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非本职工作任务对注册护士的工作积极性有影响吗?一项基于瑞典护士全国代表性样本的横断面研究。

Do illegitimate tasks matter for registered nurses' work motivation? A cross-sectional study based on a nationally representative sample of Swedish nurses.

作者信息

Ahlstedt Carina, Moberg Linda, Brulin Emma, Nyberg Anna

机构信息

Department of Public Health and Caring Sciences, Health Services Research, Uppsala University, Sweden.

Department of Government, Uppsala University, Sweden.

出版信息

Int J Nurs Stud Adv. 2023 Oct 14;5:100159. doi: 10.1016/j.ijnsa.2023.100159. eCollection 2023 Dec.

Abstract

BACKGROUND

A challenge in Western countries is the growing need for registered nurses (RNs') in hospitals, primary care and home healthcare. Decreasing illegitimate tasks and strengthening RNs' work motivation are some strategies to address this challenge.

OBJECTIVE

Our overall aim was to explore the association between RNs' experiences of illegitimate tasks and work motivation operationalised as four dimensions: work engagement, opportunities to provide high-quality care, employer satisfaction and intention to remain at the workplace. To address this aim, three specific research questions were asked: (1) Is there an association between illegitimate tasks and work motivation? (2) Do the levels of reported illegitimate tasks differ between RNs working in hospitals and those working in primary care or home healthcare settings? (3) Do associations between illegitimate work tasks and work motivation differ with type of workplace?

DESIGN

A cross-sectional design.

METHODS

We used responses from a stratified population of RNs in Sweden,  = 2,333, working either in hospitals, primary care or home healthcare. Calibrating weights were applied in all analyses to ascertain the generalisability of the findings. Illegitimate tasks were measured with the Bern Illegitimate Tasks Scale. Data were analysed using chi-squared tests and linear or logistic regression analysis. Interaction was measured on the multiplicative scale by adding an interaction term to the fully adjusted models.

RESULTS

Overall, approximately 25 % of RNs reported frequently experiencing illegitimate tasks. There were statistically significant associations between higher perceptions of illegitimate tasks and lower ratings in the four dimensions of work motivation: work engagement [beta coefficient [beta] = -0.14, confidence interval [CI] 95 % = -0.18; -0.10], opportunities to provide high-quality care [beta = -0.46, CI 95 % = -0.51; -40] and employer satisfaction [beta = -0.60, CI 95 % = -0.67; -0.54]. Experiencing higher levels of illegitimate tasks also related to a decreased intention to remain at the workplace [illegitimate tasks: odds ratio = 0.32, CI 95 % = 0.27; 0.29]. RNs who worked in home healthcare reported higher levels of illegitimate tasks than RNs who worked in hospitals.

CONCLUSIONS

Reducing the amount of illegitimate tasks may contribute to counteracting the shortage of RNs by increasing work motivation and willingness to remain at the workplace.

摘要

背景

在西方国家,一个挑战是医院、初级保健和家庭医疗保健领域对注册护士(RN)的需求日益增长。减少不合理任务并增强注册护士的工作积极性是应对这一挑战的一些策略。

目的

我们的总体目标是探讨注册护士对不合理任务的体验与工作积极性之间的关联,工作积极性从四个维度进行衡量:工作投入、提供高质量护理的机会、雇主满意度以及留在工作场所的意愿。为实现这一目标,我们提出了三个具体研究问题:(1)不合理任务与工作积极性之间是否存在关联?(2)在医院工作的注册护士与在初级保健或家庭医疗保健机构工作的注册护士所报告的不合理任务水平是否存在差异?(3)不合理工作任务与工作积极性之间的关联是否因工作场所类型而异?

设计

横断面设计。

方法

我们使用了瑞典2333名注册护士的分层抽样调查结果,这些护士分别在医院、初级保健或家庭医疗保健机构工作。在所有分析中都应用了校准权重,以确定研究结果的普遍性。不合理任务通过伯尔尼不合理任务量表进行测量。数据使用卡方检验以及线性或逻辑回归分析进行分析。通过在完全调整模型中添加交互项,以乘法尺度测量交互作用。

结果

总体而言,约25%的注册护士报告经常经历不合理任务。对不合理任务的较高认知与工作积极性四个维度的较低评分之间存在统计学显著关联:工作投入[β系数(β)=-0.14,95%置信区间(CI)=-0.18;-0.10]、提供高质量护理的机会[β=-0.46,95%CI=-0.51;-0.40]以及雇主满意度[β=-0.60,95%CI=-0.67;-0.54]。经历较高水平的不合理任务也与留在工作场所的意愿降低有关[不合理任务:优势比=0.32,95%CI=0.27;0.29]。在家庭医疗保健机构工作的注册护士报告的不合理任务水平高于在医院工作的注册护士。

结论

减少不合理任务的数量可能有助于通过提高工作积极性和留在工作场所的意愿来缓解注册护士短缺的问题。

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