Study On Professionalautonomy Of Clinical Nurses In A Military General Hospital

Objectives: To investigate the present situation of professional autonomy among clinicalnurses and nursing work environment in a military general hospitals, and explore the impactof demographic data and five environmental factors on clinical professional autonomyamong nurses from the perspective of the individual and organizational perspectives, so asto provide a theoretical basis for hospital supervisor to take specific measures to improvethe practice environment and enhance nurses’professional autonomy.Methods: A descriptive design was used.By census method，631clinical ward nurses froma military general hospital in Urumqi were investigated through a questionnaire,includingthe Chinese version of Nursing Activities Scale(NAS) and Practice EnvironmentScale(PES). Data was entered with the EpiDate3.0and analyzed by SPSS17.0version..Results:1. The mean score of professional autonomy among the military hospital nurses was(173.53±19.27) points;the NAS score of low level group was (110.50±7.55) points,including four people (0.60%); moderate level group score was (159.86±11.58)points, including326(51.70%); high level group was (189.18±11.51) points, including301(47.70%).2. The total score of the military hospital nursing practice environment was (2.94±0.44)points, the scores of each dimension from high to low were respectively that"leadership and ability of nurse manager" was (3.09±0.50) points,"nursingfoundations for quality of care " was (3.08±0.42) points," collegial nurse-physicianrelations" was (3.07±0.60) points,"the nurse participation in hospital affairs " was(2.78±0.54) points,"staffing and resource adequacy" was (2.68±0.66) points.3. Nurses’ professional autonomy was positively correlated to each dimensions of nursingpractice environment in the military hospital (P<0.05), the correlation coefficientsranged from0.267to0.354.4. The differences of the nurses’ professional autonomy in age, work experience, maritalstatus, presence of children, the highest education, job titles, job post, personnelcategory, department difference was statistically significant (P<0.05), but not in gender,ethnicity and the basic education (P>0.05).5. Binary logistic regression analysis showed that children having or not andenvironmental dimensions of "nursing foundations for quality of care" and "leadershipand ability of nurse manager" were into the regression equation.Conclusions: The nurses in the military hospitals were in the secondary and higher levels ofprofessional autonomy, but the young, unmarried, college education,low workexperience,junior titles and emergency department as well as contract ones were relatively low professional nurse autonomy, those who should be focused on by nurse managers; Thenurses work environment of the military hospitals was favorable overall,the "nurseparticipation in hospital affairs" and "staffing and resource adequacy" were the twodimensions to be improved; children having or not、"nursing foundations for quality of care"and "leadership and ability of nurse manager" were the predictors of nurses’ professionalautonomy, managers should implement the appropriate care model, strengthen the trainingof nurses and the support management.