量表（MBI）获得护士报告的信息。共收回 1178 份有效问卷，应答率为 90.62%。RN 普遍认为他们的护理实践环境有利，这是由 PES-NWI 衡量的。大约 40%的受访者报告经历了情绪疲惫和人格解体。多变量模型表明，护士倦怠与护士参与医院事务、护理对护理质量的基础以及充足的人员配备显著相关。此外，我们的结果说明了在处理分层数据时，多层次建模比传统建模在估计准确性和模型拟合优度方面具有优势。这些发现强调了旨在加强护理实践环境的措施的重要性，以防止 RN 感到倦怠，并在未来的护理研究中考虑多层次分析。
