摘要目的 调查三级医院护士长专业实践环境与职业倦怠的现状,探讨专业实践环境对职业倦怠的影响.方法 采取整群随机抽样,选择2016年6—7月湖南省三级医院335名护士长为研究对象,采用中文版护士长专业实践环境量表和职业倦怠量表调查护士长专业实践环境和职业倦怠水平.采用SPSS 18.0软件建立数据库并进行统计分析,采用单因素方差分析、多元线性回归分析进行影响因素分析.结果 发放问卷335份,纳入有效问卷331份.331名护士长专业实践环境总得分为(214.72±22.64)分;职业倦怠量表中,情绪衰竭(EE)维度得分为(26.02±11.03)分,去人格化(DP)维度得分为(9.31±4.30)分,个人成就感(PA)维度得分为(34.66±12.98)分.单因素分析显示,不同年龄护士长EE、DP维度得分差异均有统计学意义(F值分别为6.429、4.652;P<0.01);不同婚姻状况护士长EE维度得分差异有统计学意义(F=3.787,P<0.05);不同护理管理年限护士长EE、DP维度得分差异有统计学意义(F值分别为2.448、2.670;P<0.05);不同科室、最高学历和职称护士长EE维度得分差异有统计学意义(F值分别为3.951、3.047、3.256;P<0.05).多元线性回归分析结果显示,专业实践环境中的文化传承、组织文化建设、和医生之间的关系、和护士之间的关系4个维度为影响职业倦怠得分的关键变量.结论 护士长感知的专业实践环境不理想,职业倦怠倾向较明显,专业实践环境对其职业倦怠具有重要影响.

abstractsObjective To investigate of the status quo of head nurses' professional practice environment and job burnout in classⅢ hospitals, and to discuss the influence of professional practice environment on job burnout. Methods From June to July 2016, a total of 335 head nurses from classⅢ hospitals of Hu'nan province were selected by cluster sampling method. All the participants were investigated by the Chinese version of Professional Practice Environment Scale for Head Nurses and Maslach Burnout Inventory. SPSS 18.0 software was applied to establish a database and to carry out statistical analysis. The influencing factors were analyzed by single factor analysis of variance and linear regression analysis. Results A total of 335 questionnaires were distributed, including 331 valid questionnaires. The total score of 331 head nurses professional practice environment score was (214.72±22.64). In the Maslach Burnout Inventory, the emotional exhaustion (EE) score was (26.02±11.03), depersonalization (DP) score was (9.31±4.30) and personal accomplishment (PA) was (34.66±12.98). Single factor analysis showed that the differences of EE score and DP score in head nurses in different age stages were statistically significant (F=6.429, 4.652; P<0.01). There was statistical significance in the difference of EE score of head nurses in different marital status (F=3.787, P< 0.05). There were statistical significance in the differences of EE score and DP score of head nurses with different nursing management years (F=2.448, 2.670;P<0.05). The differences of EE score in head nurses in different departments,the highest education and the professional titles were statistically significant (F=3.951,3.047,3.256;P< 0.05). The results of linear regression analysis showed that the 4 dimensions of cultural heritage, organization culture construction, relationship with doctors and relationship with nurses were the key variables influencing job burnout scores. Conclusions The status quo of professional practice environment is not optimistic, the tendency of job burnout is obvious, and the professional practice environment has an impact on the job burnout of head nurses.