护理实践环境和护士工作结果：基于调查数据的路径分析。
The nursing practice environment and nurse job outcomes: A path analysis of survey data.
机构信息
College of Nursing, King Saud bin Abdulaziz University for Health Sciences, Al Ahsa, Saudi Arabia.
Department of Bio-behavioral Health Sciences, Center for Health Outcomes & Policy Research, University of Pennsylvania School of Nursing, Philadelphia, PA, USA.
出版信息
J Clin Nurs. 2020 Jul;29(13-14):2602-2614. doi: 10.1111/jocn.15283. Epub 2020 Apr 23.
AIMS AND OBJECTIVES
To assess the nursing practice environments and nurse job-related outcomes in two types of hospitals in Saudi Arabia.
BACKGROUND
The nursing shortage is a challenging problem in Saudi hospitals. Studies have shown that poor practice environments and high patient-to-nurse ratios are associated with poor nurse job outcomes (i.e. job dissatisfaction, burnout and intention to leave) and that can lead to nurse turnover and compound the nursing shortage. However, little research has been conducted on this topic in Saudi Arabia.
DESIGN
A cross-sectional design. A model that links the nursing practice environment and patient-to-nurse ratio to nurse job outcomes was tested through a path analysis of survey data.
METHODS
A sample of 404 nurses from public and military hospitals in Saudi Arabia completed a survey that included the Practice Environment Scale of the Nursing Work Index, the Maslach Burnout Inventory and questions related to job dissatisfaction and intention to leave the job. A model of nurse turnover was used to test the relationships among study variables. This study was carried out in accordance with the STROBE checklist for cross-sectional studies.
RESULTS
The nursing practice environment and nurse job outcomes were better in military hospital compared with public hospital. Overall, 53% of participants had high burnout, 39% were dissatisfied, and 26% intended to leave their jobs. The path analysis showed that the nursing practice environment and patient-to-nurse ratio were predictors of burnout and job dissatisfaction, which in turn lead to intention to leave. The tested model had good fit and explained the direct and indirect effects of study variables.
CONCLUSION
Poor nursing practice environments and high patient-to-nurse ratios contribute to poor nurse job outcomes in Saudi hospitals.
RELEVANCE TO CLINICAL PRACTICE
Nurse leaders can focus on enhancing practice environments and reducing patient-to-nurse ratios as retention strategies to improve nurse job outcomes.
目的
评估沙特阿拉伯两种类型医院的护理实践环境和护士工作相关结果。
背景
护理短缺是沙特医院面临的一个具有挑战性的问题。研究表明，较差的实践环境和较高的护士与患者比例与较差的护士工作结果（即工作不满、倦怠和离职意向）有关，这可能导致护士离职，加剧护理短缺。然而，在沙特阿拉伯，针对这一主题的研究很少。
设计
横断面设计。通过对调查数据的路径分析，测试了将护理实践环境和护士与患者比例与护士工作结果联系起来的模型。
方法
沙特阿拉伯公立和军事医院的 404 名护士完成了一项调查，其中包括护理工作指数实践环境量表、马斯拉赫倦怠量表以及与工作不满和离职意向相关的问题。使用护士离职模型来测试研究变量之间的关系。本研究按照横断面研究的 STROBE 清单进行。
结果
与公立医院相比，军事医院的护理实践环境和护士工作结果更好。总体而言，53%的参与者有较高的倦怠，39%的人感到不满，26%的人有意离职。路径分析表明，护理实践环境和护士与患者比例是倦怠和工作不满的预测因素，进而导致离职意向。测试的模型拟合良好，解释了研究变量的直接和间接效应。
结论
沙特医院较差的护理实践环境和较高的护士与患者比例导致护士工作结果不佳。
临床相关性
护理领导者可以专注于加强实践环境和降低护士与患者比例，作为提高护士工作结果的保留策略。
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