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道德韧性对护士离职意愿的影响:一项横断面研究中职业倦怠的中介作用

The impact of moral resilience on nurse turnover intentions: the mediating role of job burnout in a cross-sectional study.

作者信息

Yi Lijuan, Chen Zhuomei, Jiménez-Herrera María F, Gan Xiuni, Ren Yi, Tian Xu

机构信息

Department of Nursing, Hunan Traditional Chinese Medical College, Zhuzhou, China.

Nursing Department, Universitat Rovira i Virgili, Tarragona, Spain.

出版信息

BMC Nurs. 2024 Sep 27;23(1):687. doi: 10.1186/s12912-024-02357-2.

Abstract

BACKGROUND

High nursing staff turnover is a critical issue that negatively impacts the quality of care and patient safety. Turnover intentions, a key predictor of actual turnover, reflect an individual's likelihood of leaving their current position. Understanding the underlying mechanisms driving nurse turnover intentions is crucial for developing targeted interventions to stabilize the nursing workforce globally.

OBJECTIVES

This study aims to explore the relationship between moral resilience, job burnout, and turnover intentions among nurses, focusing on the mediating role of job burnout in this relationship.

DESIGN

This study employed a quantitative, cross-sectional design.

METHODS

A convenience sample of 322 registered nurses was recruited from two tertiary hospitals in China between August and October 2023. Data were collected using the Chinese version of the Rushton Moral Resilience Scale (Chi-RMRS), the Maslach Burnout Inventory (MBI), and the Turnover Intention Scale. Data analyses were conducted using SPSS 26.0 and Amos 21.0. The study followed the STROBE guidelines for observational research.

ETHICAL CONSIDERATION

Before the commencement of data collection, the Institutional Review Board of Hunan Traditional Chinese Medical College (YXLL202401004) granted ethical approval.

RESULTS

The proposed model exhibited an excellent fit to the data, with fit indices as follows: χ/df = 1.819, CFI = 0.977, TLI = 0.961, RMSEA = 0.072 (90% confidence interval [CI]: 0.033 to 0.107). The structural equation model revealed that moral resilience was inversely associated with job burnout and turnover intentions. Furthermore, job burnout fully mediated the relationship between moral resilience and turnover intentions (β = -0.473, p = 0.007). Further analysis indicated that the depersonalization component of job burnout was the sole mediator in the relationship between moral resilience and turnover intention (β = -3.934, 95% CI [-5.837, -1.932]).

CONCLUSION

The findings indicate that moral resilience among nurses is negatively associated with turnover intentions, with this effect fully mediated by the depersonalization dimension of job burnout. Enhancing moral resilience in nurses may be valuable strategy for healthcare administrators to mitigate job burnout and subsequently reduce turnover intentions.

摘要

背景

护理人员高离职率是一个严重问题,对护理质量和患者安全产生负面影响。离职意愿是实际离职的关键预测指标,反映了个体离开当前岗位的可能性。了解促使护士离职意愿的潜在机制对于制定有针对性的干预措施以稳定全球护理队伍至关重要。

目的

本研究旨在探讨护士道德韧性、职业倦怠和离职意愿之间的关系,重点关注职业倦怠在这种关系中的中介作用。

设计

本研究采用定量横断面设计。

方法

2023年8月至10月间,从中国两家三级医院招募了322名注册护士作为便利样本。使用中文版的拉什顿道德韧性量表(Chi-RMRS)、马氏职业倦怠量表(MBI)和离职意愿量表收集数据。使用SPSS 26.0和Amos 21.0进行数据分析。本研究遵循观察性研究的STROBE指南。

伦理考量

在数据收集开始前,湖南中医药高等专科学校伦理委员会(YXLL202401004)给予了伦理批准。

结果

所提出的模型与数据拟合良好,拟合指数如下:χ/df = 1.819,CFI = 0.977,TLI = 0.961,RMSEA = 0.072(90%置信区间[CI]:0.033至0.107)。结构方程模型显示,道德韧性与职业倦怠和离职意愿呈负相关。此外,职业倦怠完全中介了道德韧性与离职意愿之间的关系(β = -0.473,p = 0.007)。进一步分析表明,职业倦怠的去人格化成分是道德韧性与离职意愿之间关系的唯一中介因素(β = -3.934,95% CI [-5.837,-1.932])。

结论

研究结果表明,护士的道德韧性与离职意愿呈负相关,这种影响完全由职业倦怠的去人格化维度中介。增强护士的道德韧性可能是医疗管理者减轻职业倦怠并进而降低离职意愿的一项有价值策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/73cc/11437732/c45ddb316edf/12912_2024_2357_Fig1_HTML.jpg

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