长期护理护士的留职意愿、道德困扰和护士执业环境:横断面问卷调查研究。

IF 2.4 3区 医学 Q1 NURSING Journal of Nursing Scholarship Pub Date : 2024-01-02 DOI:10.1111/jnu.12953
Amil Kusain Tan Jr PhD, RN, MHC, MEDSURG-BC, Elizabeth Capezuti PhD, RN, FAAN, William Ellery Samuels PhD, Ramona Backhaus PhD, Laura M. Wagner PhD, RN, GNP, FAAN
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引用次数: 0

摘要

背景:美国许多长期护理机构都面临着护士留用和流失的严重问题。这些挑战至少部分归因于道德困扰和消极的护士执业环境:本研究的目的分为两部分:第一,调查护士执业环境、道德困扰和留任意愿之间的关系;第二,探讨护士执业环境对道德困扰程度高的护士留任意愿的潜在中介效应:本研究是一项描述性横断面调查,采用目标抽样法:共有 215 人完成了调查。根据年龄、工作年限、就业状况和医疗机构类型,参与者在全国长期护理护士中具有代表性:本研究是一项全国性在线调查,调查对象是长期护理护士对其留职意愿、道德困扰程度(道德困扰问卷)和护士执业环境(直接护理人员调查)的看法。结构方程模型分析探讨了长期护理护士的留职意愿、道德困扰和护士实践环境:结果:道德困扰的平均得分较低,而护士实践环境和留职意愿的平均得分较高。道德困扰与护士执业环境有明显的中度负相关(β = -0.41),而护士执业环境与护士的留任意愿有明显的中度正相关(β = 0.46)。道德压力与留职意愿有明显的中度负相关(β = -0.20)。计算得出的结构方程模型表明存在部分中介模型(间接效应 = -0.19,p = 0.001):由于护士执业环境部分介导了道德困扰与留职意愿之间的关系,因此改善护士执业环境的干预措施对于减轻道德困扰、提高护士留职意愿、组织和护理专业至关重要:临床相关性:我们的研究表明,护士的执业环境在道德困扰和留任意愿之间起着中介作用。临床相关性:我们的研究表明,护士的执业环境是道德困扰和留职意愿的中介。改善护士执业环境的干预措施对于减轻道德困扰和提高护士留职意愿至关重要。
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Intent to stay, moral distress, and nurse practice environment among long-term care nurses: A cross-sectional questionnaire survey study

Background

Many long-term care facilities in the United States face significant problems with nurse retention and turnover. These challenges are attributed, at least in part, to moral distress and a negative nurse practice environment.

Objective

The purpose of the study was divided into two parts: first, to investigate the relationships among nurse practice environment, moral distress, and intent to stay; second, to explore the potential mediating effect of the nurse practice environment on the intent to stay among those with high levels of moral distress.

Design

This study was a descriptive, cross-sectional survey using targeted sampling.

Participants

A total of 215 participants completed the surveys. Participants were nationally representative of long-term care nurses by age, years of experience, employment status, and type of health setting.

Methods

This study was an online national survey of long-term care nurses' perceptions of their intent to stay, moral distress level (Moral Distress Questionnaire), and nurse practice environment (Direct Care Staff Survey). Structural equation modeling analysis explored intent to stay, moral distress, and the nurse practice environment among long-term care nurses.

Results

The mean moral distress score was low, while the mean nurse practice environment and intent to stay scores were high. Moral distress had a significant, moderately negative association with the nurse practice environment (β = −0.41), while the nurse practice environment had a significant, moderately positive association with intent to stay (β = 0.46). The moral distress had a significant, moderately negative association with intent to stay (β = −0.20). The computed structural equation modeling suggested a partially mediated model (indirect effect = −0.19, p = 0.001).

Conclusion

Since the nurse practice environment partially mediates the relationship between moral distress and intent to stay, interventions to improve the nurse practice environment are crucial to alleviating moral distress and enhancing nurses' intent to stay in their jobs, organizations, and the nursing profession.

Clinical Relevance

  • Our study demonstrated that the nurse practice environment mediates moral distress and intent to stay.
  • Interventions to improve the nurse practice environment are crucial to alleviating moral distress and enhancing nurses' intent to stay in their jobs, organizations, and the nursing profession.
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来源期刊
CiteScore
6.30
自引率
5.90%
发文量
85
审稿时长
6-12 weeks
期刊介绍: This widely read and respected journal features peer-reviewed, thought-provoking articles representing research by some of the world’s leading nurse researchers. Reaching health professionals, faculty and students in 103 countries, the Journal of Nursing Scholarship is focused on health of people throughout the world. It is the official journal of Sigma Theta Tau International and it reflects the society’s dedication to providing the tools necessary to improve nursing care around the world.
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