摘要目的:通过深入分析不良得分调查条目的具体情景，持续改进医院护理管理。方法:采用横断面研究，对2020年7月9日至22日广州市胸科医院护士进行问卷调查，应参加护士441人，反馈问卷调查结果249人。依据≤25岁、>25～30岁、>30～35岁、>35～40岁、>40～45岁、>45～50岁、≥50岁7个年龄段和护士、护师、主管护师、高级护师（包括副主任护师与主任护师）4个职称类别进行护士人群分类，对护理工作环境量表（PES-NWI）问卷调查中Likert 4级计分平均分值≤2.50的不良得分条目分别计算其“非常不同意、不同意、同意、非常同意”Likert 4级分布频数、百分比及均数±标准差（ xˉ±s）。 结果:（1）在11类护士人群、PES-NWI的4个维度31个条目形成的341个（11×31）人群条目集（以下简称“群目”）中，有24个得分平均值≤2.50的不良得分群目，占群目总数的7.04%（24/341）；得分不良群目涉及PES-NWT的“护士参与医院事务”维度的6个条目和“充足的人力和物力”维度的2个条目。（2）7个年龄段护士人群得分不良群目18个，占其群目总数（7×31）的8.29%（18/217），得分不良群目涉及PES-NWT的“护士参与医院事务”维度的6个条目和“充足的人力和物力”维度的2个条目。（3）4个职称类别护士人群得分不良群目6个，占其群目总数（4×31）的4.84%（6/124），得分不良群目涉及PES-NWT的“护士参与医院事务”维度的3个条目和“充足的人力和物力”维度的3个条目。（4）年龄由小到大7个年龄段护士人群得分不良群目分别涉及0、1、5、4、3、2、3个条目，职位由低到高4个护士人群得分不良群目分别涉及0、2、3、1个条目。结论:护士年龄对护理工作环境的感知比职称类别敏感，护士在医院中的地位与护理人员数量是否充足则最受关注。

abstractsObjective:To improve the hospital nursing management by analyzing the poor-scoring survey items.Methods:In the cross-sectional study, a questionnaire survey was conducted among nurses in Guangzhou Chest Hospital from July 9 to 22, 2020; 441 nurses should participate in the survey, and 249 nurses actually gave feedback on the questionnaire results. The nurses were classified according to 7 age groups of ≤25 years old, >25-30 years old, >30-35 years old, >35-40 years old, >40-45 years old, >45-50 years old, and ≥50 years old, or 4 professional title levels of nurse, registered nurse, supervisor nurse, and senior nurse (including deputy chief nurse and chief nurse). Poor-scoring items with a Likert 4-point average score ≤2.50 in the Practice Environment Scale of the Nursing Work Index (PES-NWI) survey were selected. The distribution frequencies, percentages, and their mean±standard deviation ( xˉ±s) of "strongly disagreed", "disagreed", "agreed", and "strongly agreed" on Likert 4 levels were calculated. Results:(1) There were 341 (11 × 31) population item sets (hereinafter referred to as "groups") formed by 11 types of nurse populations and 31 items in 4 dimensions of PES-NWI. There were 24 poor-scoring groups with an average score of ≤2.50, accounting for 7.04% of the total number of groups. The poor-scoring groups involved 6 items in the dimension of "nurses' participation in hospital affairs" and 2 items in the dimension of "adequate human and material resources" of PES-NWT. (2) There were 18 poor-scoring groups in the nurses of 7 age groups, accounting for 8.29% of the total number of groups (7 × 31). The poor-scoring groups involved 6 items in the dimension of "nurses' participation in hospital affairs" and 2 items in the dimension of "adequate human and material resources" of PES-NWT. (3) There were 6 poor-scoring groups in the nurses of 4 professional title levels, accounting for 4.84% of the total number of groups (4 × 31). The poor-scoring groups involved 3 items in the dimension of "nurses' participation in hospital affairs" and 3 items in the dimension of "adequate human and material resources" of PES-NWT. (4) The poor-scoring groups of the 7 age groups involved 0, 1, 5, 4, 3, 2, and 3 items from the youngest to the oldest. The poor-scoring groups of the 4 professional title level groups involved 0, 2, 3, and 1 items respectively from lowest to highest.Conclusion:The nurses' age is more sensitive to the perception of nursing work environment than the level of professional titles, and the nurses' status in hospital and the adequacy of the number of nursing staff are the most concerned.