To Explore The Influencing Factors Of Professional Quality Of Life In Nursing:a Hierarchical Linear Modeling

Objective To examine the relationship between perceived benefits and professional quality of life in nursing at individual level; To explore the direct and moderating effect of practice environment and transformation leadership on compassion satisfaction, burnout and secondary traumatic stress at ward level.Methods From December2012to May2013, questionnaire investigation was implemented in four comprehensive hospital in Jinan city. The self-report questionnaire included five part:General demographic information, perceived benefits scale, professional quality of life, practice environment scale and transformational leadership questionnaire. Descriptive analysis and Pearson corrective analysis were performed to analyze the perceived benefits, professional quality of life, practice environment and transformational leadership of subjects by SPSS17.0. A hierarchical linear modeling was used to recognize the relationship between工perceived benefits and professional quality of life at individual level, examine the direct and moderating effect of practice environment and transformation leadership on professional quality of life at ward level.Results A total of550investigated by questionnaire, of which446effective questionnaire were returned. Detailed information was as followed: 1. The proportion of nurses with low level of compassion satisfaction was28.9%, the proportion of nurses with intermediate to high level of burnout and secondary traumatic stress were80.3%and81.7%. The score of perceived benefits was50.57; the average item score of transformation leadership and practice environment were3.13and2.30, which were in the medium level.2. Pearson corrective showed there were significantly correction between perceived benefits, transformation leadership, practice environment and professional quality of life (P<0.01), except for burnout and practice environment(r=-0.133, P<0.05); Transformation leadership were significantly corrected with compassion satisfaction and burnout, except for humane care and secondary traumatic stress(r=0.095, P>0.05); Practice environment were positively corrected with compassion satisfaction(P0.01), negatively with burnout(P<0.01), only the total score was significantly corrected with secondary traumatic stress(P<0.01), plenty of manpower and material resources were related with secondary traumatic stress(r=0.125, P<0.05; r=0.123, P<0.05).3. Empty model showed that the ICC of compassion satisfaction, burnout and secondary traumatic stress were28.5%,14.3%and16.1%; perceived benefits was positively with satisfaction compassion and negatively with burnout at individual level(γ10=0.63, P<0.01; γ10=-0.33, P<0.01); At ward level, transformation leadership and practice environment had significant positive direct effect on compassion satisfaction(γ10=:0.66, P<0.01;γ10=0.25, P<0.01), negative direct on burnout(γ10=-0.16, P<0.01;γ10=-0.09, P<0.01), positive direct on secondary traumatic stress(γ10=0.66, P<0.01; γ01=0.16, P<0.05), the more predictive effects of transformation leadership and practice environment on compassion satisfaction than burnout and secondary traumatic stress. But there were no moderating effects found in the full model.Conclusions1. The results implicated that nurses with relative low compassion satisfaction and high compassion fatigue.The nursing managers should pay attention to the severe phenomenon, recognise the dangerous signs of burnout and secondary traumatic stress, take some measures to reduce the risk of compassion fatigue. 2. The level of perceived benefits in nursing was high, transformation leadership and practice environment were average. The scores of human care, staffing and resource adequacy were relatively low. So the nursing administrators should pay take more human care measures to staffs, stimulate their enthusiasm for work, secure more high-skilled nurses and recruit new staffs to alleviate the shortage of competent nurses worldwide.3. Perceived benefits was significant with compassion satisfaction and burnout, So the managers should pay more rewards, opportunities to improve and psychological support, which can reduce the risk of burnout and improve the level of compassion satisfaction, and enhance nursing’s professional quality of life.4. Transformation leadership and practice environment had great influence on the professional quality of life in nursing. So the managers request to constantly improve their own quality, give more human care to staffs, enhance the attraction of professional nursing, thus create a supportive environment, which can elevate the level of compassion satisfaction and debase the risk of burnout. Moreover, the managers should pay more psychological support and education to enhance the mental capacity of nursing, increase the risk of secondary traumatic stress.