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具有自有患者群体的初级保健执业护士的倦怠、工作满意度和离职意愿。

Burnout, job satisfaction, and turnover intention among primary care nurse practitioners with their own patient panels.

机构信息

School of Nursing, University of Pittsburgh, Pittsburgh, PA.

School of Nursing, University of Pittsburgh, Pittsburgh, PA.

出版信息

Nurs Outlook. 2024 Jul-Aug;72(4):102190. doi: 10.1016/j.outlook.2024.102190. Epub 2024 May 23.

Abstract

BACKGROUND

Nurse practitioners (NPs) can enhance NP care and improve access to care by autonomously managing their patient panels. Yet, its impact on workforce outcomes such as burnout, job satisfaction, and turnover intention remains unexplored.

PURPOSE

To estimate the impact of NP panel management on workforce outcomes.

METHODS

Structural equation modeling was conducted using survey data from 1,244 primary care NPs. NP panel management was categorized into co-managing patients with other providers, both co-managing and autonomously managing, and fully autonomous management.

DISCUSSION

Fully autonomous management led to more burnout than co-managing (B = 0.089, bias-corrected 95% bootstrap confidence interval [0.028, 0.151]). Work hours partially (27%) mediated this relationship. This findings indicate that greater autonomy in panel management among NPs may lead to increased burnout, partially due to longer work hours.

CONCLUSION

Interventions to reduce work hours could help NPs deliver quality care without burnout.

摘要

背景

护士从业者 (NPs) 可以通过自主管理患者群体来增强 NP 护理并改善医疗服务的可及性。然而,其对劳动力成果(如倦怠、工作满意度和离职意向)的影响仍未得到探索。

目的

评估 NP 患者管理对劳动力成果的影响。

方法

使用来自 1244 名初级保健 NPs 的调查数据进行结构方程建模。NP 患者管理分为与其他提供者共同管理患者、共同管理和自主管理以及完全自主管理。

讨论

完全自主管理比共同管理更容易导致倦怠(B=0.089,偏校正 95% bootstrap 置信区间 [0.028, 0.151])。工作时间部分(27%)解释了这种关系。这一发现表明,NPs 在患者管理方面更大的自主权可能会导致倦怠增加,部分原因是工作时间延长。

结论

减少工作时间的干预措施可以帮助 NPs 在不出现倦怠的情况下提供优质护理。

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本文引用的文献

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Primary care Practice Environment and Burnout among Nurse Practitioners.初级护理实践环境与执业护士职业倦怠
J Nurse Pract. 2021 Feb;17(2):157-162. doi: 10.1016/j.nurpra.2020.11.009. Epub 2021 Jan 11.
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Methodology for a six-state survey of primary care nurse practitioners.六状态调查初级保健执业护士的方法学。
Nurs Outlook. 2021 Jul-Aug;69(4):609-616. doi: 10.1016/j.outlook.2021.01.010. Epub 2021 Feb 13.
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A concept analysis of nurse practitioner autonomy.执业护士自主性的概念分析
J Am Assoc Nurse Pract. 2020 Feb;32(2):113-119. doi: 10.1097/JXX.0000000000000374.

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