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组织学习与基层医疗护士的工作绩效及幸福感:发展中国家的多层次线性分析

Organizational Learning and Primary Care Nurses' Work Performance and Well-Being: A Multilevel Linear Analysis in a Developing Country.

作者信息

Zhao Ruixue, Wang Wenhua, Zhang Jinnan, Li Mengyao, Nicholas Stephen, Maitland Elizabeth, Yang Huiyun, Mitchell Rebecca

机构信息

School of Public Policy and Administration Xi'an Jiaotong University, Xi'an, China.

Australian National Institute of Management and Commerce, Sydney, Australia.

出版信息

J Nurs Manag. 2024 Jul 16;2024:2770347. doi: 10.1155/2024/2770347. eCollection 2024.

Abstract

AIM

This study aims to investigate the level of organizational learning within urban Chinese Community Health Centres and reveal its potential association with primary care nurses' work performance and well-being.

BACKGROUND

Globally, there is a push to establish learning healthcare systems for complex health reform challenges. Existing studies on organizational learning mainly focus on North American and European hospital settings, offering limited insights into primary care environments, particularly in developing countries.

DESIGN

Cross-sectional study.

METHODS

We recruited 175 nurses from 38 community health centres in four Chinese cities (Shanghai, Shenzhen, Tianjin, and Jinan) using convenience sampling. Trained research assistants conducted face-to-face surveys, measuring organizational learning with the Learning Orientation Scale. Nurse-level outcomes included self-directed learning, quality of care, organizational commitment, and work stress. Data analysis employed multilevel linear modelling.

RESULTS

The 38 community health centres displayed a relatively high level of organizational learning, and there was a positive and significant association between organizational learning within community health centres and nurses' self-directed learning as well as the quality of care. However, there was no significant association between organizational learning and nurses' organizational commitment or work stress.

CONCLUSION

This study demonstrates a high-level organizational learning capacity in urban community health centres in China. It provides a new perspective on the potential relationship between CHCs' organizational learning and primary care nurses' well-being and work performance. Further research is needed to clarify unexpected findings and identify factors promoting organizational learning in primary care settings. . In China's evolving primary care system, nurses play a vital role amidst physician shortages. Policy should prioritize internal management reform alongside structural changes. This study highlights the importance of fostering organizational learning in primary care settings. Strategic interventions should promote a learning culture in CHCs, which may enhance nurses' self-directed learning and improve the quality of care.

摘要

目的

本研究旨在调查中国城市社区卫生服务中心的组织学习水平,并揭示其与基层护理人员工作绩效和幸福感之间的潜在关联。

背景

在全球范围内,为应对复杂的卫生改革挑战,正推动建立学习型卫生保健系统。现有的关于组织学习的研究主要集中在北美和欧洲的医院环境,对基层医疗环境,特别是发展中国家的基层医疗环境的见解有限。

设计

横断面研究。

方法

我们采用便利抽样的方法,从中国四个城市(上海、深圳、天津和济南)的38个社区卫生服务中心招募了175名护士。经过培训的研究助理进行面对面调查,使用学习导向量表测量组织学习。护士层面的结果包括自主学习、护理质量、组织承诺和工作压力。数据分析采用多层次线性模型。

结果

38个社区卫生服务中心呈现出相对较高的组织学习水平,社区卫生服务中心的组织学习与护士的自主学习以及护理质量之间存在积极且显著的关联。然而,组织学习与护士的组织承诺或工作压力之间没有显著关联。

结论

本研究表明中国城市社区卫生服务中心具有较高水平的组织学习能力。它为社区卫生服务中心的组织学习与基层护理人员的幸福感和工作绩效之间的潜在关系提供了新的视角。需要进一步研究以阐明意外发现,并确定促进基层医疗环境中组织学习的因素。在中国不断发展的基层医疗体系中,护士在医生短缺的情况下发挥着至关重要的作用。政策应在进行结构变革的同时优先考虑内部管理改革。本研究强调了在基层医疗环境中培养组织学习的重要性。战略干预应促进社区卫生服务中心的学习文化,这可能会增强护士的自主学习并提高护理质量。

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