Hong Youjuan, Chen Meijing, Chen Caimei, Qiu Meichai
School of Nursing, Fujian Medical University, Fuzhou, China.
Critical Care Department, Longyan People's Hospital, Longyan, Fujian, China.
BMC Nurs. 2024 May 30;23(1):361. doi: 10.1186/s12912-024-02025-5.
Exploration of the relationship between nursing students' abusive supervision and their future intention to leave the nursing profession before completing the final clinical practicum is critical to the issue of nursing staff shortages and how to alleviate them. In order to further dissect the factors influencing turnover intention among student nurses in clinical practice, our study used the conservation of resources theory and job demands-resources model to explain the specific pathways that influence student nurses' intention to leave the nursing profession, with particular focus on nursing students' personality traits and certain organizational factors.
This study followed a cross-sectional design. Between March and May 2022, a convenience sampling method was used to select 531 nursing students from two medical universities in Fuzhou. The Abusive Supervision, Emotional Exhaustion, Nurse-Patient Relationship, and Turnover Intention Scales were employed to collect data. The PROCESS macro (Models 4 and 7) for SPSS 25.0 by Hayes and 5,000 bootstrap samples were used to examine the moderation and mediation impacts.
Abusive supervision was found to significantly positively predict nursing students' intention to leave the nursing profession. Emotional exhaustion significantly mediated the relationship between abusive supervision and an intention to leave the nursing profession. The moderating effect of the nurse-patient relationship in the mediation model was also found to be significant.
Abusive supervision by clinical teaching staff is a work-related stressor that leads to emotional exhaustion, consequently decreasing nursing students' future intention to work as a nurse. A nurse-patient relationship based on trust could buffer the negative effect of abusive supervision on emotional exhaustion. Healthcare organizations and nurse educators should implement programs that educate and train individuals about abusive supervision, emotion regulation, and positive nurse-patient relationships; this would serve to decrease nursing students' intention to leave the nursing profession. This study provides relevant implications for helping nursing instructors develop effective intervention strategies to retain talented nursing personnel.
在完成最后临床实习之前，探究护理专业学生遭受的辱骂性监督与他们未来离开护理行业的意愿之间的关系，对于护理人员短缺问题以及如何缓解这一问题至关重要。为了进一步剖析影响临床实习中护生离职意愿的因素，我们的研究运用资源守恒理论和工作要求-资源模型来解释影响护生离职意愿的具体途径，特别关注护生的个性特质和某些组织因素。
本研究采用横断面设计。2022年3月至5月期间，采用便利抽样法从福州的两所医科大学选取了531名护理专业学生。使用辱骂性监督、情绪耗竭、护患关系和离职意愿量表收集数据。采用Hayes的SPSS 25.0的PROCESS宏程序（模型4和7）以及5000次自抽样来检验调节和中介效应。
发现辱骂性监督能显著正向预测护理专业学生离开护理行业的意愿。情绪耗竭在辱骂性监督与离开护理行业的意愿之间起显著中介作用。还发现护患关系在中介模型中的调节作用显著。
临床教师的辱骂性监督是一种与工作相关的压力源，会导致情绪耗竭，从而降低护理专业学生未来从事护士工作的意愿。基于信任的护患关系可以缓冲辱骂性监督对情绪耗竭的负面影响。医疗保健组织和护理教育工作者应实施相关项目，对个人进行关于辱骂性监督、情绪调节和积极护患关系的教育和培训；这将有助于降低护理专业学生离开护理行业的意愿。本研究为帮助护理教师制定有效的干预策略以留住优秀护理人才提供了相关启示。
