摘要目的 调查ICU护士心理契约状况并探讨护理能级制度对心理契约的影响.方法 采用护士心理契约量表及一般资料问卷对中日友好医院102名ICU护士进行横断面调查,对不同护理能级层次间的护士心理契约评分进行比较和讨论.结果 102名护士的心理契约量表评分为(135.43±20.31)分,按人口学特征分组,各组护士的心理契约及各个维度评分,差异无统计学意义;不同护理能级护士的心理契约评分分别为:N1(138.25±20.78)分,N2(127.11±17.95)分,N3(140.70±18.34)分,得分N2<N1<N3,差异有统计学意义(F=3.465,P<0.05),进一步比较医院责任和护士责任2个维度的评分,不同能级护士医院责任分量表评分,差异有统计学意义(F=3.227,P<0.05),护士责任分量表评分,差异无统计学意义(F=1.874,P>0.05);62.7%的护士认为自己被聘用能级合理,心理契约评分为(139.52±21.26)分,37.3%认为自己的能力被低估,心理契约评分为(128.55±16.72)分,差异有统计学意义(t=2.718,P<0.05).结论 护理能级制度对护士心理契约有一定影响,然而在制度实施方面还需进行细化并且与护士加强沟通和达成共识,进一步发挥该制度的积极效应.

abstractsObjective To investigate the psychological contract status of ICU nurses and explore the effects of nursing level system on psychological contract.Methods A cross-sectional survey was con-ducted among 102 ICU nurses in China-Japan Friendship Hospital by using the nurses' psychological con-tract scale and general information questionnaire.Results The score of nurse psychological contract scale was (135.43±20.31). Grouped according to demographic characteristics, there was no significant difference in nurses' psychological contract of three groups and the score of each dimension. The average scores of psychological contract of samples in three groups with different nursing level were: (138.25±20.78) in N1 group, (127.11±17.95) in N2 group, (140.70±18.34) in N3 group, and the order of average scores was N2<N1<N3, with significant difference (F=3.465,P<0.05). Further comparison in the scores of hospital responsi-bility and nurse responsibility showed that, there was significant difference in the score of hospital responsibility sub-scale among nurses with different level (F=3.227,P<0.05), and there was no significant difference in the score of nurse responsibility sub-scale among three groups (F=1.874,P>0.05). 62.7% of nurses considered that they were hired with reasonable level, and their psychological contract was (139.52±21.26) points; 37.3% consid-ered that their abilities were underestimated, and their psychological contract score was (128.55±16.72), with a significant difference among three groups (t=2.718,P<0.05).Conclusions The nursing level system has certain effects on the psychological contract of nurses. However, it is necessary to strengthen the communication and consensus with nurses in the implementation and management of the system, so as to exert the positive effect of the system.