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调查高级执业注册护士和医师助理的实践水平和个体因素及其与韧性的关系。

Investigating practice-level and individual factors of advanced practice registered nurses and physician assistants and their relationship to resilience.

机构信息

OSF HealthCare, Center for Advanced Practice, Peoria, Illinois.

Caterpillar, Inc. Endowed Professor of Management, Foster College of Business, Bradley University, Peoria, Illinois.

出版信息

J Am Assoc Nurse Pract. 2021 Jul 29;34(2):310-321. doi: 10.1097/JXX.0000000000000639.

Abstract

BACKGROUND

Gaps in research persist related to practitioners' resilience, although much has been written about the need for strategies to strengthen personal resilience.

PURPOSE

The study's purpose was to examine practice-level (quality of physician relationship, physician presence, and autonomy) and individual factors and how they affect resilience.

METHODOLOGY

An online survey invited advanced practice registered nurses (APRNs) and physician assistants (PAs) from four states to participate in a cross-sectional study. Hierarchical ordinary least squares regression was used to test the impact of main effect variables in the context of identified control variables.

SAMPLE

A sample of 1,138 APRNs and PAs completed the survey questions.

RESULTS

Findings from the covariate model (model 1) and the main effect model (model 2) show that both models were significant at the p < .01 level, with the adjusted R2 differing from 0.02 to 0.13, respectively. Regression results show a significant positive association between quality of the physician relationship and APRN/PA resilience (b = 0.09, p < .01). A negative association between the lack of autonomy and higher levels of resilience (b = -0.14, p < .01) was also demonstrated.

CONCLUSIONS

Advanced practice registered nurse/PA resilience is affected by both practice-level and personal factors, suggesting that workplace interventions could increase resilience.

IMPLICATIONS FOR PRACTICE

Work environments allowing APRNs and PAs to function autonomously and with professional support from physician colleagues are favorable contributors to their resilience. Future studies need to investigate the meaning of physician presence/availability and organizational interventions that extend beyond individual resilience.

摘要

背景

尽管已经有很多关于需要加强个人韧性的策略的论述,但关于从业者韧性的研究仍存在差距。

目的

本研究旨在考察实践层面(医患关系质量、医生的存在和自主性)和个体因素,以及它们如何影响韧性。

方法

一项在线调查邀请了来自四个州的高级实践注册护士 (APRNs) 和医师助理 (PAs) 参与横断面研究。分层普通最小二乘法回归用于检验主要效应变量在确定的控制变量背景下的影响。

样本

共有 1138 名 APRNs 和 PAs 完成了调查问题。

结果

协变量模型(模型 1)和主要效应模型(模型 2)的结果表明,两个模型在 p <.01 水平上均具有显著意义,调整后的 R2 分别为 0.02 至 0.13。回归结果显示,医患关系质量与 APRN/PA 韧性之间呈显著正相关(b = 0.09,p <.01)。自主性不足与更高水平的韧性之间也存在负相关(b = -0.14,p <.01)。

结论

APRN/PA 的韧性受到实践层面和个人因素的影响,这表明工作场所干预措施可以提高韧性。

实践意义

允许 APRNs 和 PAs 自主运作并获得医生同事专业支持的工作环境是促进他们韧性的有利因素。未来的研究需要调查医生存在/可用性的含义以及超越个体韧性的组织干预措施。

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