Analysis On The Status And Influencing Factors Of The Nursing Work Environment In Chongqing Community Health Service Institutions

Objective1.To develop the nursing work environment scale for community health service institution and verify its reliability and validity.2.To explore the influencing factors of nursing work environment in community health service institutions in Chongqing.It is good for improving the nursing work environment.Methods1.On the basis of literature review,the status of nursing work environment in community health service institutions was preliminarily understood by semi-structural interview,which provided a basis for the preliminary formulation of the items of the nursing work environment scale for community health service institutions.2.Revision and improvement of the scale items through the Delphi Method.3.By convenient sampling,a presurvey of 30 nurses in a community health service center in Yuzhong District of Chongqing.4.By stratified sampling,500 community nurses from Chongqing five functional areas were recruited into this study,and114 nurses were reinvestigated again 30 days later.After data collection,exploratory factor analysis.5.SPSS20.0 was used for statistical analysis.Mean data,standard deviation and constituent ratio were used to describe the general information of community nurses and score of each item.Using exploratory factor analysis to verify the reliability and validity of nursing work environment scale in community health service institutions.ANOVA was used to compare the difference of nursing work environment in community health service institutions in different administrative regions of Chongqing,and multiple linear regression was used to predict the influencing factors.Results1.Through semi-structured interviews and Colaizzi phenomenology,6themes were extracted.(1)unequal status of doctors and nurses;(2)imperfect nursing quality control system,lack of specific responsibilities and processes;(3)unequal pay and benefits;(4)less learning platform,self enhancement is limited;(5)low professional ability;(6)lack of nursing human resources,low patient satisfaction.2.The nursing work environment scale for community health service institution is formed through the Delphi Method.The scale has 7 dimensions and 42 entries,including doctor-nurse relationship,leadership and management,basic security,professional development,professional autonomy,recognition atmosphere,adequate human resources.The authority coefficients of experts were 0.87,0.90,0.88,0.93,0.84,0.88,0.83.The variation coefficients of experts were 0.14,0.09;The coordination coefficients of experts were 0.301,0.332(P<0.05).The difference is significant and the result is credible.3.The CVI was 0.957,each item's CVI ranged from0.905 to 1.000.Exploratory factor analysis showed that,KMO=0.929 and Bartlett's test of sphericity?~2=19198.468,P<0.01,which showed that data was suitable for factor analysis.Principal component analysis was used to extract the common factor,one factor with eigenvalue equal to or greater than1.000 was extracted.Combined with the scree plot,a total of seven common factors were produced,which could explain71.928%of the total variation.The Cronbach's?coefficient was 0.966,Spearman-Brown split half reliability coefficient was 0.868.Cronbach's?coefficient for doctor-nurse relationship,leadership and management,basic security,professional development,professional autonomy,recognition atmosphere,adequate human resources was:0.845,0.907,0.852,0.934,0.908,0.897and 0.933 respectively.Test-retest reliability was 0.945.The scale has good reliability and validity.4.Nurses were most satisfied with recognition atmosphere(3.95±0.69),while basic security got the lowest score(3.46±0.77).The scores were highest in the items of staff approved my work(4.03±0.72)and good partnership between doctor and nurse(4.03±0.72),the score is lowest in the item of have ability to research on community nursing(3.22±0.89).The regression analysis showed that area,age,education,title,work year,working nature of community nurses influenced nursing work environment(P<0.05).ConclusionThe study is to understand the status of nursing work environment in Chongqing community health service institutions.To develop the nursing work environment scale for community health service institution with good reliability and validity.Through the scale,we analyzed the status and influencing factors of the nursing work environment.The predicting effect of community nurses area,age,education,title,work year,working nature for nursing work environment should be concerned.In order to ensure the safety and quality of community service,it is necessary to build a healthy nursing environment.