与学生困扰和离开护理教育意愿相关的心理社会工作特征；一项为期一年的随访研究。
Psychosocial work characteristics associated with distress and intention to leave nursing education among students; A one-year follow-up study.
机构信息
Rotterdam University of Applied Sciences, Research Centre Innovations in Care, P.O. Box 25035, 3001 HA Rotterdam, the Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, P.O. Box 7057, 1007 MB Amsterdam, the Netherlands.
Rotterdam University of Applied Sciences, Research Centre Innovations in Care, P.O. Box 25035, 3001 HA Rotterdam, the Netherlands; University Medical Center Groningen, University of Groningen, Department of Health Sciences, Community and Occupational Medicine, A. Deusinglaan 1, 9713 AV Groningen, the Netherlands.
出版信息
Nurse Educ Today. 2021 Jun;101:104853. doi: 10.1016/j.nedt.2021.104853. Epub 2021 Mar 6.
BACKGROUND
Dropout in later years of the nursing degree programme involves lost investment and is a particular problem for both students and educators. Reasons for late dropout seem to be related to the work and learning environment of the clinical placement.
OBJECTIVES
The aim of this study was to investigate associations between psychosocial work characteristics and distress and intention to leave nursing education among third-year nursing students.
DESIGN
A prospective cohort study.
SETTING
A Bachelor of Nursing programme of a University of Applied Sciences in the Netherlands.
PARTICIPANTS
363 third-year nursing students.
METHODS
Baseline and one-year follow-up measurements were used from a prospective cohort study. Third-year nursing students were invited annually in May between 2016 and 2018. Psychosocial work characteristics were psychological demands, supervisor and co-worker support, and acts of offensive behaviour. Logistic regression analyses were used to build multivariate models.
RESULTS
Frequent exposure to violence (OR = 2.52, 95% CI: 1.29-4.92) was univariately associated with distress. In the multivariate model for distress, psychological demands (OR = 1.63, 95% CI: 1.05-2.52) and frequent exposure to violence (OR = 3.02, 95% CI: 1.48-6.19) were associated with distress. Supervisor support (OR = 0.54, 95% CI: 0.36-0.80) and co-worker support (OR = 0.41, 95% CI: 0.24-0.72) were negatively associated with intention to leave (i.e. were protective) in the univariate model. In the adjusted multivariate model, only co-worker support (OR = 0.50, 95% CI: 0.25-0.97) was a protective factor for an intention to leave.
CONCLUSION
Psychological demands and frequent exposure to violence are risk factors for distress, and co-worker support is a protective factor reducing the intention to leave nursing education in the last stage of the programme. Improving the psychosocial working climate of nursing students may reduce the intention to leave at a late stage in nursing education, and hence actual late dropout.
背景
护理学位课程后期的辍学涉及到投资损失，这对学生和教育者来说都是一个特别的问题。导致后期辍学的原因似乎与临床实习的工作和学习环境有关。
目的
本研究旨在调查护理专业三年级学生的心理社会工作特征与压力和离开护理教育的意愿之间的关联。
设计
前瞻性队列研究。
地点
荷兰一所应用科学大学的护理学士课程。
参与者
363 名护理专业三年级学生。
方法
本研究采用前瞻性队列研究，在 2016 年至 2018 年期间，每年 5 月邀请护理专业三年级学生参加基线和一年后的随访测量。心理社会工作特征包括心理需求、主管和同事的支持以及冒犯行为。使用逻辑回归分析建立多变量模型。
结果
频繁接触暴力（OR=2.52，95%CI：1.29-4.92）与压力有关。在压力的多变量模型中，心理需求（OR=1.63，95%CI：1.05-2.52）和频繁接触暴力（OR=3.02，95%CI：1.48-6.19）与压力有关。主管支持（OR=0.54，95%CI：0.36-0.80）和同事支持（OR=0.41，95%CI：0.24-0.72）与离开（即保护性）的意愿呈负相关在单变量模型中。在调整后的多变量模型中，只有同事支持（OR=0.50，95%CI：0.25-0.97）是减少对护理教育离开意愿的保护因素。
结论
心理需求和频繁接触暴力是压力的危险因素，而同事支持是减少计划最后阶段离开护理教育意愿的保护因素。改善护理学生的心理社会工作环境可能会降低护理教育后期的离开意愿，从而减少实际的后期辍学。
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